Exploring sexual health and function among Malaysian patients with advanced cancer: insights from the EORTC QLQ SH-22 questionnaire

Sexual health is an essential yet often overlooked component of quality of life in oncological care. This study aimed to explore the sexual health experiences of Malaysian patients with advanced cancer, utilizing a culturally adapted and validated tool to guide gender-sensitive, contextually relevant supportive care interventions. Patients diagnosed with advanced solid-organ cancers were recruited from a quaternary healthcare facility in Malaysia. The study employed the validated EORTC QLQ SH-22 (EORTC Quality of Life Questionnaire Sexual Health 22), the 6-item Female Sexual Function Index (FSFI-6), alongside single-item queries regarding self-esteem and life and relationship satisfaction. Correlational analyses were conducted to investigate the relationships among gender, performance status, and sexual functioning. Of the 120 participants, the average age was 49.1 years (SD = 11.4); 63.3% were female, and 82.5% had good performance status. 51.6% reported recent sexual activity. Improved sexual functioning was linked to sexual satisfaction, perceived importance of sex, and reduced symptoms such as vaginal dryness ( r = −0.43, p < 0.01) in women and erectile confidence in men ( r = 0.51, p < 0.01). Male gender was associated with perceived importance of sex ( p = 0.005, d = 0.54) and less sexual pain ( p < 0.001, d = 0.87). Lower performance status correlated with increased fatigue-related sexual dysfunction ( p = 0.010) and concerns about incontinence ( p = 0.013). Sexual health interventions for advanced cancer patients should consider gender-specific and cultural factors. Future research should focus on longitudinal trends and intervention strategies tailored to diverse cultural contexts.