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Gil Haro B, Cordoba Largo S, Rodriguez Rodriguez I, Lozano Martin EM, Couselo Paniagua ML, Martinez Montesinos I, Belinchon Olmeda B, Vicente Ruiz P, Cerrolaza Pascual M, Payano Hernández S, Rey-Baltar Oramas D, Martinez Casares N, Barahona Orpinell M. Let's talk about sex: consensus guidelines of the GINECOR working group of the Spanish Society of Radiation Oncology: clinical recommendations after pelvic radiotherapy. Clin Transl Oncol 2024:10.1007/s12094-024-03562-w. [PMID: 39046683 DOI: 10.1007/s12094-024-03562-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/13/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE The present consensus statement was developed by the GINECOR working group on behalf of the Spanish Society of Radiation Oncology (SEOR). This document addresses sexual health management in patients with gynaecological cancer after pelvic radiotherapy. METHODS A modified two-round online Delphi study was conducted, where GINECOR members were surveyed on the diagnosis, treatment, and follow-up of sexual health problems. An expert panel of radiation oncologists, nurses and a gynaecologist participated in the Delphi study to reach a consensus, applying GRADE criteria to establish the level of agreement. RESULTS The consensus recommendations cover both diagnosis and treatment, with an emphasis on patient-reported outcome measures (PROMs). They highlight recommendations such as the systematic assessment of genitourinary, gastrointestinal, and sexual symptoms, and the use of several treatments after radiotherapy. Recommendations include pharmacological options like vaginal lubricants and hormone therapy, and mechanical interventions such as vaginal dilators and vibrators. These suggestions stem from both scientific evidence and clinical expertise. CONCLUSION This consensus statement describes a comprehensive, multidisciplinary approach developed to address the sexual needs and enhance the quality of life of patients with gynaecological tumours after pelvic radiotherapy. It offers specific recommendations for managing sexual issues, emphasizing the importance of specialized care and regular assessment. The document underscores the significance of proactive, patient-centered sexual health management in gynaecological cancer patients.
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Affiliation(s)
- Beatriz Gil Haro
- Department of Radiation Oncology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
| | - Sofía Cordoba Largo
- Department of Radiation Oncology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
| | | | | | - Maria Luz Couselo Paniagua
- Department of Radiation Oncology, University Hospital Clinico de Santiago, Santiago de Compostela, Spain
| | | | | | - Paula Vicente Ruiz
- Department of Radiation Oncology, Virgen Macarena University Hospital, Seville, Spain
| | | | | | - Dolores Rey-Baltar Oramas
- Department of Radiation Oncology, Gran Canaria Doctor Negrin University Hospital, Gran Canaria, Spain
| | - Nieves Martinez Casares
- Department of Radiation Oncology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
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Robison K, Kulkarni A, Dizon DS. Sexual Health in Women Affected by Gynecologic or Breast Cancer. Obstet Gynecol 2024; 143:499-514. [PMID: 38207333 DOI: 10.1097/aog.0000000000005506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/29/2023] [Indexed: 01/13/2024]
Abstract
Sexual health problems are prevalent among women affected by gynecologic or breast cancer. It is important to understand the effects cancer treatment can have on sexual health and to have the tools necessary to identify and treat sexual health problems. This Clinical Expert Series discusses practical methods for routinely screening for sexual dysfunction and reviews sexual health treatment options for women affected by cancer. We review the limitations of the current literature in addressing sexual health problems among sexually and gender minoritized communities. Finally, we discuss appropriate timing of referrals to sexual health experts, physical therapists, and sex therapists. Multiple resources available for both patients and clinicians are included.
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Affiliation(s)
- Katina Robison
- Tufts Medical Center, Boston, Massachusetts; Columbia University, New York, New York; and the Lifespan Cancer Institute and Legorreta Cancer Center, Brown University, Providence, Rhode Island
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Ospina Serrano AV. Overview of sexual dysfunction in patients with cancer. Clin Transl Oncol 2023; 25:3369-3377. [PMID: 37633856 DOI: 10.1007/s12094-023-03311-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/28/2023]
Abstract
Among survivor's patients with cancer, sexual dysfunction (SD) is a common treatment-related disturbance that significantly affects their quality of life. The disorder can be a short-term effect, but frequently it can be permanent and patients often do not receive adequate support to overcome the problem. The characteristics of SD may differ depending on the type of neoplasm and oncological treatment. The most common long-term effects are those related to treatment-induced menopause, ablative oncologic surgery, and altered gonadal function. Breast, prostate, and gynecologic cancers are the tumors most commonly associated with disturbances in sexual health, although there is evidence of SD in patients with other types of neoplasms. It is necessary for the healthcare team caring for oncological patients to be aware of the characteristics of sexual dysfunction in this population. This will make it possible to offer patients a comprehensive and personalized approach to improve their quality of life.
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Affiliation(s)
- Aylen Vanessa Ospina Serrano
- Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro Majadahonda, Calle Manuel de Falla 1, 28222, Madrid, Spain.
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Kusakabe A, Mawatari H, Hirano K, Ohta M, Inamori M, Morita T. Identifying the unmet physical and psychological intimacy and sexual needs of partners of patients with terminal cancer. J Sex Med 2023; 20:1312-1318. [PMID: 37750582 DOI: 10.1093/jsxmed/qdad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 07/27/2023] [Accepted: 08/12/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Palliative care aims to improve the quality of life of patients who are terminally ill, but support for the sexuality of these patients is often inadequate. AIM To identify factors related to the unmet needs of bereaved partners whose significant others died of cancer during hospitalization. METHODS Bereaved individuals in Japan aged >50 years who had lost their partners to cancer in a hospital in the last 5 years answered a questionnaire on the support desired for "time to nurture love with your partner." OUTCOMES We used 3 sexual questions in the 34-item Supportive Care Needs Survey-Short Form (SCNS-SF34) and measured the unmet needs of partners of patients with terminal cancer. RESULTS We obtained 290 responses (equal number of males and females). Respondents' age distribution was as follows: 50 to 59 years, 34.8%; 60 to 69 years, 44.5%; 70 to 79 years, 19.3%; ≥80 years, 1.4%. In total, 81% had children. Most partners died in the general ward (59.3%). Frequency of time to nurture love with one's partner before the illness was as follows: none at all, 44 (15.2%); very little, 84 (29.0%); once in a while, 76 (26.2%); occasionally, 45 (15.5%); and often, 41 (14.1%). Roughly 20% of participants reported experiencing unmet sexual needs across all 3 selected questions in the SCNS-SF34. Multivariate analysis showed that younger age (P = .00097) and a higher frequency of time to nurture love with one's partner before illness (P = .004) were positively associated with unmet needs for sexuality during hospitalization. CLINICAL IMPLICATIONS The study may help health care workers identify patients who are seeking sexual support. STRENGTHS AND LIMITATIONS This study identified the unmet needs and underlying factors regarding sexuality during hospitalization for partners of patients with terminal cancer. However, differences by cancer type could not be analyzed. Additionally, the modified version of the supportive care needs measure used in this study (SCNS-SF34) may have decreased validity owing to the alterations made for its use. CONCLUSION Some hospitalized patients with terminal cancer could need support for time to nurture love with their partners. Health care providers can play a crucial role by anticipating the needs of patients, preparing them mentally, and offering counseling and information to help them maintain an intimate connection with their loved ones.
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Affiliation(s)
- Akihiko Kusakabe
- Department of General Medicine, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Hironori Mawatari
- Department of Palliative and Supportive Care, Yokohama Minami Kyousai Hospital, Yokohama, Kanagawa 236-0004, Japan
| | - Kazue Hirano
- Yokohama Ekisaikai Hospital, Naka-ku, Yokohama 231-0036, Japan
| | - Mitsuyasu Ohta
- Department of General Medicine, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Masahiko Inamori
- Department of Medical Education, Yokohama City University Hospital Yokohama City University School of Medicine, Kanazawa-ku, Yokohama 236-0004, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara Hospital, Kita, Hamamatsu 433-8558, Japan
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Avis NE, Crawford SL, Gold EB, Greendale GA. Sexual functioning among breast cancer survivors and non-cancer controls over 5 years post diagnosis: Pink SWAN. Cancer Med 2023; 12:7356-7368. [PMID: 36440508 PMCID: PMC10067058 DOI: 10.1002/cam4.5433] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/06/2022] [Accepted: 10/31/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To compare sexual functioning from diagnosis to 5 years post diagnosis among breast cancer survivors (BCS) and women without cancer (controls). PATIENTS AND METHODS Analyses included 118 BCS and 1765 controls from 20 years of the longitudinal Study of Women's Health Across the Nation (SWAN), a multiracial/ethnic cohort of mid-life women assessed approximately annually from 1995 to 2015. Pink SWAN participants reported no cancer at SWAN enrollment and developed (BCS) or did not develop (controls) incident breast cancer after enrollment. Outcomes included: being sexually active or not, intercourse frequency, sexual desire, vaginal dryness, and pain with intercourse. Using longitudinal logistic regression, we compared BCS and controls on prevalence of sexual functioning outcomes with respect to years since diagnosis. In addition, we examined whether menopause transition stage, depressive symptoms, relationship satisfaction, vaginal dryness, or pain with intercourse modified the relation between breast cancer and sexual functioning outcomes. RESULTS Adjusting for partner status, both BCS and controls reported similar declines over time in being sexually active, sexual intercourse frequency, and sexual desire. Among sexually active women, more BCS than controls consistently reported vaginal dryness with significant differences between 2 and 4 years post-diagnosis, and pain with intercourse, with statistically significant differences between 0.5 years post-diagnosis to 2 years post-diagnosis. Being post-menopausal and reporting depressive symptoms were significant effect modifiers for pain with intercourse with both variables having positive and stronger associations with pain among the controls than among BCS. CONCLUSION Except for more reporting of vaginal dryness and pain with intercourse among BCS, negative changes in sexual function during mid-life were similar in those with and without breast cancer.
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Affiliation(s)
- Nancy E. Avis
- Department of Social Sciences & Health PolicyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Sybil L. Crawford
- Tan Chingfen Graduate School of NursingUMass Chan Medical SchoolWorcesterMassachusettsUSA
| | - Ellen B. Gold
- Department of Public Health SciencesSchool of Medicine, University of CaliforniaDavisCaliforniaUSA
| | - Gail A. Greendale
- David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
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Yan R, Wang J, Yu J. Association of sexual attitudes with sexual dysfunction and sexual distress among Chinese breast cancer survivors: a cross-sectional study. Support Care Cancer 2023; 31:154. [PMID: 36757498 DOI: 10.1007/s00520-023-07600-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/17/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE Little is known about sexual dysfunction and sexual distress in Chinese female breast cancer survivors (BCSs), and their associations with physical variables, psychological factors, body image, and sexual attitudes. METHODS A cross-sectional study of 341 BCSs was performed with the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R). Associations between physical variables, psychological factors, body image, sexual attitudes, sexual dysfunction, and sexual distress were evaluated using logistic regression, adjusted for confounding factors. RESULTS We found that 75.37% and 18.48% of BCSs reported sexual dysfunction and sexual distress during the past month, respectively. Attitudes toward sexual behavior such as "sexual activity may impede disease recovery," "sexual activity may cause cancer recurrence or metastasis," and "sexual activity may weaken treatment effects" were significantly associated with an increased likelihood of reporting sexual dysfunction and sexual distress. Body image disruption such as "felt physically less attractive as a result of your disease or treatment" was significantly associated with the experience of sexual distress. CONCLUSION Sexual dysfunction and sexual distress are common issues in Chinese BCSs. Sexual misconception likely contributes to sexual dysfunction and sexual distress, and body image has a significantly negative association with sexual distress in BCSs. Interventions targeting sexual attitudes and body image might be important to address BCSs' sexual issues and improve their overall sexual health.
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Affiliation(s)
- Rui Yan
- Big Data Center of Clinical Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
| | - Jiwei Wang
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China
| | - Jinming Yu
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China
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Physical and psychosocial factors associated with sexual satisfaction in long-term cancer survivors 5 and 10 years after diagnosis. Sci Rep 2023; 13:2011. [PMID: 36737619 PMCID: PMC9898518 DOI: 10.1038/s41598-023-28496-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/19/2023] [Indexed: 02/05/2023] Open
Abstract
Our study provides data on sexual satisfaction among long-term cancer survivors 5 and 10 years after diagnosis, and identifies factors detrimental (e.g. psychosocial and physical symptom burden) or beneficial (e.g. social support) to survivors' sexual satisfaction. We measured sexual satisfaction among cancer survivors recruited via the local clinical cancer registry across a wide range of tumor sites 5 years (cohort 1) and 10 years (cohort 2) after diagnosis. We further assessed chronic comorbidity index (CCI) and symptom scales (EORTC QLQ-C30), depression (PHQ-9) and anxiety (GAD-7), satisfaction with partnership (PFB), quality of life (EORTC QLQ-C30), and social support (OSSS). 924 patients (5-year cohort = 608/10-year cohort = 316) participated in the study (53% men, 80% cohabiting, mean age 66 years, range 18-85). We found that nearly half of the respondents perceived their sexual life as less satisfying than before cancer. High sexual satisfaction was associated with a low chronic comorbidities index (r = - 0.27, p < .001), less fatigue (r = - 0.35, p<.001), less nausea/vomiting (r = - 0.13, p<.001) and less pain (r = - 0.23, p<.001), r ; less depression (r = - 0.24, p < .001), less anxiety(r = - 0.23, p < .001); a high level of social support (r = 0.16, p < .001), a high level of satisfaction with their relationship (r = 0.24, p < .001), and high quality of life (r = 0.33, p < .001). Sexual satisfaction may be affected by both psychosocial and physical symptom burden, with the latter having a greater impact on sexual satisfaction. It is essential for health care providers that sexual health issues are understood, evaluated, and treated, including those of long-term cancer survivors.
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Benedict C, Fisher S, Kumar D, Pollom E, Schapira L, Kurian AW, Berek JS, Palesh O. Examining Associations Among Sexual Health, Unmet Care Needs, and Distress in Breast and Gynecologic Cancer Survivors. Semin Oncol Nurs 2022; 38:151316. [PMID: 35902337 PMCID: PMC9809304 DOI: 10.1016/j.soncn.2022.151316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES This study evaluated breast and gynecologic cancer patients' sexual function, unmet needs related to sexuality, and distress. DATA SOURCES Secondary analyses of a cross-sectional survey study evaluated measures of sexual function (Female Sexual Function Index [FSFI]), unmet needs (Supportive Care Needs Scale), and distress (Patient Health Questionnaire). χ2 test, t tests, and analysis of variances (ANOVAs) tested bivariate relationships. Subgroup comparisons were made based on the Female Sexual Function Index sexual dysfunction diagnostic cut-off score (<26.55; lower scores indicate greater dysfunction). A regression model tested associations between sexual function and unmet needs with distress as the outcome variable. CONCLUSION Clinically significant sexual dysfunction was common in this cohort of women. In multivariate modeling, worse sexual function and greater unmet sexuality needs related to greater distress. Future work should explore reasons behind the high levels of sexual dysfunction and unmet needs in female survivors. IMPLICATIONS FOR NURSING PRACTICE It is important to routinely screen for sexual health concerns among female cancer survivors at all phases of the cancer trajectory including years posttreatment.
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Affiliation(s)
- Catherine Benedict
- Stanford University School of Medicine, Stanford, CA; Stanford Cancer Institute, Stanford, CA.
| | | | - Dhanya Kumar
- University of Massachusetts School of Medicine, Worcester, MA
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Rottmann N, Larsen PV, Johansen C, Hagedoorn M, Dalton SO, Hansen DG. Sexual Activity in Couples Dealing With Breast Cancer. A Cohort Study of Associations With Patient, Partner and Relationship-Related Factors. Front Psychol 2022; 13:828422. [PMID: 35465483 PMCID: PMC9021795 DOI: 10.3389/fpsyg.2022.828422] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/15/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Breast cancer may profoundly affect a couple’s sex life. The present study examines whether patient-, partner- and relationship-related characteristics are associated with sexual activity of couples following breast cancer diagnosis in the treatment phase and over time. Methods Women with breast cancer and their male cohabiting partners participated in a longitudinal study in Denmark. Logistic regression was used to examine associations of patient-, partner- and relationship-related characteristics at baseline (≤4 months following surgery) with couples’ sexual activity at baseline, 5 and 12 months later. The longitudinal analyses were stratified for couples’ sexual activity status at baseline. Results A total of 722, 533 and 471 couples were included in the analyses at baseline, 5- and 12-months follow-up, respectively. Older age, depressive symptoms and lower vitality of patients were associated with lower odds of couples’ sexual activity at baseline; chemotherapy treatment and older age of patients were associated with lower odds at 5-months follow-up in couples who were not sexually active at baseline. Higher ratings of emotional closeness, affectionate behavior and satisfaction with dyadic coping were associated with higher odds for sexual activity at baseline and over time in couples who were sexually active at baseline. Conclusion Sexual counseling during cancer treatment and rehabilitation should include a couple perspective. Relationship-related variables may be a protective factor for remaining sexually active after breast cancer diagnosis. Interventions could focus on strengthening these factors. Health professionals also need to consider the patients’ breast cancer treatment, vitality, and emotional distress in counselling on sexuality.
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Affiliation(s)
- Nina Rottmann
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.,REHPA, The Danish Knowledge Center for Rehabilitation and Palliative Care, University Hospital Odense and Department of Clinical Research, University of Southern Denmark, Nyborg, Denmark
| | - Pia Veldt Larsen
- Mental Health Services in the Region of Southern Denmark, Vejle, Denmark
| | - Christoffer Johansen
- Oncology Department, Finsen Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mariët Hagedoorn
- Health Sciences/Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Gilså Hansen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Campos LS, De Nardi SP, Limberger LF, Caldas JM. Sexual function and disease progression in women with advanced cancer. Support Care Cancer 2022; 30:5093-5098. [DOI: 10.1007/s00520-022-06797-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/31/2021] [Indexed: 11/30/2022]
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Heyne S, Esser P, Geue K, Friedrich M, Mehnert-Theuerkauf A. Frequency of Sexual Problems and Related Psychosocial Characteristics in Cancer Patients-Findings From an Epidemiological Multicenter Study in Germany. Front Psychol 2021; 12:679870. [PMID: 34367002 PMCID: PMC8339199 DOI: 10.3389/fpsyg.2021.679870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022] Open
Abstract
Background Multimodal cancer treatments are often associated with sexual problems. Identifying patients with sexual problems could help further elucidate serious issues with their sexuality and thus promote or maintain patients’ sexual health. We aimed to assess the occurrence of sexual problems in patients across different tumor locations and to explore associated sociodemographic, medical and psychosocial factors. Methods We included 3,677 cancer patients (mean age 58 years, age range 18–75 years, 51.4% women) from a large epidemiological multicenter study in Germany on average 13.5 months after cancer diagnosis. The occurrence and frequency of sexual problems were assessed via a binary item on the problem checklist of the Distress Thermometer (DT). Controlled associations of these problems with sociodemographic, medical and psychosocial factors including distress (DT), anxiety (GAD-7), depression (PHQ-9), quality of life (EORTC-QLQ-C30), and social support (SSUK-8) are analyzed using logistic regression analysis. Results We found that 31.8% of patients reported sexual problems, with a significant higher proportion in men (40.5%) compared to women (23.7%), OR 2.35, 95% CI [1.80–3.07] and a higher proportion in patients with a partner (35.6%) compared to those without a partner (3.5%), OR 2.83, 95% CI [2.17–3.70]. Tumor location was associated with occurrence of sexual problems: patients with cancer, affecting the male genital organs had the highest chance for sexual problems, OR 2.65, 95% CI [1.18–3.95]. There was no significant difference in the occurrence of sexual problems between age groups OR 0.99, 95% CI [2.13–3.53] and type of therapy (e.g., operation OR 0.91, 95% CI [0.72–1.15]). Sexual problems were further associated with elevated levels of anxiety, OR 1.05, 95% CI [1.02–1.10], less social support, OR 0.93, 95% CI [0.90–0.97] and lower quality of life in terms of impaired functioning (e.g., social function, OR 0.99, 95% CI [0.99–1.00]). Conclusions Sexual problems are commonly reported by patients. Male patients and those living with a partner are more likely to report sexual problems. Sexual problems are associated with different aspects of well-being. The findings imply the practical relevance to screen for sexual problems among patients and identified groups that should be particularly monitored.
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Affiliation(s)
- Svenja Heyne
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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Wang J, Zhao J, Zhang C, Zhang Y, Jiang N, Wei X, Wang J, Yu J. Comorbidity, lifestyle factors, and sexual satisfaction among Chinese cancer survivors. Cancer Med 2021; 10:6058-6069. [PMID: 34254466 PMCID: PMC8419754 DOI: 10.1002/cam4.4118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 04/05/2021] [Accepted: 06/13/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives This study aims to explore the prevalence of sexual satisfaction among Chinese cancer survivors, and explore the association of sexual satisfaction with comorbidity and lifestyle factors. Methods A cross‐sectional study was performed among 3996 Chinese cancer survivors recruited at Shanghai Cancer Rehabilitation Club from March to April 2017. Data were collected through self‐reported questionnaires. The questionnaire includes information about demographic, cancer characteristics, comorbidities, lifestyle factors, and sexual satisfaction. Sexual satisfaction was measured by a single‐item scale. The distribution of sexual satisfaction among different demographic and cancer characteristics was compared using the chi‐squared test. Logistic regression models were conducted to assess the effects of lifestyle factors, comorbidities on sexual satisfaction after adjustment for demographic and cancer characteristics. Results More than 40% of male and female cancer survivors reported no sexual satisfaction. Sexual satisfaction of cancer survivors is significantly associated with both the number and the type of comorbidities. Heart disease, musculoskeletal system disease, diabetes, and hyperlipidemia are the comorbidities significantly associated with sexual satisfaction of cancer survivors. Lifestyle factors other than smoking, including exercise or fitness, drinking alcohol, and eating fruits and vegetables are significantly correlated with sexual satisfaction. Besides, all of the above associations show gender differences. In addition, demographic characteristics include sex, age, marital status, living status, and average monthly income are also significantly associated with sexual satisfaction of cancer survivors. Conclusion Comorbidity and lifestyle factors are associated with sexual satisfaction of cancer survivors, and the associations show gender differences. Improving the lifestyles of cancer survivors, and controlling and reducing their comorbidities are important for improving their sexual satisfaction. This study aims to investigate the prevalence of sexual satisfaction among Chinese cancer survivors, and explore the association of sexual satisfaction with comorbidity and lifestyle factors. Comorbidity and lifestyle factors are associated with sexual satisfaction of cancer survivors, and the associations show gender differences. Improving the lifestyles of cancer survivors, and controlling and reducing their comorbidities are important for improving their sexual satisfaction.
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Affiliation(s)
- Jingya Wang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Jie Zhao
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Chenggang Zhang
- Shanghai Xuhui Centre for Disease Control and Prevention, Shanghai, China
| | - Yuxin Zhang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Nan Jiang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Xiaomin Wei
- Shanghai Health Promotion Center, Shanghai, China
| | - Jiwei Wang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Jinming Yu
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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Grabovac I, Koyanagi A, Yang L, López-Sánchez GF, McDermott D, Soysal P, Turan Isik A, Veronese N, Smith L. Prospective associations between alcohol use, binge drinking and sexual activity in older adults: the English Longitudinal Study Of Ageing. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2019.1687581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University Vienna, Vienna, Austria
| | - Ai Koyanagi
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | | | - Daragh McDermott
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ahmet Turan Isik
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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15
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Male sexual dysfunction and rehabilitation strategies in the settings of salvage prostate cancer treatment. Int J Impot Res 2021; 33:457-463. [PMID: 33854206 DOI: 10.1038/s41443-021-00437-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/08/2022]
Abstract
Male sexual dysfunction, a common sequela following primary prostate cancer (PC) treatment, is likely to be more significant following salvage PC therapy. In general, these impairments in sexual domains can be divided into three groups, namely (1) sexual desire, sexuality and masculinity; (2) erectile function (EF); and (3) ejaculation and orgasm. However, there is considerable overlap between these sexual domains and male sexual response cycle, and various factors such as cancer status, mental well-being, medical conditions and social circumstances can adversely impact on the male sexual function. While several preventive and treatment strategies for the preservation and recovery of sexual function are available, there is limited consensus guidelines exist regarding the optimal rehabilitation or treatment protocol for men with sexual dysfunction following salvage therapy. While penile rehabilitation may be effective to restore erectile function and the ability to have coital sex, there is lack of effective treatments in other domains of male sexual function, thereby underscoring the importance of psychological and sexual counselling in sexual rehabilitation. Indeed, a comprehensive multidisciplinary approach is necessary to better understand and optimally assist and manage the men and their respective partners for better sexual health and activity.
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16
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McGrath M, Low MA, Power E, McCluskey A, Lever S. Addressing Sexuality Among People Living With Chronic Disease and Disability: A Systematic Mixed Methods Review of Knowledge, Attitudes, and Practices of Health Care Professionals. Arch Phys Med Rehabil 2020; 102:999-1010. [PMID: 33045226 DOI: 10.1016/j.apmr.2020.09.379] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To systematically review health care professionals' practices and attitudes toward addressing sexuality with people who are living with chronic disease and disability. DATA SOURCES Scopus, PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health, Allied and Complementary Medicine Database, and MEDLINE were searched to August 2020 for English language publications. Reference lists of relevant publications were also searched. STUDY SELECTION Eligible studies reported on knowledge, attitudes, and behaviors of health care professionals about addressing sexuality in the context of chronic disease and disability. The search yielded 2492 records; 187 full texts were assessed for eligibility and 114 documents were included (103 unique studies). Study quality was rated using the Mixed Methods Appraisal Tool. DATA EXTRACTION Characteristics of included studies were recorded independently by 2 authors. Differences were resolved through discussion or by a third author. DATA SYNTHESIS A sequential, exploratory mixed studies approach was used for synthesis. Pooled analysis showed that 14.2% (95% CI, 10.6-18.9 [I2=94.8%, P<.001]) of health professionals report routinely asking questions or providing information about sexuality. Professionals reported limited confidence, competence, and/or comfort when initiating conversations about sexuality or responding to patient questions. Sexual rehabilitation typically focused on the effect of disease, disability, and medication on sexual function. Broader dimensions of sexuality were rarely addressed. CONCLUSION Despite recognizing the value of sexuality to health and well-being, most health professionals regardless of clinical context fail to routinely include assessment of sexuality in their practice. Professionals have limited knowledge and confidence when addressing sexuality and experience significant discomfort when raising this topic with people living with chronic disease and disability. Multicomponent implementation programs are needed to improve health professionals' knowledge, competence, and comfort when addressing sexuality for people living with chronic disease and disability.
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Affiliation(s)
- Margaret McGrath
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Michelle Anne Low
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma Power
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Annie McCluskey
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; The StrokeEd Collaboration, Sydney, Australia
| | - Sandra Lever
- Graythwaite Rehabilitation Centre, Ryde Hospital, Sydney, Australia; Susan Wakil School of Nursing and Midwifery (Sydney Nursing School), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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17
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Arthur EK, Worly B, Carpenter KM, Postl C, Rosko AE, Krok-Schoen JL, Quick AM, Jenkins LC. Let's get it on: Addressing sex and intimacy in older cancer survivors. J Geriatr Oncol 2020; 12:312-315. [PMID: 32912736 DOI: 10.1016/j.jgo.2020.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Elizabeth K Arthur
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University College of Nursing, 1585 Neil Ave., Columbus, OH 43210, USA.
| | - Brett Worly
- The Ohio State University College of Medicine, 395 W. 12(th) Avenue, Columbus, OH 43210, USA; The Ohio State University Wexner Medical Center, 410 W 10(th) Ave., Columbus, OH 43210, USA.
| | - Kristen M Carpenter
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University Wexner Medical Center, 410 W 10(th) Ave., Columbus, OH 43210, USA.
| | - Claire Postl
- The Ohio State University Wexner Medical Center, 410 W 10(th) Ave., Columbus, OH 43210, USA.
| | - Ashley E Rosko
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University College of Medicine, 395 W. 12(th) Avenue, Columbus, OH 43210, USA.
| | - Jessica L Krok-Schoen
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10(th) Ave., Columbus, OH 43210, USA.
| | - Allison M Quick
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University College of Medicine, 395 W. 12(th) Avenue, Columbus, OH 43210, USA.
| | - Lawrence C Jenkins
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University College of Medicine, 395 W. 12(th) Avenue, Columbus, OH 43210, USA.
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18
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Sexuality After Treatment of Diffuse Large B-cell Lymphoma: Patients' Experiences and Psychometric Testing of the Sexual Adjustment Questionnaire-Swedish Version II. Cancer Nurs 2020; 44:499-508. [PMID: 32804757 PMCID: PMC8560151 DOI: 10.1097/ncc.0000000000000866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Sexuality is an important part of health-related quality of life. To ensure adequate supportive interventions, valid and reliable instruments specific to sexual changes and adjustments after cancer treatment are needed. Objectives The aims of this study were to test the psychometric properties of the Sexual Adjustment Questionnaire-Swedish version II (SAQ-SII) in patients treated for diffuse large B-cell lymphoma and to describe and explore patients' experiences of sexuality after treatment. Methods A cross-sectional study was conducted in 2019, using SAQ-SII and data from the National Quality Registry for Leukemia–subregistry for Lymphoma, which included 257 patients (25% response rate). An exploratory factor analysis was performed for psychometric evaluation. Internal consistency was assessed by Cronbach's α. Independent t tests, analysis of variance, and multiple regression were used to describe patients' experiences of sexuality. Results The exploratory factor analysis resulted in a 4-factor structure, explaining 65.7% of the total scale variance (SAQ-SII). The Cronbach's α for the SAQ-SII was 0.88 and varied between 0.70 and 0.89 across subscales. Sexuality was affected in various ways and extent. Sexual Interest was most affected, whereas Sexual Function was least affected. Being male, of younger age, without comorbidities, and in a relationship were associated to a higher Sexual Interest. Conclusions The SAQ-SII is a valid and reliable instrument to measure changes and adjustments in sexuality in patients treated for lymphoma. Implications for Practice Assessments of sexuality in a broad sense should be an integrated part of cancer care to ensure timely interventions for those who need and want support.
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Tran B, Vajdic CM, Webber K, Laaksonen MA, Stavrou EP, Tiller K, Suchy S, Bosco AM, Harris MF, Lloyd AR, Goldstein D. Self-reported health, lifestyle and social circumstances of Australian adult cancer survivors: A propensity score weighted cross-sectional study. Cancer Epidemiol 2020; 67:101773. [PMID: 32615538 DOI: 10.1016/j.canep.2020.101773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/19/2020] [Accepted: 06/21/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND With the prevalence of cancer survivors increasing, their unique needs must be better understood. We examined the health, lifestyles and social circumstances of adults with and without a history of cancer. METHODS We performed a cross-sectional study, using exposure and outcome data from the baseline survey (2006-2009) of participants in the 45 and Up Study, a prospective cohort study in New South Wales, Australia. We compared 20,811 cancer registry-verified adult cancer survivors with 207,148 participants without a history of cancer using propensity score weighting and accounting for multiple testing. The propensity weighting included age, sociodemographic factors and number of self-reported co-morbidities. RESULTS Cancer survivors were more likely to report poorer physical and psychological health and quality of life compared to those without a cancer history, with most deficits still evident more than 10 years after cancer diagnosis. Cancer survivors were more likely to have a higher body mass index, but were less likely to smoke. Cancer survivors had greater functional limitations, including sexual, and were less likely to work full time, volunteer and spend time outdoors. Their social connectedness was, however, similar. Those with haematological cancer, lung cancer, or distant metastases, and those diagnosed at an older age, had the greatest health deficits and functional limitations. CONCLUSIONS A history of cancer is associated with poorer health and less paid and unpaid work. Our findings reinforce the importance of routine long-term, integrated multidisciplinary care for cancer survivors and indicate the subgroups with the greatest unmet needs.
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Affiliation(s)
- Bich Tran
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
| | - Kate Webber
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia; Department of Oncology, Monash Health, Melbourne, Australia; School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Maarit A Laaksonen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Efty P Stavrou
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | | | - Sue Suchy
- Consumer Advisory Panel, Translational Cancer Research Network, Sydney, Australia
| | - Ann Marie Bosco
- Prince of Wales Hospital, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Mark F Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Andrew R Lloyd
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - David Goldstein
- Department of Medical Oncology, Nelune Cancer Centre, Prince of Wales Hospital, Sydney, Australia
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20
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Yan R, Yu J, Tanimoto T, Ozaki A, Lu X, Che B, Zhang Y, Chen P, Wang J. The relationship between sexual activity and sexual attitudes among breast cancer survivors in China. Cancer Med 2020; 9:3425-3436. [PMID: 32207884 PMCID: PMC7221310 DOI: 10.1002/cam4.2874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/23/2019] [Accepted: 01/11/2020] [Indexed: 12/29/2022] Open
Abstract
Purpose Less is known about sexual attitudes of breast cancer survivors (BCSs) and its association with sexual activity and sexual dissatisfaction. Methods We investigated the proportion of sexual activity and sexual dissatisfaction in a cross‐sectional study among 341 Chinese BCSs aged 30‐75 years old, and we described their association with sexual attitudes, as well as socio‐demographic characteristics, physical health conditions, and mental health problems. Results Only 83 (24.3%) individuals reported sexual activity in the past year. More than 50% of BCSs considered that sexual activity had adverse impact on their disease recovery. The sexual attitudes such as “sexual activity may impede disease recovery” (adjusted odds ratio [AOR] = 0.51; 95% confidence interval, 95% CI: 0.30‐0.88), “sexual activity may cause cancer recurrence or metastasizes” (AOR = 0.51; 95% CI: 0.30‐0.87), and “their partner fear contracting cancer by sexuality” (AOR = 0.47; 95% CI: 0.23‐0.98) were significantly associated with decreased likelihood of reporting sexual activity in the past year. Although 201 (58.9%) BCSs reported that breast cancer decreased the frequency of their sexual activity, only 37 (10.9%) had ever discussed sexuality with a doctor to seek advice. Conclusions Most Chinese BCSs were sexually inactive. The sexual misconceptions about cancer were great barriers of sexual activity. Professional sexual education and consultation may be regarded as easy and effective intervention measures to correct BCSs' misguided sexual attitudes, and finally improving the overall sexual health for BCSs.
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Affiliation(s)
- Rui Yan
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Jinming Yu
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Tokyo, Japan.,Jyoban Hospital of Tokiwa Foundation, Fukuhsima, Japan
| | - Akihhiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan.,Jyoban Hospital of Tokiwa Foundation, Fukuhsima, Japan
| | - Xinyuan Lu
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Beibei Che
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Yaxuan Zhang
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Panzhen Chen
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
| | - Jiwei Wang
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China
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21
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Wong ML, Cooper BA, Paul SM, Abrams G, Topp K, Kober KM, Chesney MA, Mazor M, Schumacher MA, Conley YP, Levine JD, Miaskowski C. Age-related differences in patient-reported and objective measures of chemotherapy-induced peripheral neuropathy among cancer survivors. Support Care Cancer 2019; 27:3905-3912. [PMID: 30770977 PMCID: PMC6697247 DOI: 10.1007/s00520-019-04695-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 02/07/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE While older adults with cancer are more likely to develop chemotherapy-induced peripheral neuropathy (CIPN), the study aimed to determine if patient-reported and objective measures of CIPN differ by age among cancer survivors. METHODS Cancer survivors with persistent CIPN after completion of platinum and/or taxane chemotherapy completed CIPN questionnaires (severity, interference with activities, sensory, and motor symptoms) and objective testing (light touch, vibration, pain, cold sensation). CIPN measures were compared by age group (< 65 n = 260 versus ≥ 65 n = 165) using parametric and nonparametric tests. RESULTS Among 425 cancer survivors with CIPN, mean age was 60.9 (SD 10.5). CIPN location did not differ by age (overall 68% hands and feet, 27% only feet, 5% only hands). For patient-reported measures, older survivors reported less severe pain in the hands and feet than younger survivors. In addition, older survivors reported lower interference with general activity, routine activities, normal work, enjoyment of life, sleep, mood, relations with other people, and sexual activity. No age differences in sensory and motor symptom scores were found. In contrast, for objective measures, older survivors had worse light touch and cold sensations in their feet and worse vibration detection in their hands and feet. CONCLUSIONS Despite having worse light touch, cold, and vibration sensations, older cancer survivors with CIPN reported less severe pain and interference with activities. This discordance highlights the importance of including both patient-reported and objective measures to assess CIPN in cancer survivors to better evaluate this clinical condition.
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Affiliation(s)
- Melisa L Wong
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA, 94115, USA.
| | - Bruce A Cooper
- School of Nursing Office of Research, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Steven M Paul
- School of Nursing Office of Research, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Gary Abrams
- Department of Neurology, University of California, San Francisco, 400 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Kimberly Topp
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, 513 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Kord M Kober
- Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Margaret A Chesney
- Osher Center for Integrative Medicine, University of California, San Francisco, 1545 Divisadero Street, San Francisco, CA, 94143, USA
| | - Melissa Mazor
- Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Mark A Schumacher
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, 513 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA, 15261, USA
| | - Jon D Levine
- Department of Oral and Maxillofacial Surgery, University of California, San Francisco, 513 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Christine Miaskowski
- Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
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Well-Being Among Older Gay and Bisexual Men and Women in England: A Cross-sectional Population Study. J Am Med Dir Assoc 2019; 20:1080-1085.e1. [DOI: 10.1016/j.jamda.2019.01.119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/03/2019] [Accepted: 01/05/2019] [Indexed: 12/14/2022]
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23
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Bober SL, Kingsberg SA, Faubion SS. Sexual function after cancer: paying the price of survivorship. Climacteric 2019; 22:558-564. [PMID: 31090466 DOI: 10.1080/13697137.2019.1606796] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Sexual dysfunction is one of the most prevalent and distressing treatment side effects for millions of female cancer survivors, yet the majority of survivors do not receive necessary information, support, or treatment for these sexual consequences. Cancer can devastate the body and impair sexual function and body image. Furthermore, all primary modalities of cancer treatment (surgery, radiotherapy, chemotherapy, and hormonal therapy) have the potential to negatively impact sexual function. Assessment and identification by clinicians can be done efficiently and easily with short validated tools using a style of inquiry which starts by acknowledging how common sexual dysfunction is amongst cancer survivors rather than asking direct questions. Sexual concerns are impacted by psychological, biological, and interpersonal factors, and a multidisciplinary approach to treatment allows clinicians to comfortably inquire, assess, and refer if treatment is beyond their comfort or expertise.
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Affiliation(s)
- S L Bober
- Dana-Farber Cancer Institute, Brigham and Women's Hospital , Boston , MA , USA.,Department of Psychosocial Oncology and Palliative Care, Harvard Medical School , Boston , MA , USA
| | - S A Kingsberg
- Department of Obstetrics and Gynecology, MacDonald Women's Hospital, University Hospitals Cleveland Medical Center , Cleveland , OH , USA
| | - S S Faubion
- Mayo Clinic Center for Women's Health and Department of General Internal Medicine, Mayo Clinic , Rochester , MN , USA
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24
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Windon MJ, D’Souza G, Faraji F, Troy T, Koch WM, Gourin CG, Kiess AP, Pitman K, Eisele DW, Fakhry C. Priorities, concerns, and regret among patients with head and neck cancer. Cancer 2019; 125:1281-1289. [PMID: 30645761 PMCID: PMC6443481 DOI: 10.1002/cncr.31920] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/02/2018] [Accepted: 11/06/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND In the era of deintensification, little data are available regarding patients' treatment preferences. The current study evaluated treatment-related priorities, concerns, and regret among patients with head and neck squamous cell cancer (HNSCC). METHODS A total of 150 patients with HNSCC ranked the importance of 10 nononcologic treatment goals relative to the oncologic goals of cure and survival. The level of concern regarding 11 issues and decision regret was recorded. Median rank was reported overall, and factors associated with odds of rank as a top 3 priority were modeled using logistic regression. RESULTS Among the treatment effects analyzed, the odds of being a top 3 priority was especially high for cure (odds, 9.17; 95% confidence interval [95% CI], 5.05-16.63), followed by survival and swallow (odds, 1.26 [95% CI, 0.88-1.80] and odds, 0.85 [95% CI, 0.59-1.21], respectively). Prioritization of cure, survival, and swallow was similar based on human papillomavirus (HPV) tumor status. By increasing decade of age, older participants were found to be significantly less likely than younger individuals to prioritize survival (odds ratio, 0.72; 95% CI, 0.52-1.00). Concerns regarding mortality (P = .04) and transmission of HPV to the patient's spouse (P = .03) were more frequent among participants with HPV-associated HNSCC. Regret increased with additional treatment modalities (P = .02). CONCLUSIONS Patients with HNSCC overwhelming prioritize cure, followed by survival and swallow. The decreased prioritization of survival by older age supports further examination of treatment preference by age. The precedence of oncologic over nononcologic priorities among patients regardless of HPV tumor status supports the conservative adoption of deintensification regimens until the interplay between competing oncologic and nononcologic treatment goals is better understood.
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Affiliation(s)
- Melina J. Windon
- Department of Otolaryngology-Head and Neck Surgery, Johns
Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Gypsyamber D’Souza
- Department of Otolaryngology-Head and Neck Surgery, Johns
Hopkins School of Medicine, Baltimore, Maryland, United States
- Department of Epidemiology, Johns Hopkins University
Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Farhoud Faraji
- Department of Otolaryngology-Head and Neck Surgery, Johns
Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Tanya Troy
- Department of Epidemiology, Johns Hopkins University
Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Wayne M. Koch
- Department of Otolaryngology-Head and Neck Surgery, Johns
Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Christine G. Gourin
- Department of Otolaryngology-Head and Neck Surgery, Johns
Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Ana P. Kiess
- Department of Radiation Oncology and Molecular Sciences,
Johns Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Karen Pitman
- Department of Otolaryngology-Head and Neck Surgery, Johns
Hopkins School of Medicine, Baltimore, Maryland, United States
| | - David W. Eisele
- Department of Otolaryngology-Head and Neck Surgery, Johns
Hopkins School of Medicine, Baltimore, Maryland, United States
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns
Hopkins School of Medicine, Baltimore, Maryland, United States
- Department of Epidemiology, Johns Hopkins University
Bloomberg School of Public Health, Baltimore, Maryland, United States
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Sidney
Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore,
Maryland, United States
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26
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Maree J, Fitch MI. Holding conversations with cancer patients about sexuality: Perspectives from Canadian and African healthcare professionals. Can Oncol Nurs J 2019; 29:64-69. [PMID: 31148617 PMCID: PMC6516239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Cancer treatment can have a significant impact on an individual's sexuality. However, cancer survivors are reporting that very few healthcare professionals are talking with them about the topic. This work was undertaken to gain an increased understanding about the dialogue between cancer care professionals and cancer patients regarding the topic of sexuality. It was anticipated the effort would allow the identification of barriers that could limit dialogue between patients and healthcare providers, as well as offer insight regarding how to overcome such barriers in busy clinical settings. A Canadian sample of 34 healthcare professionals were interviewed and 27 African nurses engaged in a focus group discussion. A content analysis revealed similarities in terms of personal discomfort with the topic and feeling unprepared to discuss it with patients. There were notable differences between the two samples in terms of the barriers related to culture and tradition. African nurses reported significant cultural barriers, stigma and discrimination influencing conversations about sexuality with cancer patients in contrast to their Canadian counterparts.
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Affiliation(s)
- Johanna Maree
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Margaret I Fitch
- L Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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27
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Maree J, Fitch MI. [Not Available]. Can Oncol Nurs J 2019; 29:70-76. [PMID: 31148647 PMCID: PMC6516237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Le traitement du cancer peut grandement affecter la vie sexuelle d’une personne. Pourtant, les survivants du cancer signalent que très peu de professionnels de la santé abordent le sujet. Ces travaux ont été entrepris afin de mieux comprendre le dialogue entre les professionnels de la santé et les patients atteints de cancer au sujet de la sexualité. Ils visaient à identifier les obstacles au dialogue entre les patients et les fournisseurs de soins de santé et à proposer des façons de surmonter ces obstacles, dans des milieux cliniques achalandés. Au total, 34 professionnels de la santé du Canada et 27 infirmières d’Afrique ont pris part au groupe de discussion. Une analyse de contenu a révélé des similitudes en matière d’inconfort personnel face au sujet de discussion et au fait de ne pas se sentir prêt à en discuter avec les patients. Des différences marquées ont été notées entre les deux échantillons en ce qui a trait aux obstacles reliés à la culture et aux traditions. Les infirmières d’Afrique ont mentionné que des obstacles culturels importants, de la stigmatisation et de la discrimination influencent les discussions sur la sexualité avec les patients atteints de cancer, contrairement à leurs homologues du Canada.
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Affiliation(s)
- Johanna Maree
- Département des sciences infirmières, Faculté des sciences de la santé, Université du Witwatersrand, Johannesburg, Afrique du Sud
| | - Margaret I Fitch
- Faculté des sciences infirmières Lawrence S. Bloomberg, Université de Toronto, Toronto, Canada
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Soleimani MA, Bahrami N, Yaghoobzadeh A, Parker A, Chan YH. Sexual distress and sexual function in a sample of Iranian women with gynecologic cancers. Eur J Oncol Nurs 2018; 35:47-53. [DOI: 10.1016/j.ejon.2018.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 04/06/2018] [Accepted: 05/14/2018] [Indexed: 02/07/2023]
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Birke H, Ekholm O, Højsted J, Sjøgren P, Kurita GP. Chronic Pain, Opioid Therapy, Sexual Desire, and Satisfaction in Sexual Life: A Population-Based Survey. PAIN MEDICINE 2018; 20:1132-1140. [DOI: 10.1093/pm/pny122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jette Højsted
- Multidisciplinary Pain Centre, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Per Sjøgren
- Department of Oncology
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Geana Paula Kurita
- Department of Oncology
- Multidisciplinary Pain Centre, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
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30
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Yoo KH, Kang D, Kim IR, Choi EK, Kim JS, Yoon SS, Lee CH, Park S, Kim SJ, Kim K, Kim WS, Jung CW, Choi HJ, Jang JH, Cho J. Satisfaction with sexual activity and sexual dysfunction in hematopoietic stem cell transplantation survivors and their partners: a couple study. Bone Marrow Transplant 2018; 53:967-976. [PMID: 29403022 DOI: 10.1038/s41409-018-0097-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 12/03/2017] [Accepted: 12/23/2017] [Indexed: 11/09/2022]
Abstract
Sexual dysfunction is a common long-term complication of hematopoietic stem cell transplantation (HSCT). We assessed the extent to which HSCT survivors and their partners agree on the importance of and satisfaction with sexual activity and causes of sexual dysfunction, using a cross-sectional survey. Ratings of the importance of sexual activity were significantly higher in survivors than those of partners (2.57 vs. 2.14, P < 0.01). More survivors (48.4%) tried to discuss about sexuality with their partners than partners themselves (23.1%, P < 0.01). Male survivors were more likely to be sexually active than female survivors (odds ratio [OR] 5.04, 95% CI 1.85, 13.74). While 23.3 and 38% of male survivors and partners reported "rejection of partners" as a cause of sexual dysfunction, only 13.3% and none of female partners and survivors pointed this as a cause of sexual dysfunction respectively. There was poor concordance between survivors and partners in attitudes toward sexuality, satisfaction with sexual activity, and causes of sexual dysfunction. Couples who considered adequate sexual activity important were more likely to be sexually active than those who did not (OR 5.53, 95% CI 1.18, 25.89). Our study highlights the need for providing information and counselling about sexuality both to survivors and partners.
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Affiliation(s)
- Kwai Han Yoo
- Division of Hematology and Oncology, Department of Medicine,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Division of Hematology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Im-Ryung Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eun-Kyung Choi
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | | | - Silvia Park
- Division of Hematology and Oncology, Department of Medicine,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Kim
- Division of Hematology and Oncology, Department of Medicine,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kihyun Kim
- Division of Hematology and Oncology, Department of Medicine,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won Seog Kim
- Division of Hematology and Oncology, Department of Medicine,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chul Won Jung
- Division of Hematology and Oncology, Department of Medicine,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Jin Choi
- Division of Hematology and Oncology, Department of Medicine,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jun Ho Jang
- Division of Hematology and Oncology, Department of Medicine,Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea. .,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Departments of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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31
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Shahbazi M, Holzberg S, Thirunavukkarasu S, Ciani G. Perceptions of sexuality in individuals with Amyotrophic Lateral Sclerosis (ALS) and their treating clinicians. NeuroRehabilitation 2017; 41:331-342. [DOI: 10.3233/nre-172204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Mona Shahbazi
- Department of Neurology, Hospital for Special Surgery, New York, NY, USA
| | - Shara Holzberg
- Department of Neurology, Hospital for Special Surgery, New York, NY, USA
| | | | - Gioia Ciani
- Department of Health Professions, Hofstra University, Hempstead, NY, USA
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32
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Denlinger CS, Sanft T, Baker KS, Baxi S, Broderick G, Demark-Wahnefried W, Friedman DL, Goldman M, Hudson M, Khakpour N, King A, Koura D, Kvale E, Lally RM, Langbaum TS, Melisko M, Montoya JG, Mooney K, Moslehi JJ, O'Connor T, Overholser L, Paskett ED, Peppercorn J, Rodriguez MA, Ruddy KJ, Silverman P, Smith S, Syrjala KL, Tevaarwerk A, Urba SG, Wakabayashi MT, Zee P, Freedman-Cass DA, McMillian NR. Survivorship, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2017; 15:1140-1163. [PMID: 28874599 PMCID: PMC5865602 DOI: 10.6004/jnccn.2017.0146] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Many cancer survivors experience menopausal symptoms, including female survivors taking aromatase inhibitors or with a history of oophorectomy or chemotherapy, and male survivors who received or are receiving androgen-ablative therapies. Sexual dysfunction is also common in cancer survivors. Sexual dysfunction and menopause-related symptoms can increase distress and have a significant negative impact on quality of life. This portion of the NCCN Guidelines for Survivorship provide recommendations for screening, evaluation, and treatment of sexual dysfunction and menopausal symptoms to help healthcare professionals who work with survivors of adult-onset cancer in the posttreatment period.
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Jackson SE, Steptoe A, Fisher A. Reply to Sexual quality of life in the cancer continuum. Cancer 2017; 123:530-531. [PMID: 27893930 DOI: 10.1002/cncr.30447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 10/18/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Sarah E Jackson
- Department of Epidemiology and Public Health, University College LondonLondon, United Kingdom
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College LondonLondon, United Kingdom
| | - Abigail Fisher
- Department of Epidemiology and Public Health, University College LondonLondon, United Kingdom
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34
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Srilatha B, Leong JC, Ong YJ. Sexual quality of life in the cancer continuum. Cancer 2017; 123:529-530. [DOI: 10.1002/cncr.30448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 10/18/2016] [Indexed: 11/12/2022]
Affiliation(s)
| | | | - Yew Jin Ong
- Rehabilitation Center Singapore Cancer Society; Singapore
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