The Impact of Radiation Therapy on Sexual Health in Breast, Cervix, and Prostate Cancer Patients: A Systematic Review

To examine the effects of radiation therapy on sexual health in cervical, breast, and prostate cancer patients. Four electronic databases (PubMed/PubMed Central, Google Scholar, Embase(Ovid), and SCOPUS) were searched, and articles published in English from January 1, 2011, through 2022 were extracted. Five reviewers independently selected primary studies that reported patient sexual health symptoms caused by cervical, breast, or prostate cancer following radiation therapy treatment. The primary outcome measures sexual health trends during or after radiation therapy through external beam radiotherapy or brachytherapy where applicable. Secondary outcomes measured predictive factors contributing to sexual health scores (age, race, and geographical location). 32 studies with a total of 5033 individuals were included in the systematic review. Overall, 19 studies reported a reduction in sexual health trends, 8 reported mixed trends, and 4 reported no significant trends in sexual health. Of the 10 breast cancer studies, 6 reported decreased sexual well-being, 2 found no trends, and 2 stated mixed trends. Among 12 prostate cancer studies, 5 reported worsening sexual health, 2 found no trends, 1 reported positive sexual functioning, and 4 found mixed trends. Among 10 cervical cancer studies, 8 reported worse sexual health, while 2 reported mixed trends. Younger breast and cervical cancer patients who received radiation therapy experienced greater body image and sexual health concerns. Evidence was insufficient to evaluate trends in geographical location or race between sexual health and radiation therapy. In this study, prostate, breast, and cervical cancer patients who received radiation therapy treatment experienced more troublesome sexual health symptoms compared to non-irradiated cancer patients. Interventions to improve sexual health should be prioritized.