Erectile dysfunction (ED) affects about three in ten male childhood cancer survivors, scientists report, adding that ED “may be a modifiable condition” for this population.
Their study, discussed in a recent research letter in JAMA Oncology, involved 1,021 male childhood cancer survivors between the ages of 19 and 62 (median age 31 years). At least ten years had passed between the men’s cancer diagnosis and the start of the study.
For sexually active men, researchers used the 6-item International Index of Erectile Function (IIEF), with scores of 25 or less indicating mild to severe ED. Men who were not sexually active answered questions about their erections.
The men also filled out questionnaires to assess psychological distress, body image concerns, and health-related quality of life.
Testosterone levels were evaluated, along with lean muscle mass, vitality, physical activity, slowness, weakness, and exercise tolerance.
ED information was available for 956 men. Of these, 29% met the criteria for ED.
The authors noted that the prevalence of ED was “considerably higher” compared to other cohorts of male childhood cancer survivors or the general population.
For the 873 sexually active men in the group, the researchers noted the following independent risk factors for ED: Hispanic or other race/ethnicity, age at the time of the study, and low testosterone levels (less than 250 ng/dL). Black race became a risk factor when data for sexually active and non-sexually active men were combined.
The reasons for the link between nonwhite race and ED were not clear and need further investigation, the study authors said.
In both groups, ED was more common in men who were more dissatisfied with their body image and those with low lean muscle mass.
The authors also pointed out that hypogonadism is “often undiagnosed” in male childhood cancer survivors, but “could explain the associations between low testosterone levels, low lean muscle mass, and ED.”
“Clinicians should be aware that appropriate management of hypogonadism may improve impaired sexual function in [childhood cancer survivors],” they wrote.
They added that connection between poor body image and ED could be bidirectional and stressed that ED treatment should include both psychological counseling and medical treatment.
“Childhood cancer survivors may be at increased risk for erectile dysfunction”
(October 4, 2018)
van Iersel, Laura, MD, et al.
“Erectile Dysfunction in Male Survivors of Childhood Cancer”
(Full text. October 4, 2018)
Medscape Medical News
“Erectile Dysfunction Common in Childhood Cancer Survivors”
(October 15, 2018)
“Male Childhood Cancer Survivors May Face Sexual Problems, Infertility as Adults”
(March 20, 2018)