Can Childhood Cancer Treatments Impact Psychosexual Development Milestones?

It is well known that chemotherapy—–the ultimate double-edged sword––wreaks havoc on the bodies of patients with cancer. In children, treatments can have detrimental effects on brain development and can cause long-lasting neurocognitive impairments that may impact sexual and romantic interactions in adulthood.

In an analysis published in Cancer, investigators sought to analyze the effects of cancer treatments on romantic and sexual relationships in adult survivors of childhood cancer.

“Psychosexual development entails reaching certain milestones, such as sexual debut, entering committed relationships, or having children,” said investigator Vicky Lehmann, PhD. “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 understudies among survivors of childhood cancer.”

The investigators asked 144 young adult survivors of childhood cancer, as well as 144 matched controls, to complete questionnaires regarding psychosexual development, sexual satisfaction, and satisfaction with current relationship status.

Additionally, the investigators used information obtained from medical charts to rate the neurotoxicity of the received treatments.

Besides having fewer lifetime sex partners, the results of the analysis showed that cancer survivors did not differ from the controls.

However, subgroups of survivors—–those with brain tumors who received high-dose neurotoxic treatments––had the lowest reported rates of achieving psychosexual development milestones.

The investigators noted that although survivors who received high-dose neurotoxic treatments were less likely to meet certain milestones of psychosexual development, it did not necessarily indicate that they were less satisfied than others.

“This highlights the subjective nature of psychosexual issues, and the importance of addressing any concerns in survivorship care,” Dr Lehmann said.

The authors suggest the use of a comprehensive and novel rating system for the neurotoxicity of childhood cancer treatments to detect patients who are at a higher risk for impaired sexual outcomes.

“This rating might be used as a checklist in clinical practice,” Dr Lehmann concluded.