Neurotoxic treatment for cancer during childhood may influence sexual activity and relationships in adulthood, according to new research.
Study co-author Vicky Lehmann, Ph.D., of Nationwide Children's Hospital and Ohio State University - both in Columbus, OH - and colleagues found that adults who received high-intensity neurotoxic treatment for cancer as a child were less likely to meet certain sexual and romantic milestones.
However, the team found that childhood cancer treatment did not affect overall satisfaction for sexual and romantic relationships in adulthood.
Lehmann and team recently reported their findings in the journal Cancer.
According to the American Cancer Society, it is estimated that around 10,380 children aged 15 and under were diagnosed with cancer in the United States last year.
Leukemia is the most common form of childhood cancer, accounting for around 30 percent of all cases, followed by brain and spinal cord tumors, which make up around 26 percent of all childhood cancer cases.
Childhood cancer treatment and psychosexual development
While cancer was responsible for more than 1,200 childhood deaths last year, over 80 percent of children diagnosed with the disease will survive for at least 5 years. This is due to significant advances in cancer treatment, which include surgery, chemotherapy, and radiation therapy.
However, such treatment is certainly not without risk. For example, studies have shown that cranial radiation - often used to treat brain tumors - may cause harm to the developing brain, leading to long-term neurocognitive impairment.
Previous research has shown that neurocognitive impairment as a result of childhood cancer treatment may impact social interaction in adulthood, but studies investigating the effects of such treatment on psychosexual development are few and far between.
"Psychosexual development entails reaching certain milestones, such as sexual debut, entering committed relationships, or having children.
It is a normative part of becoming an adolescent or young adult, but only comparing such milestones without taking satisfaction into account falls short. These issues are understudied among survivors of childhood cancer."
Vicky Lehmann, Ph.D.
To address this gap in research, the team enrolled 144 survivors of childhood cancer aged between 20 and 40. A further 144 participants who were not treated for childhood cancer (the controls) were matched by age and sex.
All participants completed questionnaires on psychosexual development, sexual satisfaction, and relationship satisfaction.
To determine the brain toxicity of cancer treatments in childhood, the researchers used data from the participants' medical charts.
Neurotoxic cancer treatment might predict later-life psychosexual issues
Overall, the team found that adults who were treated for cancer in childhood did not differ significantly from the controls in terms of psychosexual development, sexual satisfaction, and relationship satisfaction.
However, on analyzing subgroups of childhood cancer survivors, the researchers found that those who previously received treatments high in neurotoxicity were less likely to have had sexual intercourse, be in a relationship, or have had children, compared with controls.
The type of cancer treatment in childhood did not appear to affect sexual satisfaction, the team reports. "This highlights the subjective nature of psychosexual issues, and the importance of addressing any concerns in survivorship care," notes Lehmann.
The researchers say that their findings indicate that the neurotoxicity of cancer treatment in childhood may predict the likelihood of psychosexual problems in adulthood. They add:
"Additional research is needed to delineate how neurocognitive impairment undermines social outcomes for survivors, as well as other related factors.
Given the findings of the current study, healthcare providers should assess romantic/sexual problems among survivors, especially those who received high-dose neurotoxic treatments. Referrals to psychosocial care could prevent or reduce potential difficulties."