2369 - Sexual Toxicity after Chemoradiation for Anal Cancer among Men who have Sex with Men

Purpose/Objective(s): Chemoradiation (CRT) for squamous cell carcinoma of the anus (SCCA) often impacts sexual health and wellness. However, the incidence, nature, and impact of sexual dysfunction after pelvic radiation among men who have sex with men (MSM) is not well understood. This study analyzed patient-reported sexual health outcomes among MSM patients and evaluated the utility of existing measures in this population.

Materials/Methods: Participants were recruited via fliers and virtual platforms. MSM who completed CRT for SCCA =6 months prior self-selected and provided consent. EORTC QLQ-ANL27, Sexual Activities Inventory, PROMIS Sexual Function and Satisfaction Questionnaire, International Index of Erectile Function (IIEF-5) and Anodyspareunia Questionnaire were completed prior to completing a semi-structured interview. Descriptive statistics were used to quantify demographic information and survey results. Bowker’s test was used to evaluate sexual activities pre- and post-CRT. Emergent themes were analyzed using inductive coding based on interview summaries.

Results: 20 participants completed the questionnaire, and 15 completed an interview. Most were married/partnered (60.0%), White (95.0%), Non-Hispanic (80.0%) and from the United States (90.0%). The average time since completing CRT was 3.2 years. Most (60.0%) had moderate to severe erectile dysfunction (median IIEF-5=12; IQR 5.5-20.5). Since receiving a cancer diagnosis, 8 (40%) patients had attempted or engaged in receptive anal penetration. Most participants reported pain with receptive anal penetration, and 63% reported mod-severe distress and interpersonal/relationship difficulty as a result. In general, patients reported participating in fewer sexual activities within 30 days of the survey compared to 1 year prior to CRT (Table 1). Emergent themes from interviews included the need for patient education about sexual health, altered sexual practices and relationships, and positive reactions to the survey measures.

Conclusion: Sexual dysfunction is a prevalent issue among MSM following CRT for SCCA. Many experience significant changes in sexual function, distress, and interpersonal relationships. Future research should seek to improve patient education and refine interventions to improve sexual function and quality of life in MSM after CRT.