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Quality of life, self-esteem, fatigue, and sexual function in young men after cancer
A controlled cross-sectional study
Article first published online: 22 FEB 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 6, pages 1592–1601, 15 March 2010
How to Cite
Greenfield, D. M., Walters, S. J., Coleman, R. E., Hancock, B. W., Snowden, J. A., Shalet, S. M., DeRogatis, L. R. and Ross, R. J. M. (2010), Quality of life, self-esteem, fatigue, and sexual function in young men after cancer. Cancer, 116: 1592–1601. doi: 10.1002/cncr.24898
- Issue published online: 3 MAR 2010
- Article first published online: 22 FEB 2010
- Manuscript Accepted: 20 JUL 2009
- Manuscript Revised: 3 JUL 2009
- Manuscript Received: 22 MAY 2009
- Weston Park Hospital Cancer Charity
- Laura Crane Trust
- quality of life;
- sexual function;
- cancer survivors;
- androgen deficiency
Androgen deficiency is increasingly recognized in young male cancer survivors; however, its impact on quality of life (QOL) is not established. The authors investigated the relationship between androgen levels, QOL, self-esteem, fatigue, and sexual function in young male cancer survivors compared with control subjects.
A cross-sectional, observational study of 176 male cancer survivors and 213 male controls aged 25 to 45 years was performed. Subjects completed 3 QOL scales (Medical Outcomes Study 36-Item Short-Form Health Survey version 2, the 12-item General Health Questionnaire [GHQ-12], and Aging Male Scale), and measures of self-esteem (Rosenberg Self-Esteem Scale), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), and sexual function (Derogatis Interview for Sexual Functioning-II Self-Report-Male).
Cancer survivors had lower scores for all components of the Short-Form Health Survey, Aging Male Scale, and Functional Assessment of Chronic Illness Therapy-Fatigue, and for 4 of 5 subsections of the Derogatis Interview for Sexual Functioning than controls. The majority of these differences remained after adjusting by linear regression analysis. Levels of psychiatric disorder or self-esteem did not differ between the 2 groups. In cancer survivors, those with androgen deficiency (serum testosterone ≤10 nmol/L) had lower scores than those without for all components of the Short-Form Health Survey, the General Health Questionnaire, Functional Assessment of Chronic Illness Therapy-Fatigue, and the Derogatis Interview for Sexual Functioning. Serum testosterone only weakly correlated with health measures.
Young male cancer survivors self-report a marked impairment in QOL, energy levels, and quality of sexual functioning, and this was exacerbated in those with androgen deficiency. However, psychological distress was not elevated, self-esteem was normal, and sexual relationships were not impaired. The relationship with testosterone is complex, and appears dependent on a threshold level rather than direct correlation. Interventional trials are needed to determine whether testosterone replacement would improve QOL in young male cancer survivors. Cancer 2010. © 2010 American Cancer Society.