Originally published as JCO Early Release 10.1200/JCO.2009.23.2280 on October 26 2009

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Do Male Lymphoma Survivors Have Impaired Sexual Function?

From the Departments of Clinical Cancer Research, Oncology, and Laboratory Medicine, Norwegian Radium Hospital, Oslo University Hospital; Faculty Division of Norwegian Radium Hospital and Faculty Division of Rikshospitalet, University of Oslo, Oslo; Faculty of Medicine, The National University for Science and Technology, Trondheim, Norway; and Departments of Behavioral Science and Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX.

Corresponding author: Cecilie E. Kiserud, MD, Department of Clinical Cancer Research, The Norwegian Radium Hospital, 0310 Oslo, Norway; e-mail: cecilie.essholt.kiserud{at}radiumhospitalet.no.

Purpose Sexual function in male lymphoma survivors was examined and compared with that of age-matched controls.

Patients and Methods This cross-sectional study included serum gonadal hormone levels (testosterone, sex hormone–binding globulin, luteinizing hormone [LH], and follicle-stimulating hormone) and responses to questionnaires assessing sexual function (Brief Sexual Function Inventory [BSFI]), socioeconomic factors, quality of life, emotional distress, and fatigue. The lymphoma group included 246 men 50 years old at diagnosis who were diagnosed from 1980 to 2002 and treated at the Norwegian Radium Hospital. For each lymphoma survivor, two age-matched controls (n = 492) were drawn from a normative sample with BSFI scores.

Results The lymphoma survivors had a mean age at survey of 47.4 years, the mean duration of follow-up was 14.8 years, and 79% lived in committed relationships. All BSFI domain scores decreased significantly with age. Lymphoma survivors having low testosterone and/or elevated LH had lower BSFI scores than survivors with normal gonadal hormones. Multivariate analyses showed that increasing age, more emotional distress, poor physical health, and low testosterone and/or elevated LH were significantly associated with reduced sexual function within the lymphoma group. Lymphoma survivors had significantly lower BSFI domain scores than did controls on erection, ejaculation, and sexual satisfaction.

Conclusion Lymphoma survivors had significantly poorer sexual function than normative controls. It is unclear whether the abnormal hormone levels directly cause the reduced sexual function within the lymphoma group or if a mediating factor is involved, such as aging, emotional distress, or perceived health status.

Supported by EXTRA funds from the Norwegian Foundation for Health and Rehabilitation, The Norwegian Cancer Society, The Norwegian Research Council (Leiv Erikssons Mobility Program), and Fulbright Norway.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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