Biopsychosocial Effects of Cancer Treatment on Sexual Health Among Cancer Survivors at Kenyatta National Hospital

Abstract

The incidence of cancer is on the increase. The number of cancer survivors is also on the increase due to early diagnosis, advancement in treatment, and an increase in an aging population. Cancer treatment has significant negative effects on cancer survivors’ sexual health. These effects have a long-term effect on the sexual health and sexuality of the survivors. Sexual health and sexuality are complex and sensitive topics that both healthcare providers and patients do not want to talk about. Sexual health remains a neglected topic despite the number of cancer survivors increasing in the last decade. There is a need to address this topic to bridge the gap and also address the unmet needs on sexual health among cancer survivors. The purpose of this study was to assess the biopsychosocial effects of cancer treatment on sexual health among cancer survivors at KNH. It was a mixed study. It involved quantitative and qualitative data collection methods. Data was collected over a period of 4 weeks at KNH-CTC among cancer survivors. A modified EORTC SHQ-22 questionnaire was used to collect quantitative data from 216 participants who were systematically sampled. Two Focus Group Discussions were held where the participants were sampled randomly. The study population was patients attending cancer treatment clinics after completion of cancer treatment. Data was collected over a period of one month, Monday to Friday, using self-administered questionnaires and Focused Group Discussions. Consent was obtained from the participants before they participated in the study. Pretesting was done at the haemato-oncology clinic at KNH. The quantitative data collected was analyzed using SPSS version 28. Chi square and one-way anova analysis were also used to analyze the data. Results from the focused group discussions was used to support the quantitative data. Approval and clearance to carry out the study were sought from the KNH-UoN review and ethics board, NACOSTI, and the Kenyatta National Hospital Department of Medical Research. Most of the participants in the study were females (69.4%) and the most reported conditions were breast cancer (30.6%) and cervical cancer (23.1%). 203 (94%) of the participants reported to have received chemotherapy as part of their treatment. 62% of the participants reported that their sexual health had been affected after cancer treatment. tiredness was the most reported biological effect by 89.2% of the participants while in psychological effects low self-esteem was the most reported by 75.5% of the participants. Males reported more biological effects (mean total of 3.58) as compared to females (mean total of 3.43). in psychological effects, an inverse observation was made, in females the mean was 4.97 compared to males mean of 4.59. a chi square test showed men (36.4%) were more anxious of sexual activity compared to women at (33.1%) after cancer treatment. further analysis showed both biological and psychological effects of cancer treatment on sexual health increased as age increased. Cancer survivors at Kenyatta National Hospital experience biological, psychological, and sociological distress after cancer treatment that affects their sexual health and quality of life. There is need for psychosexual education to address changes in sexuality, effects of cancer treatment, sex therapy, and couple therapy as a part of post-cancer care and follow-up