Sexual quality of life in hormonotherapy for breast cancer patients

ABSTRACT

Objectives: To evaluate how hormonal therapy can impact breast cancer patients sexual quality of life and compare two widely used therapeutic agents: anastrozole and tamoxifen. Studies so far have evaluated the side effects of such therapy on patients general quality of life, but literature remains scarce regarding the impact it has on sexual aspects. We believe there is a demand for a detailed view of these aspects since most patients undergo these treatments for at least five years.

Material and Methods: Transverse observational study evaluated in 2019, 41 women with a history of breast cancer, all of them undergoing hormonal therapy. Group presented a mean age of 55.4 years (35 to 77 years); those in menopause with a mean time of menopause of 10.92 years (2 to 28 years). Thirty-eight women lived maritally and/or were sexually active. The mean duration of treatment was 36.84 months. We analyzed data in pre-and postmenopausal women, evaluating the results of questionnaires with general parameters (age, treatment time, general quality of life, adaptation to therapy) as well as specific instruments for evaluation of sexual dysfunction (FSDS-R) and quality of life with specific aspects for breast cancer (FACT-B). The results were placed in 2×2 contingency tables comparing the group receiving tamoxifen versus anastrozole.

Results and Conclusion: Tamoxifen compared to anastrozole is a drug with apparent less impact on most common sexual dysfunctions (orgasm, dyspareunia, and feeling good quality of sex life), following those already published in international literature. We found no impact on physical, socio-familiar, and emotional well-being. Finally, we conclude that the results of this study significantly contribute to the choice of adequate therapeutic agent and highlight the need to bring this topic during routine consults and to the decision with the patient for the best suited treatment option.

RESUMO

Objetivos: Avaliar como a terapia hormonal pode impactar na qualidade de vida sexual de pacientes com câncer de mama e comparar dois agentes terapêuticos amplamente utilizados: anastrozol e tamoxifeno. Os estudos até o momento avaliaram os efeitos colaterais dessa terapia na qualidade de vida geral dos pacientes, mas a literatura ainda é escassa quanto ao impacto que ela tem nos aspectos sexuais. Acreditamos que haja uma demanda por uma visão detalhada desses aspectos, pois a maioria dos pacientes faz esses tratamentos há pelo menos cinco anos.

Material e Métodos: Estudo observacional transversal avaliou em 2019, 41 mulheres com histórico de câncer de mama, todas em terapia hormonal. Grupo apresentou média de idade de 55,4 anos (35 a 77 anos); aquelas na menopausa com tempo médio de menopausa de 10,92 anos (2 a 28 anos). Trinta e oito mulheres viviam conjugalmente e/ou eram sexualmente ativas. A duração média do tratamento foi de 36,84 meses. Analisamos dados em mulheres na pré e pós-menopausa, avaliando os resultados de questionários com parâmetros gerais (idade, tempo de tratamento, qualidade de vida geral, adaptação à terapia) e instrumentos específicos para avaliação de disfunção sexual (FSDS-R) e qualidade de vida com aspectos específicos para o câncer de mama (FACT-B). Os resultados foram colocados em tabelas de contingência 2×2 comparando o grupo que recebeu tamoxifeno versus anastrozol.

Resultados e Conclusão: O tamoxifeno comparado ao anastrozol é um fármaco com aparente menor impacto nas disfunções sexuais mais comuns (orgasmo, dispareunia e sensação de boa qualidade de vida sexual), seguindo os já publicados na literatura internacional. Não encontramos impacto no bem-estar físico, sociofamiliar e emocional. Por fim, concluímos que os resultados deste estudo contribuem significativamente para a escolha do agente terapêutico adequado e evidenciam a necessidade de trazer este tema durante as consultas de rotina e para a decisão com o paciente sobre a opção de tratamento mais adequada.

Keywords:

Breast neoplasms - Antineoplastic agents, Hormonal - Sexual dysfunction, Physiological - Quality of life - Tamoxifen - Anastrozole

Descritores:

Neoplasias mamárias - Agentes antineoplásicos hormonais - Disfunção sexual fisiológica - Qualidade de vida - Tamoxifeno - Anastrozol

Publikationsverlauf

Eingereicht: 21. April 2022

Angenommen: 23. September 2022

Artikel online veröffentlicht:
13. Dezember 2022

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