Sexual health at the end of life in patients with advanced cancer and their partners. Results of a Dutch prospective longitudinal study (eQuiPe)

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Background Sexual health can be negatively affected by cancer. There is a paucity of literature exploring changes in sexual health during the end of life. Aim To assess changes in sexual health in patients with advanced cancer and their partners at the end of life, and to identify the associated factors. Design A prospective longitudinal study of patients with advanced cancer and their partners on the quality of care and quality of life (QoL) (eQuiPe). Patients and partners completed 3-monthly questionnaires. Sexual health (desire, activity, satisfaction and enjoyment) was measured using the EORTC QLQ-SH22. Setting/participants Patients aged ≥18 years and diagnosed with advanced cancer were recruited in one of the forty participating Dutch hospitals. Relatives were recruited through patients, and for this study only couples (patient-partner) were included (n=352). Results Towards death, patients remained relatively stable in sexual activity (range 15-19), satisfaction (range 40-45), and enjoyment (range 30-44). Similar results were found for partners. In patients, sexual desire significantly decreased towards the end of life (β 0.4, 95%CI 0.1-0.7). Moreover, greater decline in physical functioning was associated with poorer outcomes in most aspects of sexual health. Sexual desire, activity and satisfaction were individually associated with QoL in patients. Conclusions Sexual health remains relatively stable at the end of life in patients with advanced cancer and their partner. Patients with worse physical functioning report worse sexual health and sexual desire, activity and satisfaction are individually associated with better QoL. Therefore, addressing sexual health in palliative care is essential.

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