Home Gender & Sexuality Testicular Cancer Survivors Face Challenges in Sexuality and Fertility, Affecting Relationships and Well-Being

Testicular Cancer Survivors Face Challenges in Sexuality and Fertility, Affecting Relationships and Well-Being

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A new study from the University Medical Center Utrecht has unveiled significant insights into the sexual health concerns of adolescents and young adults (AYAs) treated for testicular germ cell tumour (TGCT). Researchers explored the numerous difficulties these patients face with regard to sexuality after treatment in the PRICELESS study. Through individual interviews with 13 TGCT survivors, the study identifies seven major themes that encapsulate the sexual and emotional struggles encountered by these young men.

The most prominent concern identified among participants was the desire to have children, a theme that emerged immediately after diagnosis and treatment. Patients were often suddenly confronted with the need to consider their future fertility when asked to preserve semen before starting cancer treatment. This early and unexpected discussion about fertility forced many young men to think about having children sooner than they might have naturally.

For many, uncertainty about reproduction persisted even after treatment. Semen preservation provided some reassurance, but concerns about fertility remained, particularly the fear of losing the remaining testicle or being unable to conceive naturally. This uncertainty also impacted patients’ willingness to form new relationships, with some expressing a need for clarity about their fertility status before committing to a partner.

Following the acute phase of treatment, patients entered a period of rediscovering their sexuality. This phase involved coping with physical changes and grappling with insecurities about sexual performance. The study found that many young men experienced a loss of masculinity and confidence, which hindered their sexual expression and intimate relationships.

Insecurity about sexual performance was a common theme among participants. The physical and emotional toll of TGCT treatment often left patients feeling inadequate in their sexual lives. The pressure to fulfil their partners’ sexual needs, which many felt they could no longer do satisfactorily, exacerbated this insecurity. The burden of these expectations often strains relationships, leading to further emotional distress.

Acceptance of the physical changes resulting from TGCT treatment was another significant theme. Patients struggled with body image issues and the perception of losing their masculine identity. These changes required a period of adjustment, during which young men had to come to terms with their new bodies and the implications for their sexual health.

The study highlighted the considerable burden that sexual health concerns place on relationships. Patients reported that fertility issues and sexual dysfunctions created tensions with their partners. This strain was particularly evident when the partners’ needs were not met or when communication about sexual health was insufficient. The involvement of partners in discussions about sexual health was seen as crucial in managing these challenges and fostering mutual understanding and support.

Despite the significant impact of TGCT on sexuality, the study found that discussions about sexual health were often neglected in clinical settings. Patients expressed a need for healthcare providers to initiate conversations about sexuality and provide relevant information and support. The lack of open dialogue contributed to feelings of isolation and inadequacy among patients.

The PRICELESS-study underscores the importance of addressing sexual health as an integral part of the follow-up care for TGCT patients. Healthcare providers are encouraged to proactively engage in discussions about sexuality, offer resources for managing sexual dysfunction, and involve partners in the care process. Early identification of sexual health issues and tailored support can significantly enhance the quality of life for TGCT survivors.

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