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Eeltink CM, Rood JAJ, Nauta IH, Lissenberg-Witte BI, Incrocci L, Visser O, Verdonck-de Leeuw IM, Zweegman S. Reply to: "Discussing sexuality in cancer care: towards personalized information for cancer patients and survivors". Support Care Cancer 2020; 29:535-537. [PMID: 32671563 DOI: 10.1007/s00520-020-05625-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 07/09/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Corien M Eeltink
- Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands.
| | - Janneke A J Rood
- Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands
| | - Irene H Nauta
- Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands
| | | | - Luca Incrocci
- Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands
| | - Otto Visser
- Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands
| | | | - Sonja Zweegman
- Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands
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Self-Reported Sexual Function in Sexually Active Male Hodgkin Lymphoma Survivors. Sex Med 2020; 8:428-435. [PMID: 32507555 PMCID: PMC7471085 DOI: 10.1016/j.esxm.2020.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Unambiguous data on sexual dysfunction after Hodgkin lymphoma (HL) treatment are scarce. Aims To form a baseline in this area, we compared patient-reported sexual function in sexually active male HL survivors in complete remission with a sexually active, age-matched, male Dutch sample population. Furthermore, we explored whether sociodemographic and clinical factors were associated with sexual dysfunction in HL survivors and investigated whether reporting to perceive sexual problems was indicative for sexual dysfunction. Methods This cross-sectional study included male patients with HL who were treated with chemotherapy and age-matched sexually active males. Main outcome measures Outcome measures included the internationally validated International Index of Erectile Function (IIEF) and self-reported sexual problems by adding 3 items to the study-specific questionnaire. Results Erectile dysfunction (ED) occurred in 23.3% of the HL survivors vs in 23.0% of controls: respectively 13.3% and 12.3% had moderate to severe ED. However, more HL survivors positively answered the question whether they did perceive sexual problems than controls (20.0% vs 7.0%; P = .087). More patients treated with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procabazine, and prednisone (BEACOPP) had sexual problems 33.3% vs 8.3% who were treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (P = .057). Importantly, we found that the mean IIEF score for erectile function was 15.7 in HL survivors who reported to perceive sexual problems (moderate ED) vs 28.3 (normal) in those without perceiving sexual problems. Conclusion In general, sexual function of male HL survivors is comparable to that of matched normal controls. Perceiving sexual problems was associated with lower sexual function measured by the IIEF. None of the HL survivors who were treated with doxorubicin, bleomycin, vinblastine, and dacarbazine perceived sexual problems. However, one-third of HL survivors who were treated with BEACOPP did, including ED in one-third of the cases. This is an important consideration for daily clinical practice as BEACOPP is increasingly used as standard therapy in advanced-stage HL. Eeltink CM, Lissenberg-Witte BI, Incrocci L, et al. Self-Reported Sexual Function in Sexually Active Male Hodgkin Lymphoma Survivors. Sex Med 2020;8:428–435.
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Can the provision of sexual healthcare for oncology patients be improved? A literature review of educational interventions for healthcare professionals. J Cancer Surviv 2020; 14:858-866. [PMID: 32488631 PMCID: PMC7572328 DOI: 10.1007/s11764-020-00898-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/18/2020] [Indexed: 01/21/2023]
Abstract
Purpose Sexual health is an important quality-of-life concern for cancer patients and survivors, but a difficult discussion topic for patients and healthcare professionals. The most important barriers causing healthcare professionals to avoid the topic are lack of education and lack of knowledge. How effective education about sexual health is for oncology healthcare professionals is not clear. The aim of this review is to examine the effectiveness of interventions in improving the provision of sexual healthcare for cancer patients. Methods A systematic literature review was conducted according to PRISMA guidelines using the following data sources: PubMed, PsychInfo, Embase and Emcare. Quantitative research was included which contained pre-intervention and post-intervention outcomes. The assessment of the studies was conducted independently by two reviewers. A third reviewer was involved if there was no consensus. Results Seven studies were included. In total, 572 oncology healthcare professionals participated, including physicians, nurses and allied healthcare professionals. Interventions consisted of 6 face-to-face sessions and one online program. Primary objectives of the studies were the assessment of improvement in knowledge about sexual health, improvement of practice, frequency of discussing sexual health and comfort level and the decline of perceived barriers to discussing sexual health. Studies showed that interventions resulted in improved realization of the objectives. Conclusions Although improvement in the knowledge of healthcare professionals was achieved, it was not possible to give an overall recommendation for the development of interventions due to the limited number of studies and heterogeneity of the data. Implications for Cancer Survivors Sexual health is an important area of survivorship that is often neglected. Many oncology healthcare professionals lack training and knowledge to provide such care. More evidence-based practices are needed to improve sexual healthcare for cancer survivors. Electronic supplementary material The online version of this article (10.1007/s11764-020-00898-4) contains supplementary material, which is available to authorized users.
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Reese JB, Zimmaro LA, Lepore SJ, Sorice KA, Handorf E, Daly MB, Schover LR, Kashy D, Westbrook K, Porter LS. Evaluating a couple-based intervention addressing sexual concerns for breast cancer survivors: study protocol for a randomized controlled trial. Trials 2020; 21:173. [PMID: 32051002 PMCID: PMC7014745 DOI: 10.1186/s13063-019-3975-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/09/2019] [Indexed: 12/11/2022] Open
Abstract
Background Sexual concerns are distressing for breast cancer survivors and interfere with their intimate relationships. This study evaluates the efficacy of a four-session couple-based intervention delivered via telephone, called Intimacy Enhancement (IE). The IE intervention is grounded in social cognitive theory and integrates evidence-based techniques from cognitive behavioral couple therapy and sex therapy to address survivors’ sexual concerns and enhance their and their partners’ sexual, relationship, and psychological outcomes. Methods This trial is designed to evaluate the efficacy of the IE intervention in improving survivors’ sexual function, the primary study outcome. Secondary outcomes include survivors’ sexual distress, partners’ sexual function, and survivors’ and partners’ relationship intimacy and quality as well as psychological distress (depressive symptoms and anxiety symptoms). Additional aims are to examine whether treatment effects on patient sexual function are mediated by sexual communication and self-efficacy for coping with sexual concerns and to explore whether survivor age and race/ethnicity moderate intervention effects on survivors’ sexual function. Eligible adult female breast cancer survivors reporting sexual concerns and their intimate partners are recruited from two academic sites in the USA and are randomized to either the IE intervention or to a control condition of equal length offering education and support around breast cancer-related health topics (Living Healthy Together). The target sample size is 120 couples. Self-report outcome measures are administered to participants in both conditions at baseline (T1), post-treatment (T2), 3 months post-treatment (T3), and 6 months post-treatment (T4). Discussion Evidence-based interventions are needed to address sexual concerns for breast cancer survivors and to enhance their and their intimate partners’ sexual, relationship, and psychological well-being. This randomized controlled trial will allow us to examine the efficacy of a novel couple-based intervention delivered via telephone for breast cancer survivors experiencing sexual concerns and their intimate partners, in comparison with an attention control. Findings of this study could influence clinical care for women with breast cancer and inform theory guiding cancer-related sexual rehabilitation. Trial registration ClinicalTrials.gov, NCT03930797. Registered on 24 April 2019.
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Affiliation(s)
- Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.
| | - Lauren A Zimmaro
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
| | - Stephen J Lepore
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.,Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, Philadelphia, PA, 19122, USA
| | - Kristen A Sorice
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
| | - Elizabeth Handorf
- Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
| | - Leslie R Schover
- Will2Love LLC, 1333 Old Spanish Trail, Suite G, #134, Houston, TX, 77054, USA
| | - Deborah Kashy
- Department of Psychology, Michigan State University, 316 Physics Road, Room 262, East Lansing, MI, 48824, USA
| | - Kelly Westbrook
- Department of Medicine-Oncology, Duke University Medical Center, DUMC 3459, Durham, NC, 27710, USA
| | - Laura S Porter
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, DUMC 90399, Durham, NC, 27708, USA
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Shankar A, Patil J, Luther A, Mandrelle K, Chakraborty A, Dubey A, Saini D, Bharat RP, Abrol D, Bharti SJ, Bentrad V. Sexual Dysfunction in Carcinoma Cervix: Assessment in Post Treated Cases by LENTSOMA Scale. Asian Pac J Cancer Prev 2020; 21:349-354. [PMID: 32102510 PMCID: PMC7332127 DOI: 10.31557/apjcp.2020.21.2.349] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Indexed: 11/25/2022] Open
Abstract
Treatment for cervical cancer consists of hysterectomy, radiotherapy, chemotherapy and targeted therapy in different combination based on stage at presentation. However, late consequences of such radical treatments are known but not many Indian studies have reported it. Quality of life and impact on sexual health has become an important issue in view of long survival of cervical cancer patients. LENTSOMA scale is one such scale validated for scoring radiotherapy related morbidity. However, there is need for a comprehensive scale covering all aspects of physical and psychological disruptions to provide complete recovery and rehabilitation. The study was prospective and patients who were treated for cervical cancer on follow up were included in this study. A total of 85 patients, who were treated with surgery, radiotherapy, chemotherapy alone or in combination, comprising of stage I to stage IV disease, participated in this study. Findings of this study showed that pain during intercourse and altered sexual life were reported by 32.9% and 25.9% patients respectively whereas 24.7% found it problematic and in 22.3% patients, alteration in interest in sex were reported. Vaginal stenosis was seen in 75.29% of patients after treatment with decreased frequency of intercourse after treatment was seen in 16.4 % of patients. Combination of surgery and radiotherapy in cervical cancer patients caused more sexual dysfunction and dissatisfaction, especially in lower age group. Treatment morbidity in term of sexual function was more with advanced stage disease and with the patients on longer follow up. Sexual function is an important aspect of quality of life but there is no single self-report measure in routine clinical follow up use which is brief, easy to complete and incorporates all (physical, psychological, emotional) aspects of sexual health for people affected by cancer.
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Affiliation(s)
- Abhishek Shankar
- Preventive Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Jaineet Patil
- Radiation Oncology, Christian Medical College, Ludhiana, India
| | - Anil Luther
- General Surgery, Christian Medical College, Ludhiana, India
| | - Kavita Mandrelle
- Obstetrics & Gynecology, Christian Medical College, Ludhiana, India
| | | | - Anusha Dubey
- Indian Society of Clinical Oncology, Delhi, India
| | - Deepak Saini
- Indian Society of Clinical Oncology, Delhi, India
| | - Ram Pukar Bharat
- Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Deepak Abrol
- Radiation Oncology, Government Medical College, Kathua, JK, India
| | - Sachidanand Jee Bharti
- Oncoanaesthesia and Palliative Medicine, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Veronika Bentrad
- Department of Tumour Biochemistry & Oncopharmacology, RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, NASU, Kiev, Ukraine
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Discussing sexuality in cancer care: towards personalized information for cancer patients and survivors. Support Care Cancer 2020; 28:4227-4233. [PMID: 31900615 DOI: 10.1007/s00520-019-05257-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/20/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The needs of cancer patients and survivors regarding discussing sexuality are frequently unmet, with many not receiving adequate information. To optimize information about sexuality and cancer, patients' perspective is needed. The goals of this study were to investigate what kind of information Dutch cancer patients need, their ideas on how to improve communication, and to identify patients who are more in need of information regarding sexuality. METHODS The Dutch Federation of Cancer Patient Organizations developed and conducted a nationwide 28-item online survey. The survey was distributed among cancer patients and survivors. RESULTS In total, 2657 (ex) cancer patients participated, with a median age of 61 years, and half were male (45.2%). Of the respondents, 65% were in need of information about sexuality. Patients ≤ 61 years (p < 0.001), patients with a self-reported negative effect of cancer on sexuality (p < 0.001) and patients who were diagnosed less than 2 years ago (p < 0.04) reported a higher need for information. Regardless of type of cancer, patients were most in need of practical tips and practical information regarding sexuality. To enhance communication about sexuality, 64% of the respondents suggested that it would be of help if care providers give information as standard care. CONCLUSIONS (Ex) cancer patient prefer to receive standard information about sexuality by their care providers. According to patients' preferences, information must include practical tips. Age, self-reported negative effect on sexuality status and time from diagnoses influenced the need for information.
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Christiansen RS, Azawi N, Højgaard A, Lund L. Informing patients about the negative effect of nephrectomy on sexual function. Turk J Urol 2020; 46:18-25. [PMID: 31905121 DOI: 10.5152/tud.2019.19169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 11/24/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The quality-of-life concept has increasingly gained attention, but an important aspect has been neglected, which is the sexual function of patients with kidney cancer after surgery. The aim of this study was to explore the impact of nephrectomy on sexual function in patients with kidney cancer and the information patients received with this regard. MATERIAL AND METHODS We conducted a retrospective study of patients who underwent nephrectomy or nephro-ureterectomy within a 5-year period at the Department of Urology, Odense University Hospital, Denmark. Among 310 patients having undergone surgery, 226 were still alive and eligible for participation. Their records were reviewed, and a validated questionnaire concerning their sex life was mailed to them. All participants were invited to take part in a semi-structured interview in person or by phone. RESULTS Of 154 former patients who replied, 95 were men (mean age, 66 years, range 37-89), 59 were women (mean age 63 years, range 26-87). A significant difference was observed regarding problems with sexual relationships prior to operation compared after (P<0.0001). Seven patients (5%) had been informed about potential effects and changes in their sex life following operation. Both male and female participants were worried about their sex life (61.4%). Among sexually active male responders, 54.7% reported having some degree of erectile dysfunction. CONCLUSION Patients experience significantly more problems in their sexual relationships after surgery. Very few were informed about this, showing the need to offer sex counselling before surgery. More research is required to fully comprehend the magnitude of the problem.
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Affiliation(s)
| | - Nessn Azawi
- Department of Urology, Odense University Hospital, Odense, Denmark.,Department of Urology, Zealand University Hospital, Roskilde, Denmark
| | - Astrid Højgaard
- Sexological Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Lars Lund
- Department of Urology, Odense University Hospital, Odense, Denmark.,Department of Clinical Institute, University of Southern Denmark, Odense, Denmark
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Cruz M, Brandão J, Casalta J, Sousa C, Pereira K, Alves P. [Sexual dysfunction among oncological patients: The importance of a specialized approach]. Rev Int Androl 2019; 19:1-8. [PMID: 31630968 DOI: 10.1016/j.androl.2019.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/08/2019] [Accepted: 05/27/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Determination of the emotional and sexual impact after oncologic disease and patient's satisfaction regarding information provided by healthcare professionals. We also aim to evaluate the importance of sexology care during cancer treatment and follow-up. METHODS This is a cross-sectional study including patients admitted for radiation therapy. A questionnaire and an assessment of clinical data were assessed. RESULTS The study sample was composed by 104 patients. 60.6% had a negative impact on their sexual life after treatment and 62.5% were satisfied about the information given by healthcare professionals. About two thirds of the patients would accept sexology care during cancer treatment and/or follow-up. After a sub-group analysis, there were no statistically significant differences between groups regarding the prevalence of sexual dysfunction or needs for sexual care. DISCUSSION There is a well-known impact of cancer on sexuality since its diagnosis. Our patients feel themselves well informed about this by health professionals. Most of them would accept being referred to an oncosexology appointment. CONCLUSIONS Sexuality must be discussed with cancer patients since their diagnosis. Oncosexuality care is necessary and desired by most patients as a mean for reduction of the cancer impact in their life quality.
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Affiliation(s)
- Mafalda Cruz
- Serviço de Radioterapia do Instituto Português de Oncologia de Coimbra Francisco Gentil, EPE, Portugal.
| | - Joana Brandão
- Serviço de Radioterapia do Instituto Português de Oncologia de Coimbra Francisco Gentil, EPE, Portugal
| | - João Casalta
- Serviço de Radioterapia do Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Cláudia Sousa
- Serviço de Radioterapia do Instituto Português de Oncologia de Coimbra Francisco Gentil, EPE, Portugal
| | - Kayla Pereira
- Serviço de Radioterapia do Instituto Português de Oncologia de Coimbra Francisco Gentil, EPE, Portugal
| | - Paula Alves
- Serviço de Radioterapia do Instituto Português de Oncologia de Coimbra Francisco Gentil, EPE, Portugal
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The association of sexual dysfunction with race in women with gynecologic malignancies. Gynecol Oncol Rep 2019; 30:100495. [PMID: 31656849 PMCID: PMC6806462 DOI: 10.1016/j.gore.2019.100495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 11/23/2022] Open
Abstract
Gynecologic cancer survivors report sexual health among their highest concerns. The aim of this study was to identify the prevalence of sexual dysfunction (SD) in survivors of gynecologic malignancies and to evaluate the association of sexual function with race, ethnicity and treatment modality. In this study, survivors of endometrial, cervical, vaginal, and vulvar cancer who presented to the gynecologic oncology practice were asked to self-administer the Female Sexual Function Index (FSFI) survey to evaluate their sexual function. The prevalence of SD was estimated and its association with demographic and clinical co-variates was analyzed. Of the 155 participants, the prevalence of SD was 44.5% (95%CI: 36.7–52.7). Patients were significantly more likely to report SD if they did not currently have a partner (69% vs 22% p < .01). Abstinence within six months of their cancer diagnosis was also associated with SD (72% vs 26% p < .01). Patients who self-identified as black race compared to white race were three times more likely to have SD (OR = 3.9, 95% CI 1.1–14.3). Patients who received adjuvant chemotherapy and radiation therapy compared to those who did not among the entire cohort had an increased risk of SD (OR = 3.4, 95% CI 1.2–9.6). In our diverse population, almost half of our patients were identified to have SD. Black as compared to white race reported significantly higher sexual dysfunction. An increased risk for sexual dysfunction was observed among those women who received chemotherapy and radiation with or without surgery. Precis Survivorship is an important issue for women with gynecologic malignancies. This study addresses the high rates of sexual dysfunction in a racially diverse patient population. Sexual dysfunction was noted in 44.5% of women with gynecologic malignancies. Participants of black race were 3 more times more likely to have sexual dysfunction. We suggest early discussion addressing sexual function at time of cancer diagnosis.
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Athanasiou S, Pitsouni E, Douskos A, Salvatore S, Loutradis D, Grigoriadis T. Intravaginal energy-based devices and sexual health of female cancer survivors: a systematic review and meta-analysis. Lasers Med Sci 2019; 35:1-11. [PMID: 31396795 DOI: 10.1007/s10103-019-02855-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/26/2019] [Indexed: 02/07/2023]
Abstract
A systematic review and meta-analysis was undertaken to assess the efficacy and safety of intravaginal energy-based therapies (laser and radiofrequency) on sexual health of cancer survivors (CS) (breast cancer (BCS) and/or gynecological cancer (GCS)). PubMed, Scopus, Web of Science, and Cochrane Library were searched until 21/02/2019. Quality of reporting, methodology, and body of evidence were assessed using STROBE, MINORS, and GRADE. Primary outcomes were dyspareunia, dryness, and sexual health (FSFI, FSDS-R). Secondary outcomes were burning, itching, dysuria, incontinence, Vaginal Health Index Score (VHIS), microbiome-cytokine evaluation, and adverse events. Main analyses, subgroup analyses, and sensitivity analyses were performed. Eight observational studies (n = 274) were eligible for inclusion. None of the studies evaluated radiofrequency. BCS and BCS-GCS were included in 87% and 13% of studies, respectively. All primary outcomes improved significantly with the exception of FSDS-R (dyspareunia (5 studies (n = 233), standardized mean difference (StdMD) (- 1.17), 95%CI [- 1.59, - 0.75]; p < 0.001; I2 = 55%), vaginal dryness (4 studies (n = 183), StdMD (- 1.98), 95%CI [- 3.31, - 0.65]; p = 0.003; I2 = 91%), FSFI (2 studies, n = 28, MD (12.79), 95%CI [7.69, 17.89]; p < 0.001; I2 = 0%). Itching, dysuria, and VHIS increased significantly, while burning was not improved. Serious adverse events were not observed by any of the studies. Intravaginal laser therapies appear to have a positive effect on dyspareunia, vaginal dryness, and FSFI of CS. However, the quality of evidence is "very low," with no data on intravaginal radiofrequency therapy. Further research with high-quality RCTs and long-term follow-up is needed to evaluate the value of energy-based devices as a therapeutic option for CS with sexual problems.
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Affiliation(s)
- Stavros Athanasiou
- Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens, Vasilisis Sofias Ave. 80, 115 28, Athens, Greece.
| | - Eleni Pitsouni
- Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens, Vasilisis Sofias Ave. 80, 115 28, Athens, Greece
| | - Athanasios Douskos
- Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens, Vasilisis Sofias Ave. 80, 115 28, Athens, Greece
| | - Stefano Salvatore
- Obstetrics and Gynecology Unit, Urogynecology Unit, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Dimitrios Loutradis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Themos Grigoriadis
- Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, Medical School, National and Kapodistrian University of Athens, Vasilisis Sofias Ave. 80, 115 28, Athens, Greece
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Arthur EK, Wills CE, Browning K, Overcash J, Menon U. The Self-Efficacy to Communicate about Sex and Intimacy (SECSI) scale: psychometric assessment in women treated for cancer. Support Care Cancer 2019; 28:1449-1457. [PMID: 31273504 DOI: 10.1007/s00520-019-04963-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 06/20/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this study was to conduct a preliminary validation of the psychometric performance of the newly developed Self-Efficacy to Communicate about Sex and Intimacy (SECSI) scale in a sample of women treated for cancer. METHODS Partnered women (n = 250) who had received treatment for cancer completed an online survey that included the SECSI scale and measures of health-related quality of life, depression, anxiety, sexual function, sexual distress, self-efficacy for sexual functioning, sexual behaviors, relationship satisfaction, and satisfaction with sexual communication. Sociodemographic and clinical cancer characteristics data were collected. RESULTS High internal consistency and strong test-retest reliability of the SECSI scale were shown with a Cronbach's alpha coefficient of 0.94 and test-retest reliability of r = 0.82, respectively. Construct validity of the SECSI scale, including discriminant, convergent, and divergent validity, was supported except regarding hypothesized relationships between SECSI scores and participant age and time since treatment. CONCLUSIONS The SECSI scale is a valid, reliable measure for use with partnered women treated for cancer. Clinicians working with cancer survivors who may be at risk for difficulties communicating about sex and intimacy needs after cancer treatment may use this scale to identify women who would benefit from interventions to increase their confidence to communicate with their partner. The SECSI scale fills an important gap in ability to assess self-efficacy to communicate about sex and intimacy.
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Affiliation(s)
- Elizabeth K Arthur
- College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, 43210, USA.
| | - Celia E Wills
- College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, 43210, USA
| | - Kristine Browning
- College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, 43210, USA
| | - Janine Overcash
- College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, 43210, USA
| | - Usha Menon
- College of Nursing, University of South Florida, 12901 Bruce B. Downs, MDN 22, Tampa, FL, 33612-4742, USA
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Quality of Life and Sexual Functioning After Vulvar Reconstruction With the Lotus Petal Flap. Int J Gynecol Cancer 2019; 28:1728-1736. [PMID: 30157166 DOI: 10.1097/igc.0000000000001340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Resection of (pre) malignant lesions in the vulvoperineal area may result in large defects that cannot be closed primarily. The lotus petal flap technique is widely used for reconstruction. The aim of this study was to evaluate both quality of life (QoL) and sexual functioning of patients who underwent the lotus petal flap procedure, because no data are available on this topic. METHODS A cross-sectional study was performed on all eligible patients (N = 38) who underwent the lotus petal flap procedure between 2005 and 2016. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, Female Sexual Function Index, and Body Image Scale were used to evaluate QoL and sexual functioning. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Female Sexual Function Index scores were compared with scores of age-matched healthy women. RESULTS Twenty-six patients (68%) responded. The mean (SD) age was 65.5 (16.3) years, and the median follow-up time was 38.5 months (range 16-141 months). Quality of life scores were lower compared with healthy women in the domains physical, role, and social functioning. Sexual activity rates were comparable with healthy women; however, sexual functioning was worse. Although patients were satisfied about their sexual life, pain was reported. CONCLUSIONS Patients who underwent vulvar reconstructive surgery with lotus petal flaps seem to have a lower QoL compared with healthy women. Patients report more pain during sexual activity but are satisfied about their sexual functioning. These results should be included in preoperative counseling and follow-up of future patients eligible for vulvar reconstruction with a lotus petal flap.
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63
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Changes in Sexual Function of Patients with Cancer in Turkey. SEXUALITY AND DISABILITY 2019. [DOI: 10.1007/s11195-019-09579-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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64
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Arthur EK, Wills CE, Menon U. A Systematic Review of Interventions for Sexual Well-Being in Women With Gynecologic, Anal, or Rectal Cancer. Oncol Nurs Forum 2019; 45:469-482. [PMID: 29947348 DOI: 10.1188/18.onf.469-482] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Treatments for cancer in the lower pelvis often cause lasting effects on women's sexual well-being. The purpose of this review is to describe interventions to improve sexual well-being in gynecologic, anal, or rectal cancer survivors. LITERATURE SEARCH This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 checklist and guidelines. A literature search was conducted using PubMed, CINAHL®, PsycINFO, and Cochrane Library. DATA EVALUATION Articles were original intervention research studies of women treated for gynecologic, anal, or rectal cancer and included sexual well-being outcomes. Study characteristics were extracted and compared in a table for analysis and synthesis. SYNTHESIS Of the 16 included studies, 1 focused on genitourinary rehabilitation, 12 focused on psychoeducational interventions, and 3 focused on combination interventions. Most interventions reported at least one positive sexual well-being outcome. Intervention format, delivery, dose, and outcome variables varied widely. IMPLICATIONS FOR RESEARCH Preliminary efficacy and feasibility of interventions are promising, but larger studies designed to discern optimal content, delivery format, dose, and timing are needed.
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Quality of Life in Vietnamese Gastric Cancer Patients. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7167065. [PMID: 31236411 PMCID: PMC6545786 DOI: 10.1155/2019/7167065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 04/03/2019] [Accepted: 04/30/2019] [Indexed: 12/19/2022]
Abstract
Background Gastric cancer (GC) is one of the leading causes of cancer-related death in Vietnam. Research on health-related quality of life of Vietnamese gastric cancer patients is still in its infancy. Aim To assess the health-related quality of life (HRQOL) of GC patients using the 15D instrument. Materials and Method 182 Vietnamese gastric cancer patients were selected to be interviewed and their HRQOL was assessed using the generic 15D questionnaire. Tables regarding history, disease characteristics, and HRQOL of participants were formulated according to genders using STATA 12.0. Results The average age of the participants was 60.8 ± 11.6. The average time from diagnosis to the date of interview was 14.8 ± 8.4 months. The health-related quality of life (HRQOL) index score of gastric cancer patients using the 15D instrument was 0.92 ± 0.08, in which the "sexual activity" dimension had the lowest score of 0.66. Also, our study found several factors affecting HRQOL, including age, occupation, education, disease stage, treatment, and time from the date of diagnosis. Conclusion The 15D instrument was a suitable tool to assess Vietnamese gastric cancer patients' quality of life. Findings from the study suggest the importance of frequently measuring personal functioning and performance of GC patients as parts of QOL assessment during clinical examination. It also implies the needs for more focused policies on raising the overall quality of life of patients such as encouragement of periodical HQROL assessment and acknowledging HRQOL as a treatment/intervention goal besides the 5-year survival rate.
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Bond CB, Jensen PT, Groenvold M, Johnsen AT. Prevalence and possible predictors of sexual dysfunction and self-reported needs related to the sexual life of advanced cancer patients. Acta Oncol 2019; 58:769-775. [PMID: 30724646 DOI: 10.1080/0284186x.2019.1566774] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Sexual dysfunction and problems are common late effects after treatment of cancer. However, little is known about the prevalence and risk factors for sexual dysfunction in patients with advanced cancer. The aim of this study was to investigate the prevalence and predictors of sexual problems and needs in a large sample of Danish patients with advanced cancer. Methodology: The data derived from a representative cross-sectional study of patients with advanced cancer. Patients who had been in contact with 1 of 54 hospital departments were invited to fill out a questionnaire on symptoms and problems. Five items asked about sexuality. Ordinal logistic regression was used to identify variables associated with sexual functioning in explorative analyses. Results: A total of 1,447 patients completed the questionnaire and of those, 961 patients (66%) completed the sexuality items. More than half of the patients (60%) had not been sexually active within the previous month, despite a high prevalence of desire for sexual intimacy (62%). More than half of the patients (57%) experienced that their physical condition or treatment had impaired their sex life. Of those, 52% experienced an unmet need for help with sexual problems from the health care system. Older patients were less likely to report sexual problems than younger patients. Having prostate or gynecologic cancer was associated with the feeling that one's sexual life was negatively influenced. Conclusion: Sexual problems are common among patients with advanced cancer and should be addressed by the health care system.
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Affiliation(s)
| | - Pernille Tine Jensen
- Department of Gynecology, Odense University Hospital and The Clinical Institute, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Mogens Groenvold
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anna Thit Johnsen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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Lampic C, Ljungman L, Micaux Obol C, Eriksson LE, Wettergren L. A web-based psycho-educational intervention (Fex-Can) targeting sexual dysfunction and fertility-related distress in young adults with cancer: study protocol of a randomized controlled trial. BMC Cancer 2019; 19:344. [PMID: 30975116 PMCID: PMC6458789 DOI: 10.1186/s12885-019-5518-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 03/25/2019] [Indexed: 12/12/2022] Open
Abstract
Background This study protocol describes the clinical trial of the Fex-Can intervention, a web-based self-help program targeting sexual dysfunction and fertility-related distress. The psycho-educational intervention has been developed in collaboration with young patients with cancer and shown to be feasible. The primary objective is to determine whether the Fex-Can intervention, provided in addition to standard care, is superior to standard care in terms of reduction of sexual dysfunction and fertility-related distress directly after end of the 12-week program. The trial also aims to determine whether the intervention has an effect on the secondary outcomes including health-related quality of life, anxiety, depression, body image, fertility knowledge, and self-efficacy related to sexuality and fertility. Methods The trial has an randomized clinical trial (RCT) design with two parallel arms. The active groups receive either the version of the Fex-Can intervention targeting sexual problems or the version targeting fertility-related distress. Control groups receive standard care. Primary outcomes will be sexual function assessed with the Patient-Reported Outcomes Measurement Information System® Sexual Function and Satisfaction measure version 2.0 (SexFS) and fertility-related distress assessed with the Reproductive Concerns After Cancer scale (RCAC). The effect of the intervention will be evaluated directly after end of the program. Primary and secondary outcomes will also be assessed at the short- (12 weeks after end of program) and long-term (20 and 44 months after end of program) follow-up. At least 64 completers will be needed in each arm (total n = 256) to achieve adequate statistical power in the analyses. In order to increase the understanding of how the intervention brings about a possible change, semi-structured interviews will additionally be conducted with a purposeful sample shortly after completion of the intervention. Discussion If the Fex-Can intervention proves to be efficacious the necessary steps will be taken to implement it in routine care for young adults diagnosed with cancer. Healthcare could thereby be provided with an easily accessible, cost-effective intervention to offer to young adults suffering from fertility-related distress or sexual problems. Trial registration ISRCTN36621459. Registered 25 January 2016.
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Affiliation(s)
- C Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
| | - L Ljungman
- Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
| | - C Micaux Obol
- Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
| | - L E Eriksson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,School of Health Sciences, City, University of London, London, EC1V 0HB, UK.,Department of Infectious Diseases, Karolinska University Hospital, SE-141 86, Huddinge, Sweden
| | - L Wettergren
- Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden.
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Reese JB, Lepore SJ, Daly MB, Handorf E, Sorice KA, Porter LS, Tulsky JA, Beach MC. A brief intervention to enhance breast cancer clinicians' communication about sexual health: Feasibility, acceptability, and preliminary outcomes. Psychooncology 2019; 28:872-879. [PMID: 30811732 DOI: 10.1002/pon.5036] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/01/2019] [Accepted: 02/21/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Sexual concerns are often unaddressed for breast cancer patients; one reason is inadequate clinician training. We examined the feasibility, acceptability, and potential benefits of a novel intervention, improving Sexual Health and Augmenting Relationships through Education (iSHARE) for breast cancer clinicians. METHODS Clinicians received training in communicating about sexual concerns with breast cancer patients. Intervention feasibility and acceptability were measured through enrollment/participation and postintervention program evaluations, respectively. Intervention effects were assessed through (1) clinician self-reported beliefs about sexual health communication, assessed at baseline, post-intervention, and 1- or 6-month follow-up, (2) clinical communication coded from audio recorded, transcribed clinic encounters at preintervention or postintervention, and (3) patient satisfaction with clinical care, reported immediately after the clinic visit. Patients also reported sociodemographic characteristics and level of sexual concerns. RESULTS Seven breast cancer clinicians enrolled (88% participation), completed the intervention, and were audio recorded in clinic encounters with 134 breast cancer outpatients (67 each at preintervention or postintervention). Program evaluations supported intervention acceptability. Effect sizes suggest iSHARE increased clinicians' self-efficacy (d = 0.27) and outcome expectancies for communicating about sexual concerns (d = 0.69) and reduced communication barriers (d = -0.14). Clinicians' sexual health communication behaviors increased from baseline to postintervention, including for raising the topic (28% vs 48%), asking questions (33% vs 45%), and offering information (18% vs 24%). Neither patient satisfaction nor duration of sexual health communication changed (mean duration less than 1 minute at both time points). CONCLUSIONS The iSHARE intervention was feasible and well received by clinicians and may change breast cancer clinicians' beliefs and communication behaviors regarding sexual health.
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Affiliation(s)
- Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania.,Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Stephen J Lepore
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania.,Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Elizabeth Handorf
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Kristen A Sorice
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Laura S Porter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mary Catherine Beach
- Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
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Reese JB, Sorice K, Lepore SJ, Daly MB, Tulsky JA, Beach MC. Patient-clinician communication about sexual health in breast cancer: A mixed-methods analysis of clinic dialogue. PATIENT EDUCATION AND COUNSELING 2019; 102:436-442. [PMID: 30314828 PMCID: PMC6421101 DOI: 10.1016/j.pec.2018.10.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/07/2018] [Accepted: 10/02/2018] [Indexed: 05/08/2023]
Abstract
OBJECTIVES Breast cancer patients' sexual health needs are frequently unmet. We examined the prevalence and content of communication about sexual health between breast cancer patients and clinicians. METHODS Female breast cancer patients being seen in oncology clinic follow-up had a clinic visit audio recorded and self-reported sexual problems after the visit. Transcripts were coded for sexual health communication; data were analyzed descriptively or using Chi-square tests. RESULTS We recorded 67 patients (81% participation rate) interacting with one of 7 cancer clinicians (5 physicians; 2 advanced practice clinicians). Approximately 1/3 of women (n = 22) reported sexual problems; sexual health communication occurred with 10/22 of those women (45%). Across all 67 patients, 27 (40%) visits contained communication about sexual health. Seventy-percent of sexual health communication was clinician-initiated. When in-depth sexual health discussions occurred, the most common topics discussed were sexual inactivity (6), body image (5), vaginal dryness (4), and safety of sexual activity (2). CONCLUSION Communication about sexual health was uncommon even for women reporting sexual problems and was largely initiated by clinicians. PRACTICE IMPLICATIONS Because women with breast cancer often do not raise sexual concerns during clinic visits, breast cancer clinicians should raise the topic of sexual health for all patients.
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Affiliation(s)
| | - Kristen Sorice
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, USA
| | - Stephen J Lepore
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, USA
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, USA
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA
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Nappi RE, Martini E, Cucinella L, Martella S, Tiranini L, Inzoli A, Brambilla E, Bosoni D, Cassani C, Gardella B. Addressing Vulvovaginal Atrophy (VVA)/Genitourinary Syndrome of Menopause (GSM) for Healthy Aging in Women. Front Endocrinol (Lausanne) 2019; 10:561. [PMID: 31496993 PMCID: PMC6712495 DOI: 10.3389/fendo.2019.00561] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/31/2019] [Indexed: 12/23/2022] Open
Abstract
Vaginal health is an essential component of active and healthy aging in women at midlife and beyond. As a consequence of hormonal deprivation and senescence, the anatomy and function of urogenital tissues are significantly affected and vulvovaginal atrophy (VVA) may occur. In a high proportion of postmenopausal women, progressive and chronic VVA symptoms have a strong impact on sexual function and quality of life. The new definition of genitourinary syndrome of menopause (GSM) comprises genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections). Many variables (age, sexual activity and partnership status) influence the clinical impact VVA/GSM symptoms and attitudes of elderly women to consult for receiving effective treatments. Psychosocial factors play a critical role in sexual functioning, but the integrity of the urogenital system is as well important affecting many domains of postmenopausal women's health, including sexual function. Several international surveys have extensively documented the need to improve VVA/GSM management because of the strong impact on women's daily life and on couple's intimacy. Health care providers (HCPs) need to be proactive in the early recognition of VVA/GSM in order to preserve urogenital and sexual longevity, by using hormonal and non-hormonal strategies. The clinical diagnosis is based on genital examination to identify objective signs and on the use of subjective scales to rate most bothersome symptoms (MBS), especially vaginal dryness. Recent studies point to the importance of addressing VVA/GSM as a potential early marker of poor general health in analogy with vasomotor symptoms. Therefore, a standard of VVA/GSM care in elderly women is desirable to enhance physical, emotional and mental well-being.
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Affiliation(s)
- Rossella E. Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- *Correspondence: Rossella E. Nappi
| | - Ellis Martini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
| | - Laura Cucinella
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Silvia Martella
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Lara Tiranini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Alessandra Inzoli
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Emanuela Brambilla
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - David Bosoni
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Chiara Cassani
- Obstetrics and Gynecology Unit, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Obstetrics and Gynecology Unit, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
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71
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Reese JB, Smith KC, Handorf E, Sorice K, Bober SL, Bantug ET, Schwartz S, Porter LS. A randomized pilot trial of a couple-based intervention addressing sexual concerns for breast cancer survivors. J Psychosoc Oncol 2018; 37:242-263. [PMID: 30580675 DOI: 10.1080/07347332.2018.1510869] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose was to test the feasibility, acceptability, and preliminary efficacy of a 4-session couple-based Intimacy Enhancement (IE) intervention addressing breast cancer survivors' sexual concerns delivered via telephone. Twenty-nine post-treatment breast cancer survivors reporting sexual concerns and their intimate partners were randomized (2:1) to the IE intervention or to an educational control condition, both of which were delivered by trained psychosocial providers. Feasibility and acceptability were measured through recruitment, retention, session completion, and post-intervention program evaluations. Couples completed validated sexual, relationship, and psychosocial outcome measures at pre- and post-intervention. Between-group effect sizes and 95% confidence intervals were calculated using the Hedges g. Data supported intervention feasibility and acceptability. For survivors, the IE intervention had medium to large positive effects on all sexual outcomes and most psychosocial outcomes. Effects were less visible for relationship outcomes and were similar but somewhat smaller for partners. The IE intervention demonstrated feasibility, acceptability, and promise in addressing breast cancer survivors' sexual concerns and enhancing their and their partners' intimate relationships and psychosocial well-being. Implications for Psychosocial Oncology Practice The IE intervention demonstrated feasibility and acceptability, suggesting it could be well-received by breast cancer survivors with sexual concerns and their partners. Effects of the IE intervention on breast cancer survivors' sexual concerns and on their and their partners' intimate relationships and psychosocial well-being could not be attributed to therapist time and attention. Interventions that psychosocial providers can use to address breast cancer survivors' sexual concerns are important to the growing number of breast cancer survivors living for many years after their diagnosis.
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Affiliation(s)
- Jennifer Barsky Reese
- a Cancer Prevention and Control Program , Fox Chase Cancer Center , Philadelphia , Pennsylvania , USA.,b Department of Social and Behavioral Sciences; Temple University College of Public Health , Philadelphia , Pennsylvania , USA
| | - Katherine Clegg Smith
- c Department of Health, Behavior and Society; Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA.,d Johns Hopkins Sidney Kimmel Comprehensive Cancer Center , Baltimore , Maryland , USA
| | - Elizabeth Handorf
- e Department of Biostatistics and Bioinformatics , Fox Chase Cancer Center , Philadelphia , Pennsylvania , USA
| | - Kristen Sorice
- a Cancer Prevention and Control Program , Fox Chase Cancer Center , Philadelphia , Pennsylvania , USA
| | - Sharon L Bober
- f Department of Psychosocial Oncology and Palliative Care; Sexual Health Program, Dana-Farber Cancer Institute/Harvard Medical School , Boston , Massachusetts , USA
| | - Elissa T Bantug
- d Johns Hopkins Sidney Kimmel Comprehensive Cancer Center , Baltimore , Maryland , USA
| | - Sharon Schwartz
- g Department of Gynecology , Fox Chase Cancer Center , Philadelphia , Pennsylvania , USA
| | - Laura S Porter
- h Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA
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Chapman CH, Heath G, Fairchild P, Berger MB, Wittmann D, Uppal S, Tolpadi A, Maturen K, Jolly S. Gynecologic radiation oncology patients report unmet needs regarding sexual health communication with providers. J Cancer Res Clin Oncol 2018; 145:495-502. [PMID: 30539283 DOI: 10.1007/s00432-018-2813-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE Following radiation therapy (RT), women with gynecologic malignancies report high rates of sexual dysfunction, but little is known regarding sexual health communication between these patients and health-care providers. This study assessed these patients' beliefs/attitudes toward providers' sexual history taking. METHODS Surveys were administered to women who presented for follow-up care for gynecologic cancers in an academic radiation oncology department. The surveys assessed patient sexual health beliefs and inquiry preferences. Sexual functioning was assessed using the Female Sexual Function Index (FSFI). Ordered logistic regressions were performed to assess for correlations between survey responses, FSFI, and demographic characteristics. RESULTS Seventy-five subjects participated. Most (89.8%) had FSFI scores indicating sexual dysfunction. Most patients agreed that sexual function is an important component of overall health (78.7%) and that providers should inquire regularly (62.8%). Few (12.0%) reported embarrassment around provider discussions. Most (62.7%) preferred discussion with female providers, especially married patients (p = 0.03). Half (53.4%) agreed that sexual problems are an unavoidable part of aging, a view that was more common as education level decreased (p = 0.01). Most (62.7%) patients agreed that providers should regularly ask about their sexual history, with patients having significant differences in education level. Patients with low FSFI scores were less likely to report inquiry from their OB/Gyn (p = 0.03). CONCLUSIONS Gynecologic cancer radiotherapy patients want to discuss sexual health, but report suboptimal provider inquiry. Patient views and experiences varied based on marital status, education level, and FSFI score. This work highlights the need for improved sexual health communication between cancer patients and providers.
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Affiliation(s)
- Christina Hunter Chapman
- Department of Radiation Oncology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.,Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, 2800 Plymouth Road, Building 16, Ann Arbor, MI, 48109, USA
| | - Gerard Heath
- Department of Radiation Oncology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Pamela Fairchild
- Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Mitchell B Berger
- Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Daniela Wittmann
- Department of Urology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Shitanshu Uppal
- Department of Obstetrics and Gynecology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Anagha Tolpadi
- Department of Biostatistics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Katherine Maturen
- Department of Radiology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Shruti Jolly
- Department of Radiation Oncology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Lopes Cardozo AMF, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, Aaronson NK. Sexual Functioning and Relationship Satisfaction of Partners of Breast Cancer Survivors Who Receive Internet-Based Sex Therapy. JOURNAL OF SEX & MARITAL THERAPY 2018; 45:91-102. [PMID: 30040589 DOI: 10.1080/0092623x.2018.1488325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/17/2018] [Accepted: 05/31/2018] [Indexed: 06/08/2023]
Abstract
As part of a larger, randomized controlled trial, we evaluated longitudinally the sexual functioning and relationship satisfaction of 69 partners of breast cancer (BC) survivors who received Internet-based cognitive behavioral therapy (CBT) for sexual dysfunction. The findings suggest that Internet-based CBT positively affects the partners' immediate post-CBT and longer-term overall sexual satisfaction, sexual intimacy, and sexual relationship satisfaction. No sustained changes in other areas of sexual functioning were observed. Our CBT program was focused primarily on the sexual health of the BC survivors. We recommend that future programs include more psychoeducational and behavioral elements targeted at the partners.
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Affiliation(s)
- Susanna B Hummel
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jacques J D M van Lankveld
- b Faculty of Psychology and Educational Sciences , Open University of The Netherlands , Heerlen , The Netherlands
| | - Hester S A Oldenburg
- c Department of Surgical Oncology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Daniela E E Hahn
- d Department of Quality of Life , The Netherlands Cancer Institute , Amsterdam , The Netherlands
- e Family Cancer Clinic , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jacobien M Kieffer
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Miranda A Gerritsma
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Marianne A Kuenen
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Nina Bijker
- f Department of Radiotherapy , Academic Medical Center , Amsterdam , The Netherlands
| | - Paul J Borgstein
- g Department of Surgical Oncology , Onze Lieve Vrouwe Gasthuis, Location East , Amsterdam , The Netherlands
| | - Gijsbert Heuff
- h Department of Surgical Oncology , Spaarne Gasthuis Hoofddorp , Hoofddorp , The Netherlands
| | | | - Peter W Plaisier
- j Department of General Surgery , Albert Schweitzer Hospital , Dordrecht , The Netherlands
| | - Herman Rijna
- k Department of Surgical Oncology , Spaarne Gasthuis Haarlem , Haarlem , The Netherlands
| | - Suzan van der Meij
- l Department of Surgical Oncology , Flevo Hospital , Almere , The Netherlands
| | - Eric J van Dulken
- m Department of Surgical Oncology , Medical Center Slotervaart , Amsterdam , The Netherlands
| | - Bart C Vrouenraets
- n Department of Surgery , Onze Lieve Vrouwe Gasthuis, Location West , Amsterdam , The Netherlands
| | - Eva Broomans
- o Department of Adult Care , Virenze Institute of Mental Health Care , Utrecht , The Netherlands
- p PsyQ Institute of Mental Health Care , Almere , The Netherlands
| | - Neil K Aaronson
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
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74
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Traumer L, Jacobsen MH, Laursen BS. Patients’ experiences of sexuality as a taboo subject in the Danish healthcare system: a qualitative interview study. Scand J Caring Sci 2018; 33:57-66. [DOI: 10.1111/scs.12600] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/14/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Line Traumer
- Clinical Nursing Research Unit Aalborg University Hospital Aalborg Denmark
| | | | - Birgitte Schantz Laursen
- Clinical Nursing Research Unit Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
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75
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Latif N, Ali N. Patient and Physician Perspective on Sperm Banking to Overcome Post-Treatment Infertility in Young Cancer Patients in Pakistan. J Adolesc Young Adult Oncol 2018; 8:54-60. [PMID: 30256151 DOI: 10.1089/jayao.2018.0079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cancer survivor rates have increased over the past few decades leading to a growing interest in research related to quality of life (QoL). We attempted to explore the unique barriers that might prevent adult male cancer patients from accessing sperm cryopreservation in Pakistan. METHODS Semi-structured interviews of male cancer patients aged 18-45 years were audio-recorded in Urdu and translated to English and were transcribed ad verbatim. The topics included information regarding risk of infertility following chemotherapy, future reproductive choices, and barriers to sperm cryopreservation. Questionnaire to physicians containing four content domains of knowledge, attitude, practice, and barriers to sperm banking was also delivered. Data were entered and analyzed on SPSS. RESULTS Of the 25 patients interviewed, there were 10 cases of leukemia, 3 cases of lymphoma, 2 cases each of colorectal carcinoma and multiple myeloma, 1 case each of neuroblastoma and osteosarcoma, and solitary cases involving the lung, breast, thymus, brain, jaw, and testis. Four patients knew about the risk of infertility. All patients were aware of the option of sperm cryopreservation. Two patients had their sperm preserved before the initiation of chemotherapy. Perceived treatment-related expenses appeared to be the major barrier to sperm cryopreservation in nine patients. This was followed by lack of information, which was cited by eight patients, and religious reasons (n = 2 patients). Other barriers were female gender of the doctor and patient's preferences. Four patients stated no barriers. Nine physicians responded to the questionnaire. Seventy-eight percent of physicians agreed that cancer treatment increases the risk of infertility. 33.3% strongly agreed and 55.6% agreed that infertility can have an adverse impact on QoL. CONCLUSIONS There is a significant lack of awareness among male cancer patients regarding infertility following cancer treatment. It is imperative that physicians inform them of this and discuss treatment options, along with addressing potential barriers.
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Affiliation(s)
- Nida Latif
- 1 Civil Hospital Karachi, Karachi, Pakistan
| | - Natasha Ali
- 2 Department of Pathology and Laboratory Medicine/Oncology, Aga Khan University, Karachi, Pakistan
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76
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Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh J, Khera M, McVary KT, Miner MM, Nelson CJ, Sadeghi-Nejad H, Seftel AD, Shindel AW. Erectile Dysfunction: AUA Guideline. J Urol 2018; 200:633-641. [PMID: 29746858 DOI: 10.1016/j.juro.2018.05.004] [Citation(s) in RCA: 359] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE The purpose of this guideline is to provide a clinical strategy for the diagnosis and treatment of erectile dysfunction. MATERIALS AND METHODS A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates 1/1/1965 to 7/29/17) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of erectile dysfunction. Evidence-based statements were based on body of evidence strength Grade A, B, or C and were designated as Strong, Moderate, and Conditional Recommendations with additional statements presented in the form of Clinical Principles or Expert Opinions. RESULTS The American Urological Association has developed an evidence-based guideline on the management of erectile dysfunction. This document is designed to be used in conjunction with the associated treatment algorithm. CONCLUSIONS Using the shared decision-making process as a cornerstone for care, all patients should be informed of all treatment modalities that are not contraindicated, regardless of invasiveness or irreversibility, as potential first-line treatments. For each treatment, the clinician should ensure that the man and his partner have a full understanding of the benefits and risk/burdens associated with that choice.
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Affiliation(s)
- Arthur L Burnett
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Ajay Nehra
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Rodney H Breau
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Daniel J Culkin
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Martha M Faraday
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Lawrence S Hakim
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Joel Heidelbaugh
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Mohit Khera
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Kevin T McVary
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Martin M Miner
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Christian J Nelson
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | | | - Allen D Seftel
- American Urological Association Education and Research, Inc., Linthicum, Maryland
| | - Alan W Shindel
- American Urological Association Education and Research, Inc., Linthicum, Maryland
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77
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Cobo-Cuenca AI, Martín-Espinosa NM, Sampietro-Crespo A, Rodríguez-Borrego MA, Carmona-Torres JM. Sexual dysfunction in Spanish women with breast cancer. PLoS One 2018; 13:e0203151. [PMID: 30169506 PMCID: PMC6118366 DOI: 10.1371/journal.pone.0203151] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 08/15/2018] [Indexed: 12/15/2022] Open
Abstract
Purpose To determine whether there are changes in sexuality after breast cancer, to better understand the sexual function of women with breast cancer, and to investigate the potential relationship between sexual dysfunction and socio-demographic and clinical variables. Methods A cross-sectional study. This study included 514 women with breast cancer between 21- and 66-years-old. The cases were gathered between June 2016 and January 2017. The instruments used were the questionnaire on Women’s Sexual Function and a questionnaire to collect socio-demographic and clinical data. Results The average age (± standard deviation, SD) of participants was 46.34 ± 8.28 years. Their average age at date of diagnosis was 42.26 ± 8.56 years, and the average time suffering from cancer was 4.05 ± 5.23 years. There were significant differences (p = 0.002) in the presence of sexual dysfunction before (32.1%) and after (91.2%) cancer. The primary sexual dysfunctions were due to penetration pain (50.6%), lubrication (50.6%), dysfunctional desire (44.6%), and dysfunctional excitement (44.6%). Two-thirds of participants were satisfied with their sexual relations. The women who presented most sexual dysfunction were those that had a bilateral mastectomy (p = 0.009) and those who received chemotherapy, radiotherapy and hormonal-therapy (p < 0.001). Conclusion Sexual function was changed in women with breast cancer. The main problems included penetration pain, desire, lubrication, and dysfunctional excitement. It is important that Health professionals recognize which circumstances influence the sexual function of women with breast cancer and to make interventions that facilitate sexual adjustment.
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Affiliation(s)
- Ana Isabel Cobo-Cuenca
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, E.U. Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha (UCLM), Toledo, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- * E-mail:
| | - Noelia María Martín-Espinosa
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, E.U. Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha (UCLM), Toledo, Spain
| | | | - María Aurora Rodríguez-Borrego
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Departamento de Enfermería, Facultad de Medicina y Enfermería, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | - Juan Manuel Carmona-Torres
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, E.U. Enfermería y Fisioterapia de Toledo, Universidad de Castilla la Mancha (UCLM), Toledo, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
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78
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Almont T, Farsi F, Krakowski I, El Osta R, Bondil P, Huyghe É. Sexual health in cancer: the results of a survey exploring practices, attitudes, knowledge, communication, and professional interactions in oncology healthcare providers. Support Care Cancer 2018; 27:887-894. [PMID: 30109489 DOI: 10.1007/s00520-018-4376-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/24/2018] [Indexed: 01/31/2023]
Abstract
PURPOSE To assess, focusing on population of healthcare professionals providing oncosexology care to men with cancer, clinical practice, attitudes, knowledge, communication, and professional interaction. METHODS We performed a descriptive cross-sectional study with an online self-administered e-questionnaire addressed to all medical, paramedical, or administrative professionals attending the 4th "Cancer, Sexuality and Fertility" Meeting in Toulouse, France. Their participation was voluntary and totally anonymous. RESULTS The 165 respondents comprised 44% of physicians, 47% of paramedics, and 9% of other health professionals in oncology, from all French regions. Paramedics were significantly younger than physicians (p = .006). One third of respondents were degreed in sexology, but 75.8% were in demand of oncosexology-specific trainings, particularly paramedics (p = .029). Regarding the oncosexology network, respondents declared being linked to organ specialists (56.8%), psychologists (49.5%), oncologists (47.4%), nurses (31.5%), radiation therapists (27.4%), and general practitioners (25.3%). Compared to paramedics, physicians were more likely to be engaged in oncosexology care (p = .039) and couple counseling (p = .005), but the proportions of counseled patients or couple were identical (p = .430 and p = .252, respectively). Overall, 90% of respondents reported discussing sexuality issues with patients. Regarding the time for discussion, physicians reported communicating more at cancer announcement (p = .004) or after treatments (p = .015), while more paramedics reported discussing at another time (p = .005). Regarding the place for discussion, paramedics more frequently reported talking about sexuality in the hospital room (p = .001) or during a specific consult (p = .007). CONCLUSIONS Results emphasize various levels for improving existing oncosexology care, such as developing oncosexology-specific educational and practical training programs, particularly for paramedics; consolidating information, counseling, and therapeutic education with formal procedures like implementing medical and paramedical "oncosexology moments," or strengthening the community-hospital networks, from diagnosis to survivorship.
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Affiliation(s)
- Thierry Almont
- EA 3694 Human Fertility Research Group, CHU Toulouse, Paule de Viguier, Reproductive Medicine Department, 330 avenue de Grande- Bretagne TSA 70034, 31059, Toulouse cedex 9, France.
- French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Paule de Viguier University Hospital, Reproductive Medicine Department, 330 avenue de Grande- Bretagne TSA 70034, 31059, Toulouse cedex 9, France.
| | - Fadila Farsi
- Francophone Association for Supportive Care (AFSOS), 76, rue Marcel Sembat, 33130, Bègles, France
| | - Ivan Krakowski
- Francophone Association for Supportive Care (AFSOS), 76, rue Marcel Sembat, 33130, Bègles, France
| | - Rabih El Osta
- Urology Department of Brabois University Hospital, CHU de Nancy, Allée du Morvan, 54511, Vandoeuvre les Nancy, France
| | - Pierre Bondil
- Francophone Association for Supportive Care (AFSOS), 76, rue Marcel Sembat, 33130, Bègles, France
| | - Éric Huyghe
- EA 3694 Human Fertility Research Group, CHU Toulouse, Paule de Viguier, Reproductive Medicine Department, 330 avenue de Grande- Bretagne TSA 70034, 31059, Toulouse cedex 9, France
- French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Paule de Viguier University Hospital, Reproductive Medicine Department, 330 avenue de Grande- Bretagne TSA 70034, 31059, Toulouse cedex 9, France
- Francophone Association for Supportive Care (AFSOS), 76, rue Marcel Sembat, 33130, Bègles, France
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79
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Sexual health and needs for sexology care in digestive cancer patients undergoing chemotherapy: a 4-month cross-sectional study in a French University Hospital. Support Care Cancer 2018. [DOI: 10.1007/s00520-018-4125-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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80
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Cardozo AMFL, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, Aaronson NK. Internet-Based Cognitive Behavioral Therapy Realizes Long-Term Improvement in the Sexual Functioning and Body Image of Breast Cancer Survivors. JOURNAL OF SEX & MARITAL THERAPY 2018; 44:485-496. [PMID: 29297781 DOI: 10.1080/0092623x.2017.1408047] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The study aim was to evaluate the long-term efficacy of Internet-based cognitive behavioral therapy (CBT) for sexual dysfunctions in 84 breast cancer survivors. The positive effects of the intervention on overall sexual functioning, sexual desire, sexual arousal, vaginal lubrication, discomfort during sex, sexual distress, and body image observed immediately posttreatment were maintained at three- and nine-month follow-ups. Although sexual pleasure decreased during follow-up, it did not return to baseline levels. Our findings provide evidence that Internet-based CBT has a sustained, positive effect on sexual functioning and body image of breast cancer survivors with a sexual dysfunction.
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Affiliation(s)
- Susanna B Hummel
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jacques J D M van Lankveld
- b Faculty of Psychology and Educational Sciences , Open University of The Netherlands , Heerlen , The Netherlands
| | - Hester S A Oldenburg
- c Department of Surgical Oncology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Daniela E E Hahn
- d Department of Psychosocial Counseling , The Netherlands Cancer Institute , Amsterdam , The Netherlands
- e Family Cancer Clinic , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jacobien M Kieffer
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Miranda A Gerritsma
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Marianne A Kuenen
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Nina Bijker
- f Department of Radiotherapy , Academic Medical Center , Amsterdam , The Netherlands
| | - Paul J Borgstein
- g Department of Surgical Oncology , Onze Lieve Vrouwe Gasthuis Location East , Amsterdam , The Netherlands
| | - Gijsbert Heuff
- h Department of Surgical Oncology , Spaarne Gasthuis Hoofddorp , Hoofddorp , The Netherlands
| | | | - Peter W Plaisier
- j Department of General Surgery , Albert Schweitzer Hospital , Dordrecht , The Netherlands
| | - Herman Rijna
- k Department of Surgical Oncology , Spaarne Gasthuis Haarlem , Haarlem , The Netherlands
| | - Suzan van der Meij
- l Department of Surgical Oncology , Flevo Hospital , Almere , The Netherlands
| | - Eric J van Dulken
- m Department of Surgical Oncology , Medical Center Slotervaart , Amsterdam , The Netherlands
| | - Bart C Vrouenraets
- n Department of Surgery , Onze Lieve Vrouwe Gasthuis Location West , Amsterdam , The Netherlands
| | - Eva Broomans
- o Department of Adult Care , Virenze Institute of Mental Health Care , Utrecht , The Netherlands
- p PsyQ Institute of Mental Health Care , Almere , The Netherlands
| | - Neil K Aaronson
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
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81
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Eder SE. Early effect of fractional CO 2 laser treatment in Post-menopausal women with vaginal atrophy. Laser Ther 2018; 27:41-47. [PMID: 29795970 DOI: 10.5978/islsm.18-or-04] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 12/11/2017] [Indexed: 01/28/2023]
Abstract
Background and Aim Fractional CO2 lasers have been shown to provide improvement of vulvovaginal atrophy (VVA). The aim of the current study was to assess the early effect of a fractional CO2 laser system in treating postmenopausal women with clinical symptoms of VVA. Methods 28 healthy post-menopausal women (mean age 60.1 ± 5.55 years) with VVA-related symptoms were treated with fractional CO2 laser 3 times, in 4-week intervals. At each study visit, VHIS score and VVA symptom severity were recorded. Sexual function was assessed with the Female Sexual Function Index (FSFI). Results One month following the first laser treatment, the mean VHIS score was significantly improved (13.89 ± 4.25 vs. baseline 11.93 ± 3.82; p < 0.05), and improved further at 3 and 6 months following all three laser treatments (16.43 ± 4.20 and 17.46 ± 4.07, respectively). Almost all VVA symptoms were significantly improved at one month following the first treatment. A further significant improvement in VVA symptoms was noted at 3 and 6 months following the third laser treatment. Following treatments, the FSFI score increased significantly (22.36 ± 10.40 vs. baseline 13.78 ± 7.70; p < 0.05), and remained significantly higher than baseline at the 3- and 6-month follow-up visits. Conclusion CO2 laser therapy for post-menopausal women can be considered an effective therapeutic option providing relief of symptoms already noted after one laser treatment.
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Affiliation(s)
- Scott Evan Eder
- The Center for Women's Health & Wellness, Plainsboro, New Jersey, USA
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82
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Reese JB, Bober SL, Daly MB. Talking about women's sexual health after cancer: Why is it so hard to move the needle? Cancer 2017; 123:4757-4763. [PMID: 29116655 PMCID: PMC5716835 DOI: 10.1002/cncr.31084] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/22/2017] [Accepted: 09/22/2017] [Indexed: 01/06/2023]
Abstract
Despite increasing calls to integrate sexual health into routine cancer care, the majority of women diagnosed with cancer do not receive information about how their cancer treatments will affect their sexual health. With the significant challenges that exist to clinical discussion of sexual health, efforts on multiple fronts are needed to close the gap in the care of women diagnosed with cancer.
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Affiliation(s)
- Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center
- Department of Social and Behavioral Sciences, College of Public Health, Temple University
| | - Sharon L. Bober
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center
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83
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Chung E. Management of treatment-related sexual complications in cancer care: evidence for erectile function recovery and penile rehabilitation after radical prostatectomy in prostate cancer survivorship. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23809000.2017.1403851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Eric Chung
- Department of Urology, University of Queensland, Princess Alexandra Hospital, Brisbane, Australia
- AndroUrology Centre, St Andrew’s War Memorial Hospital, Brisbane, Australia
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84
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Jonsdottir JI, Jonsdottir H, Klinke ME. A systematic review of characteristics of couple-based intervention studies addressing sexuality following cancer. J Adv Nurs 2017; 74:760-773. [DOI: 10.1111/jan.13470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2017] [Indexed: 01/18/2023]
Affiliation(s)
- Jona Ingibjorg Jonsdottir
- Faculty of Nursing; School of Health Sciences; University of Iceland; Reykjavik Iceland
- Landspitali - The National University Hospital of Iceland; Reykjavik Iceland
| | - Helga Jonsdottir
- Faculty of Nursing; School of Health Sciences; University of Iceland; Reykjavik Iceland
- Landspitali - The National University Hospital of Iceland; Reykjavik Iceland
| | - Marianne E. Klinke
- Faculty of Nursing; School of Health Sciences; University of Iceland; Reykjavik Iceland
- Landspitali - The National University Hospital of Iceland; Reykjavik Iceland
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85
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Sexual function in adolescents and young adults diagnosed with cancer: A systematic review. J Cancer Surviv 2017; 12:47-63. [DOI: 10.1007/s11764-017-0643-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 08/29/2017] [Indexed: 10/18/2022]
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86
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Affiliation(s)
- Lisa Astalos Chism
- Lisa Astalos Chism is Clinical Director, Women's Wellness Clinic, Certified Menopause Practitioner and Certified Sexual Health Counselor, Karmanos Cancer Institute, Detroit, Mich. Morris A. Magnan is Clinical Nurse Specialist, Ambulatory Care, Karmanos Cancer Institute, Detroit, Mich
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87
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Catamero D, Noonan K, Richards T, Faiman B, Manchulenko C, Devine H, Bertolotti P, Gleason C, Board A. Distress, Fatigue, and Sexuality: Understanding and Treating Concerns and Symptoms in Patients With Multiple Myeloma. Clin J Oncol Nurs 2017; 21:7-18. [DOI: 10.1188/17.cjon.s5.7-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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88
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Pereira N, Schattman GL. Fertility Preservation and Sexual Health After Cancer Therapy. J Oncol Pract 2017; 13:643-651. [PMID: 28809602 DOI: 10.1200/jop.2017.023705] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Recent developments in cancer diagnostics and treatments have considerably improved long-term survival rates. Despite improvements in chemotherapy regimens, more focused radiotherapy and diverse surgical options, cancer treatments often have gonadotoxic side-effects that can manifest as loss of fertility or sexual dysfunction, particularly in young cancer survivors. In this review, we focus on two pertinent quality-of-life issues in female cancer survivors of reproductive age-fertility preservation and sexual function. Fertility preservation encompasses all clinical and laboratory efforts to preserve a woman's chance to achieve future genetic motherhood. These efforts range from well-established protocols such as ovarian stimulation with cryopreservation of embryos or oocytes, to nascent clinical trials involving cryopreservation and re-implantation of ovarian tissue. Therefore, fertility preservation strategies are individualized to the cancer diagnosis, time interval until initiation of treatments must begin, prognosis, pubertal status, and maturity level of patient. Some patients choose not to pursue fertility preservation, and the conversation then centers around other quality of life issues. Not all cancer treatments cause loss of fertility; however, most treatments can directly impact the physical and psychosocial aspects of sexual function. Cancer treatment is also associated with fear, anxiety, and depression, which can further decrease sexual desire, function, and frequency. Sexual dysfunction after cancer treatment is generally ascertained by compassionate inquiry. Strategies to promote sexual function after cancer treatment include pelvic floor exercises, clitoral therapy devices, pharmacologic agents, as well as couples-based psychotherapeutic and psycho-educational interventions. Quality-of-life issues in young cancer survivors are often best addressed by utilizing a multidisciplinary team consisting of physicians, nurses, social workers, psychiatrists, sex educators, counselors, or therapists.
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Affiliation(s)
- Nigel Pereira
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY
| | - Glenn L Schattman
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY
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89
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Effect of a pH-Balanced Vaginal Gel on Dyspareunia and Sexual Function in Breast Cancer Survivors Who Were Premenopausal at Diagnosis: A Randomized Controlled Trial. Obstet Gynecol 2017; 129:870-876. [PMID: 28383379 DOI: 10.1097/aog.0000000000001988] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess whether a pH-balanced vaginal gel containing lactic acid is more effective than a placebo (lactate-free gel) in improving dyspareunia and sexual function among breast cancer survivors who were premenopausal at diagnosis and had dyspareunia after adjuvant chemotherapy. METHODS In a single-center, double-blind, randomized trial, a pH-balanced gel or placebo was administered three times per week at bedtime as well as during sexual intercourse for 8 weeks. The primary outcome was the improvement of dyspareunia measured by pain score of the Female Sexual Function Index after the treatment. Secondary outcomes included the total and individual domains of Female Sexual Function Index score, sexual dysfunction (a total Female Sexual Function Index score less than 25.0), vaginal pH, vaginal maturation index, and adverse events related to the intervention. A sample size of 47 per group was planned to achieve 80% power to detect a 19% difference in the primary outcome. RESULTS From October 2009 and March 2013, 167 women were screened and 136 were randomized: 69 to a pH-balanced gel and 67 to placebo. Baseline characteristics were similar in both groups. Although there was no difference between the two groups, both experienced a significant improvement of dyspareunia. The increase in median pain score from baseline was 1.2 in both groups (median [interquartile range] from 2.8 [2.0-4.0] to 4.0 [2.8-4.8] in the pH-balanced group and from 3.2 [2.0-4.0] to 4.4 [3.2-4.8] in the placebo group; all P<.01). Overall Female Sexual Function Index score and the frequency of sexual dysfunction also did not differ between the two groups although there was a significant improvement. On the other hand, vaginal pH and vaginal maturation index were slightly but significantly improved only in the pH-balanced group. There were no severe adverse events in either group. CONCLUSION The pH-balanced vaginal gel is not superior to the placebo in improving dyspareunia and overall sexual function. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, https://www.clinicaltrials.gov, NCT00981305.
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Bernard S, Moffet H, Plante M, Ouellet MP, Leblond J, Dumoulin C. Pelvic-Floor Properties in Women Reporting Urinary Incontinence After Surgery and Radiotherapy for Endometrial Cancer. Phys Ther 2017; 97:438-448. [PMID: 28201796 DOI: 10.1093/ptj/pzx012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Endometrial cancer is the fourth most prevalent cancer in Canadian women. Radiotherapy (RT) is frequently recommended as an adjuvant treatment. There is a high prevalence (>80%) of urinary incontinence (UI) after RT. It is plausible that UI is associated, at least in part, with alterations of the pelvic-floor muscles (PFM). OBJECTIVE The aim of this exploratory study was to compare the PFM functional properties of women reporting UI after hysterectomy and RT for endometrial cancer with those of women with a history of hysterectomy but without UI. DESIGN A descriptive cross-sectional study was conducted. Eleven women were recruited for the affected group, and 18 were recruited for the comparison group. METHODS Urogenital and bowel functions were assessed using International Consultation on Incontinence Questionnaires, and PFM properties were evaluated using a Montreal dynamometer. Nonparametric tests were used for comparison of personal characteristics, functional status, and muscle properties. A correspondence analysis detailed the association between UI severity and PFM properties. RESULTS Maximal opening of dynamometer branches, maximal vaginal length, PFM maximum force and rate of force development in a strength test, and number of rapid contractions during a speed test were reduced in the affected group. No significant difference was found for the endurance test. The severity of UI was found to correspond to the rate of force development and the number of rapid contractions in a speed test, endurance, age, and vaginal length. LIMITATIONS The results are limited to the population studied. The small sample size limited the strength of the conclusions. CONCLUSIONS Some evidence of alterations in PFM properties were found in women with UI after hysterectomy and RT for endometrial cancer. These alterations appeared to be associated with UI, suggesting a possible role for rehabilitation.
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Lopes Cardozo AMF, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, Aaronson NK. Efficacy of Internet-Based Cognitive Behavioral Therapy in Improving Sexual Functioning of Breast Cancer Survivors: Results of a Randomized Controlled Trial. J Clin Oncol 2017; 35:1328-1340. [PMID: 28240966 DOI: 10.1200/jco.2016.69.6021] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose We evaluated the effect of Internet-based cognitive behavioral therapy (CBT) on sexual functioning and relationship intimacy (primary outcomes) and body image, menopausal symptoms, marital functioning, psychological distress, and health-related quality of life (secondary outcomes) in breast cancer survivors (BCSs) with a DSM-IV diagnosis of a sexual dysfunction. Patients and Methods We randomly assigned 169 BCSs to either Internet-based CBT or a waiting-list control group. The CBT consisted of weekly therapist-guided sessions, with a maximum duration of 24 weeks. Self-report questionnaires were completed by the intervention group at baseline (T0), midtherapy (T1), and post-therapy (T2) and at equivalent times by the control group. We used a mixed-effect modeling approach to compare the groups over time. Results Compared with the control group, the intervention group showed a significant improvement over time in overall sexual functioning (effect size for T2 [EST2] = .43; P = .031), which was reflected in an increase in sexual desire (EST1 = .48 and EST2 = .72; P < .001), sexual arousal (EST2 = .50; P = .008), and vaginal lubrication (EST2 = .46; P = .013). The intervention group reported more improvement over time in sexual pleasure (EST1 = .32 and EST2 = .62; P = .001), less discomfort during sex (EST1 = .49 and EST2 = .66; P = .001), and less sexual distress (EST2 = .59; P = .002) compared with the control group. The intervention group reported greater improvement in body image (EST2 = .45; P = .009) and fewer menopausal symptoms (EST1 = .39; P = .007) than the control group. No significant effects were observed for orgasmic function, sexual satisfaction, intercourse frequency, relationship intimacy, marital functioning, psychological distress, or health-related quality of life. Conclusion Internet-based CBT has salutary effects on sexual functioning, body image, and menopausal symptoms in BCSs with a sexual dysfunction.
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Affiliation(s)
- Susanna B Hummel
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Jacques J D M van Lankveld
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Hester S A Oldenburg
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Daniela E E Hahn
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Jacobien M Kieffer
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Miranda A Gerritsma
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Marianne A Kuenen
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Nina Bijker
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Paul J Borgstein
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Gijsbert Heuff
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Alexander M F Lopes Cardozo
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Peter W Plaisier
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Herman Rijna
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Suzan van der Meij
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Eric J van Dulken
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Bart C Vrouenraets
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Eva Broomans
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Neil K Aaronson
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
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Sexual Consequences of Cancer and Its Treatment in Adolescents and Young Adults. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_24] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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White ID, Sangha A, Lucas G, Wiseman T. Assessment of sexual difficulties associated with multi-modal treatment for cervical or endometrial cancer: A systematic review of measurement instruments. Gynecol Oncol 2016; 143:664-673. [DOI: 10.1016/j.ygyno.2016.08.332] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/26/2016] [Accepted: 08/27/2016] [Indexed: 10/21/2022]
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Atema V, van Leeuwen M, Oldenburg HSA, Retèl V, van Beurden M, Hunter MS, Aaronson NK. Design of a randomized controlled trial of Internet-based cognitive behavioral therapy for treatment-induced menopausal symptoms in breast cancer survivors. BMC Cancer 2016; 16:920. [PMID: 27887581 PMCID: PMC5124313 DOI: 10.1186/s12885-016-2946-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 11/10/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Menopausal symptoms are common and may be particularly severe in younger women who undergo treatment-induced menopause. Medications to reduce menopausal symptoms are either contra-indicated or have bothersome side effects. Previous studies have demonstrated that face-to-face cognitive behavioral therapy (CBT) is effective in alleviating menopausal symptoms in women with breast cancer. However, compliance with face-to-face CBT programs can be problematic. A promising approach is to use the Internet to make this form of CBT more accessible and feasible for patients. This study is evaluating the efficacy and cost-effectiveness of an Internet-based CBT program, with or without therapist guidance, in alleviating or reducing the severity of menopausal symptoms. METHODS/DESIGN In a multicenter, randomized controlled trial we are evaluating the efficacy of two Internet-based CBT programs in alleviating or reducing the impact of menopausal symptoms, and particularly hot flushes and night sweats, in breast cancer survivors who have experienced a treatment-induced menopause. Secondary outcomes include sexual functioning, sleep quality, hot flush frequency, psychological distress, health-related quality of life and cost-effectiveness. We will recruit 248 women who will be randomized to either a therapist guided or a self-management version of the 6-week Internet-based CBT program, or to a usual care, waiting list control group. Self-administered questionnaires are completed at baseline (T0), and at 10 weeks (T1) and 24 weeks (T2) post-randomization. DISCUSSION Internet-based CBT is a potentially useful treatment for reducing menopausal symptoms in breast cancer survivors. This study will provide evidence on the efficacy and cost-effectiveness of such an Internet-based CBT program, with or without therapist support. If demonstrated to be efficacious and cost-effective, the availability of such structured supportive intervention programs will be a welcome addition to standard medical treatment offered to cancer patients with treatment-induced menopause. TRIAL REGISTRATION The study is retrospectively registered at ClinicalTrials.gov on January 26th 2016 ( NCT02672189 ).
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Affiliation(s)
- Vera Atema
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Marieke van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Hester S. A. Oldenburg
- Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Valesca Retèl
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of HTSR, School of Governance and Management, University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands
| | - Marc van Beurden
- Department of Gynecology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Myra S. Hunter
- Department of Psychology (at Guy’s), Institute of Psychiatry, Kings College London, 5th floor Bermondsey Wing, Guy’s Campus, SE1 9RT London, UK
| | - Neil K. Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
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Patient-provider communication about sexual concerns in cancer: a systematic review. J Cancer Surviv 2016; 11:175-188. [PMID: 27858322 DOI: 10.1007/s11764-016-0577-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 10/04/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE Cancer survivors' needs around sexual concerns are often unmet. The primary objective of this systematic review was to examine the prevalence of and factors associated with patient-provider communication about sexual concerns in cancer. METHODS Using PRISMA guidelines, we searched PubMed/MEDLINE, PsychInfo, and CINAHL databases for peer-reviewed quantitative research papers (2000-2015) in cancer samples. Search terms across three linked categories were used (sexuality, communication, and cancer). The National Comprehensive Cancer Network (NCCN) Sexual Function Guidelines were used as a framework to categorize communication reported in each study. RESULTS Twenty-nine studies from 10 countries (29 % in USA) were included. Studies assessed patients only (21), providers only (4), and both (4). Communication measures differed across studies and many lacked validity data. When reported by patients or providers, the average prevalence of discussing potential treatment effects on sexual function was 50 (60 % for men and 28 % for women) and 88 %, respectively. As reported by patients or providers, respectively, assessing patients' sexual concerns (10 and 21 %) and offering treatments (22 and 17 %) were measured in fewer studies and were reported less frequently. Both patients and providers (28 and 32 %, respectively) reported a low prevalence of other non-specific communication. Greater prevalence of communication was associated with male patient gender and more years of provider experience. CONCLUSIONS Sexual issues go unaddressed for many cancer survivors, particularly women. Both patient and provider interventions are needed. IMPLICATIONS FOR CANCER SURVIVORS Enhancing patient-provider communication about sexual concerns through evidence-based interventions could improve patient sexual function and quality of life.
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96
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Cairo Notari S, Favez N, Notari L, Panes-Ruedin B, Antonini T, Delaloye JF. Women's experiences of sexual functioning in the early weeks of breast cancer treatment. Eur J Cancer Care (Engl) 2016; 27. [PMID: 29372622 DOI: 10.1111/ecc.12607] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2016] [Indexed: 12/24/2022]
Abstract
This study describes women's sexual functioning in the early weeks of breast cancer treatment and the possible sexual changes that women may experience compared with pre-treatment functioning. Seventy-five patients filled out a questionnaire on sexual functioning and participated in a semi-structured interview on changes in sexual life and intimacy after treatment. Sixty-two women were sexually active before treatment; three post-treatment patterns of sexual behaviour were identified: 22.6% of these women were as active as before treatment, 35.5% stopped any sexual activity and 41.9% experienced quantitative and qualitative changes. Analyses showed that each pattern had specific characteristics regarding current sexual functioning, the kinds of changes reported (e.g. decreased frequency and increased tenderness) and the reasons for these changes (e.g. tiredness and sex not a priority). Even in the immediate post-surgical period, women may react in very different ways to treatment in terms of sexual functioning. Most women experience changes, but cessation of sexual activity is not inevitable. Positive changes (growing tenderness and affection) also exist. These important interindividual differences require a person-centred approach when the topic of sexuality is being addressed, and practitioners need to be sensitive to individual perceptions of change. Early detection of sexual changes may prevent the crystallisation of difficulties over time.
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Affiliation(s)
- S Cairo Notari
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - N Favez
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - L Notari
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - B Panes-Ruedin
- Senology Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - T Antonini
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - J-F Delaloye
- Senology Unit, University Hospital of Lausanne, Lausanne, Switzerland
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97
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Reese JB, Porter LS, Casale KE, Bantug ET, Bober SL, Schwartz SC, Smith KC. Adapting a couple-based intimacy enhancement intervention to breast cancer: A developmental study. Health Psychol 2016; 35:1085-96. [PMID: 27657981 DOI: 10.1037/hea0000413] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Sexual concerns continue to be poorly addressed for women treated for breast cancer and evidence-based interventions that adequately address these concerns are scarce. The objective of this study was to adapt a telephone-based intimacy enhancement intervention, previously tested in couples facing colorectal cancer, to the needs of women with breast cancer through qualitative focus groups, cognitive interviews, and expert review. METHOD Three semistructured qualitative focus groups in partnered posttreatment breast cancer survivors (n = 15) reporting sexual concerns were conducted to investigate experiences of breast cancer-related sexual concerns and intervention preferences. Focus group data were coded using the framework approach to qualitative analysis; 8 key themes were identified and used to develop the content and format of the intervention. Feedback from cognitive interviews with study-naïve breast cancer survivors (n = 4) and expert review of materials were also incorporated in finalizing the intervention materials. RESULTS Qualitative findings centered on the impact of breast cancer and its treatment on women's sexuality and on the intimate relationship, experiences of helpful and unhelpful coping methods, and explicit intervention preferences. Focus group data were particularly helpful in identifying the scope of educational topics and in determining how to structure intervention skills practice (e.g., intimacy-related communication) to be optimally relevant and helpful for both women and their partners. Cognitive interview feedback helped refine intervention materials. CONCLUSION An intimacy enhancement intervention was adapted for women with breast cancer and their partners. This intervention offers a promising, potentially disseminable approach to addressing breast cancer-related sexual concerns. (PsycINFO Database Record
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Affiliation(s)
| | - Laura S Porter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center
| | | | | | - Sharon L Bober
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School
| | | | - Katherine Clegg Smith
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health
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98
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Bueno Robles LS. Desarrollo investigativo en salud sexual de mujeres con cáncer de mama: una revisión integrativa. AVANCES EN ENFERMERÍA 2016. [DOI: 10.15446/av.enferm.v34n1.57616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
<p>Objetivo: Caracterizar la producción científica relacionada con la salud sexual en mujeres con cáncer de mama.Metodología: Revisión integrativa. Se realizó una búsqueda en las bases de datos Scopus, Medline, LILACS y SciELO, así comobúsquedas secundarias en revistas científicas. Se encontraron 85artículos organizados y caracterizados por año, idioma y continente; edad promedio y tipos de tratamiento; metodología, perspectiva, enfoque, diseño, perspectiva disciplinar y tendenciatemática.Resultados: La temática reportó mayor producción de conocimiento en los últimos 10 años. La tendencia de investigación se orienta hacia tres categorías: Salud sexual y cáncer de mama; Salud sexual en la mujer y tratamientosdel cáncer de mama; y Salud sexual y relaciones de pareja.Conclusiones: La salud sexual en mujeres con cáncer de mamaes un aspecto importante en la calidad de vida, que continuamente se ve alterada como resultado de la enfermedad y los efectos adversos de los tratamientos. Esta condición no sólo aqueja a la persona enferma, sino también a su pareja, por lo que se requiere del desarrollo de líneas de acción que permitan dar una atención integral a las mujeres con esta enfermedad.</p>
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99
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Finocchiaro CY, Petruzzi A, Fedeli G, Vistalli MG, Innocenti A, Silvani A, Lamperti E. Hidden reality: sexual sphere in brain tumor patients. PSYCHOL HEALTH MED 2016; 22:370-380. [DOI: 10.1080/13548506.2016.1210176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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100
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Wettergren L, Kent EE, Mitchell SA, Zebrack B, Lynch CF, Rubenstein MB, Keegan THM, Wu XC, Parsons HM, Smith AW. Cancer negatively impacts on sexual function in adolescents and young adults: The AYA HOPE study. Psychooncology 2016; 26:1632-1639. [PMID: 27240019 DOI: 10.1002/pon.4181] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 04/16/2016] [Accepted: 05/22/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This cohort study examined the impact of cancer on sexual function and intimate relationships in adolescents and young adults (AYAs). We also explored factors predicting an increased likelihood that cancer had negatively affected these outcomes. METHODS Participants (n = 465, ages 15-39) in the Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) study completed two surveys approximately 1 and 2 years post-cancer diagnosis. We used multivariable logistic regression to determine factors negatively affected by perceptions of sexual function at 2 years post-diagnosis. RESULTS Forty-nine percent of AYAs reported negative effects on sexual function at 1 year post-cancer diagnosis and 70% of those persisted in their negative perceptions 2 years after diagnosis. Those reporting a negative impact at 2 years were more likely to be 25 years or older (OR, 2.53; 95% CI, 1.44-4.42), currently not raising children (OR, 1.81; 95% CI, 1.06-3.08), experiencing fatigue (OR, 0.99; 95% CI, 0.975-0.998) and more likely to report that their diagnosis has had a negative effect on physical appearance (OR, 3.08; 95% CI, 1.97-4.81). Clinical factors and mental health were not significant predictors of negative effects on sexual function. CONCLUSIONS Many AYAs diagnosed with cancer experience a persistent negative impact on sexual life up to 2 years following diagnosis. The findings underscore the need to develop routine protocols to assess sexual function in AYAs with cancer and to provide comprehensive management in the clinical setting. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Lena Wettergren
- Outcomes Research Branch, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Erin E Kent
- Outcomes Research Branch, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA
| | - Sandra A Mitchell
- Outcomes Research Branch, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA
| | - Brad Zebrack
- University of Michigan, School of Social Work, Ann Arbor, MI, USA
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | | | - Theresa H M Keegan
- Division of Hematology and Oncology, UC Davis Comprehensive Cancer Center, CA, USA
| | - Xiao-Cheng Wu
- Epidemiology Program/Louisiana Tumor Registry, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Helen M Parsons
- Department of Epidemiology and Biostatistics, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Ashley Wilder Smith
- Outcomes Research Branch, Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA
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- The AYA HOPE Study Collaborative Group, National Cancer Institute, Bethesda, MD, USA
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