• 11/13/2001
  • Reuters Health

Survivors of head and neck cancer generally report more morbidity, including more sexual dysfunction, than survivors of prostate cancer, but age and marital status appear to influence morbidity in both patient groups, according a study reported at the American Society for Therapeutic Radiation and Oncology annual meeting in San Francisco.

Dr. Charles Scott, lead author and statistician for the American College of Radiology, told Reuters Health the findings suggest “cancer survivors are often ill-prepared for the types of impairments that may accompany aggressive treatment.”

For example, Dr. Scott said that head and neck cancer survivors 65 years of age or older are more likely to have speech impairments, but that “younger survivors are more likely to complain about speech impairment. This is probably because younger survivors are more likely to be employed, which makes communication more important.”

Dr. Scott identified head and neck and prostate cancer survivors from the Radiation Therapy Oncology Group database. There were 460 survivors, 276 of whom agreed to participate in a survey that included questions on quality of life, mood, sexual function, alcohol and tobacco use, and mental status.

Twenty-one percent of the patients had head and neck cancers and 79% were prostate cancer patients. The average age of prostate cancer survivors was 75 years, while the average age for the head and neck cancer survivors was 65 years. Twelve percent of the head and neck cancer patients were African American, as were 16% of the prostate cancer patients.

Older head and neck cancer patients reported fewer chronic effects of disease and treatment, and said they had “greater spiritual well-being” than did younger survivors, Dr. Scott said. But regardless of age, head and neck cancer survivors reported “more illness and anger and more sexual dysfunction.” Among prostate cancer survivors, sexual dysfunction was much more common among married survivors, he said.

The findings suggest the need to “be more open when discussing the long-term effects of aggressive treatment,” Dr. Scott concluded. For example, radiation oncologists tend to “tell prostate cancer patients that there is less sexual dysfunction associated with radiation therapy. That’s true, but what if the patient is in that 20% that does experience sexual dysfunction? I don’t think this possibility is well-addressed.”

He also believes the findings suggest clinicians do not adequately assess the needs of older patients in terms of social interactions and sexual relationships. “These very aggressive treatments can have long-term effects and those need to be addressed before treatment begins,” he said.