癌症病人腫瘤部位對生活品質以及性健康的影響

Abstract

背景介紹 癌症病人在經過診斷以及疾病的治療過程中，會對於身體、心理以及社會層面造成影響，這些因素會進而影響到癌症病人的生活品質以及性健康。在過去文獻回顧中，有許多研究描述了在癌症病人當中性功能障礙問題，研究對象也主要針對腫瘤部位直接影響到性生活的病人。在本次研究中，我們比較腫瘤部位直接影響到性生活的癌症病人，與同樣是癌症病人，但腫瘤部位未直接影響到性生活的病人來比較兩者之間生活品質以及性健康的不同。

材料與方法 本研究對象來自2017年11月8日至2018年5月28日台大醫院的年齡大於20歲，組織切片診斷確診為癌症的病人，其中所有癌症的種類以及階段都會被納入，但若同時有兩種以上的癌症則會被排除。並使用EORTC SHQ-C22來量測性健康、EORTC QLQ-C30來量測生活品質。患者的醫療記錄由研究人員使用國立台灣大學醫院電子系統獲取醫療記錄，基本人口統計信息由訪調員根據病例報告表（CRF）收集。 結果 在79位癌症病人中，有13位無性伴侶，2位發病至今無性生活，最後共納入了64人。其中有27位為腫瘤部位直接影響到性生活的病人，37位為腫瘤部位未直接影響到性生活的病人。在性健康結果方面，腫瘤部位直接影響到性生活的癌症病人有較差的關係(51.2±14.3, p=0.019)以及整體性生活(21.7±22.9)。在生活品質方面兩組無差異。在年齡調整過後，影響性健康的副作用在腫瘤部位直接影響到性生活的病人有較顯著的影響(70.3±23.1, p=0.0247)。 結論 對於腫瘤部位直接影響性健康的癌症患者，與伴侶在性生活方面的溝通、擔憂和滿意度較差。在性生活的活躍度、滿意度也較低，也有較多的治療上的產生的副作用影響到性健康。對於腫瘤部位不直接影響性健康的患者，其診斷和治療引起的性健康問題值得關注。

Introduction The diagnosis and treatment of cancer usually affect patients’ physical, psychological and social status, and thus affect the patients’ sexual health. Most of previous studies described on patients’ sexual dysfunction, and the study population mainly focused on a single type of cancer, especially in the cancer type which tumor site was directly affecting sexual health. In this study, we would investigate that is there any difference in sexual health issue and quality of life between cancer patients whose tumor sites directly affected sexual life and also were cancer patients but the tumor did not direct affect sexual life. Materials and Methods Patients of histological confirmed diagnosis of cancer age higher than 20 we investigated in this study all came from National Taiwan University Hospital, from November 8, 2017 to May 28, 2018. All of cancer types and stages were included, patients with more than two types of cancer were excluded. EORTC SHQ-C22 and EORTC QLQ-C30 were used to measure sexual health and quality of life. Patients' medical records were obtained by the researchers using the National Taiwan University Hospital electronic system to retrieve the medical records. Patients’ basic demographic information was collected by interviewers according to the case report form (CRF). Results Among the 79 cancer patients, 13 were without sexual partners, and 2 had no sexual life since the onset of the disease. Finally, 64 people were included. 27 of them were patients whose tumor sites directly affected sexual health, 37 of them were patients whose tumor sites did not directly affect sexual health. Relationship (51.2±14.3, p=0.019) and global sexual health (21.7±22.9) were lower in patients whose tumor sites directly affected sexual health. There was no difference in the quality of life between the two groups. After the age adjustment, the side effects influencing sexual health had a significant impact on patients whose tumor sites directly affected sexual health (70.3±23.1, p=0.0247). Conclusion Cancer patients whose tumor sites directly affected sexual health had worsen communication, worry and satisfaction with their sexual partner, and had less activation and satisfaction of their sexual life. There are also more therapeutic side effects that affect sexual health. For patients whose tumor sites did not directly affect sexual health, the diagnosis and treatment of sexual health problems deserve attention in the future.