Sexual health at the end of life in patients with advanced cancer and their partners. Results of a Dutch prospective longitudinal study (eQuiPe)

Background: Sexual health can be negatively affected by cancer, yet little is known about changes at the end of life. Aim: To assess changes in sexual health in patients with advanced cancer and their partners at the end of life, and identify associated factors. Design: Prospective longitudinal study of patients with advanced cancer and their partners on quality of life and care (eQuiPe). Patients and partners completed three-monthly questionnaires until patient’s death. Sexual health was measured in all questionnaires using the EORTC QLQ-SH22, covering four subdomains (desire, activity, satisfaction and enjoyment; scores 0–100). Setting/participants: Patients, aged ⩾ 18 years, diagnosed with stage IV cancer were recruited from 40 Dutch hospitals. Relatives were recruited through patients. For this study only couples (patient-partner) were included (n = 352). Results: Median number of completed questionnaires per couple was one (range 1–7). Toward death, patients remained relatively stable in sexual activity (range 15–19), satisfaction (range 39–45), and enjoyment (range 30–45). Similar results were found for partners. In patients, sexual desire significantly decreased toward death (β 0.4, 95% CI 0.1–0.7). Greater decline in physical functioning and being diagnosed with prostate cancer was associated with poorer outcomes in most sexual health domains. Sexual desire, activity, and satisfaction were individually associated with quality of life in patients. Conclusions: Sexual health remains relatively stable at the end of life in patients with advanced cancer and their partner. Patients with worse physical functioning and/or prostate cancer report worse sexual health. Sexual desire, activity, and satisfaction are individually associated with better quality of life.