Introduction
Penile cancer, though rare, significantly affects survivors' quality of life (QoL), especially in low-resource settings like India, where psychosocial and sexual health concerns are under-addressed. This study explores clinico-psychosocial factors influencing QoL among penile cancer survivors (PCS) in South India.
Methods
A cross-sectional study was conducted among 74 PCS at the Cancer Institute (WIA), Chennai. Participants had at least six months of disease-free survival post-curative surgery. Validated tools were used: EORTC QLQ-C30 (QoL), SHQ-22 (psycho-sexual functioning), NCCN Distress Thermometer, ICIQ-SF (voiding dysfunction), IIEF-5 (erectile function), FCR-7 (fear of recurrence), LYMQOL-Leg (lymphedema QoL), and DASS-21 (psychological distress). Spearman’s correlation and non-parametric tests were applied.
Results
Distress was strongly correlated with lower QoL (r = -.717**), emotional function (r = -.745**), and higher fatigue, pain, and financial burden. Fear of cancer recurrence (FCR) was associated with greater distress (r = .437**) and lower QoL (r = -.583**). Depression, anxiety, and stress significantly impacted sexual functioning, including sexual satisfaction, performance anxiety, and pain. Voiding dysfunction correlated with sexual fatigue (r = .394**), and lymphedema-related QoL showed strong associations with overall QoL (r = .887**). Erectile function varied by treatment modality (r = .455**) and was linked to sexual pain. Socio-demographic factors such as lower income and education influenced anxiety, sexual pain, and perceptions about sex.
Conclusion
Distress, FCR, and sexual and lymphedema-related challenges significantly affect QoL in PCS. These findings highlight the need for integrated care addressing physical, sexual, and psychosocial domains.
Clinical Implications
Early screening and culturally sensitive interventions for distress, FCR, and sexual dysfunction are essential. Addressing lymphedema proactively and tailoring psychosocial support to socio-demographic contexts can meaningfully improve survivors' QoL.