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Tian Z, Xiaolu Z, Jing Y, Min W, Jiaqian L, Shouli C, Yingyin W, Xiaoyuan D, Xiaoyan L, Guorong W. A longitudinal study of sexual activity and influencing factors in breast cancer patients during treatment in the Southwest of China: a trajectory analysis model. BMC Womens Health 2024; 24:352. [PMID: 38890676 PMCID: PMC11184704 DOI: 10.1186/s12905-024-03150-8] [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: 01/08/2023] [Accepted: 05/16/2024] [Indexed: 06/20/2024] Open
Abstract
PURPOSE The aim of this study was to describe the longitudinal developmental trajectories and its influencing factors of sexual activity in patients with breast cancer during treatment. METHODS A prospective longitudinal study was conducted, including 225 newly diagnosed breast cancer patients in A tumor specialty three-class hospital in Southwest China. We measured sexual activity at the time of admission and diagnosis (T0) and one month (T1), three months (T2), six months (T3), and nine months (T4) after diagnosis. A trajectory analysis model (GBTM) was used to explore the changes in sexual activity in breast cancer patients. Multivariate binary logistic regression analysis was used to analyse the factors that affected the classification of sexual activity trajectories. RESULTS The ratio of sexual activity abruptly declined from 100% at baseline to 39.1% at T1. The percentage of sexual activity was improved, from 51.4% at T2 to 63.1% at T4. The optimal model was a 2-group trajectory of sexual activity in breast cancer patients,36.6% in the "low activity group" and 63.4% in the "high activity group." The multivariate binary logistic regression analysis revealed statistically significant and positive correlations between sexual activity and age (β = 0.085, OR = 1.089, 95%CI 1.035 ∼ 1.145, P = 0.001),libido(β = 0.774, OR = 2.168, 95%CI 1.337 ∼ 3.515, P = 0.002), vaginal lubrication(β = 1.254, OR = 33.503, 95%CI 2.000 ∼ 6.137, P<0.001). CONCLUSIONS Breast cancer patients exhibited varying levels of sexual activity during treatment; higher age was associated with increased sexual activity, which can contribute to the recovery of sexual function. Therefore, it is crucial to provide appropriate guidance on sexual health for younger patients.
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Affiliation(s)
- Zhang Tian
- Nursing Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China
| | - Zhang Xiaolu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yang Jing
- Ward 2, Breast Surgery Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China
| | - Wen Min
- Ward 2, Breast Surgery Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, China
| | - Liao Jiaqian
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Chen Shouli
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Wang Yingyin
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Deng Xiaoyuan
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, 610075, China
| | - Liu Xiaoyan
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Wang Guorong
- Nursing Department, West China School of Public Health and West China Fourth Hospital,West China Nursing School, Sichuan University, Chengdu, Sichuan, 610041, China.
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Liu K, Huang AL, Chen XQ, Wu SG. Patterns of distant metastasis and survival outcomes in de novo metastatic breast cancer according to age groups. Front Endocrinol (Lausanne) 2024; 15:1385756. [PMID: 38752173 PMCID: PMC11094241 DOI: 10.3389/fendo.2024.1385756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Background Is de novo metastatic breast cancer (dnMBC) the same disease in the elderly as in younger breast cancer remains unclear. This study aimed to determine the metastatic patterns and survival outcomes in dnMBC according to age groups. Methods We included patients from the Surveillance Epidemiology and End Results program. Chi-square test, multivariate logistic regression analyses, and multivariate Cox regression models were used for statistical analyses. Results A total of 17719 patients were included. There were 3.6% (n=638), 18.6% (n=3290), 38.0% (n=6725), and 39.9% (n=7066) of patients aged <35, 35-49, 50-64, and ≥65 years, respectively. Older patients had a significantly higher risk of lung metastasis and a significantly lower risk of liver metastasis. There were 19.1%, 25.6%, 30.9%, and 35.7% of patients with lung metastasis in those aged <35, 35-49, 50-64, and ≥65 years, respectively. Moreover, the proportion of liver metastasis was 37.6%, 29.5%, 26.3%, and 19.2%, respectively. Age was the independent prognostic factor associated with breast cancer-specific survival (BCSS) and overall survival (OS). Those aged 50-64 years had significantly inferior BCSS (P<0.001) and OS (P<0.001) than those aged <35 years. Patients aged ≥65 years also had significantly lower BCSS (P<0.001) and OS (P<0.001) than those aged <35 years. However, similar outcomes were found between those aged 35-49 and <35 years. Conclusion Our study suggests that different age groups may affect the metastatic patterns among patients with dnMBC and the survival of younger patients is more favorable than those of older patients.
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Affiliation(s)
- Ke Liu
- Xiamen Key Laboratory of Clinical Efficacy and Evidence Studies of Traditional Chinese Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - An-Le Huang
- Department of Gastrointestinal Oncology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xue-Qin Chen
- Xiamen Key Laboratory of Clinical Efficacy and Evidence Studies of Traditional Chinese Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - San-Gang Wu
- Department of Radiation Oncology, Xiamen Cancer Quality Control Center, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Franzoi MA, Aupomerol M, Havas J, Soldato D, Lambertini M, Massarotti C, Hang H, Pistilli B, Fasse L, Tredan O, Gillanders E, Joly F, Cottu P, Mouret-Reynier MA, Tarpin C, Arnaud A, Everhard S, Martin AL, Di Meglio A, Vaz-Luis I. Investigating sexual health after breast cancer by longitudinal assessment of patient-reported outcomes. ESMO Open 2024; 9:102236. [PMID: 38350335 PMCID: PMC10937197 DOI: 10.1016/j.esmoop.2024.102236] [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: 08/07/2023] [Revised: 11/28/2023] [Accepted: 01/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Sexual concerns are a major unaddressed need among survivors of breast cancer (BC) with significant negative effects on quality of life. We longitudinally analyzed sexual health over time, using patient-reported outcomes. METHODS Patients with stage I-III BC prospectively included from the CANcer TOxicity cohort (CANTO) provided data at diagnosis, then 1, 2, and 4 years afterward. Sexual concerns outcomes included poor body image (score ≤91/100), poor sexual functioning (≤16/100), poor sexual enjoyment (≤66/100), and sexual inactivity (EORTC QLQ-B23). Multivariate generalized estimating equation models assessed associations with sexual concerns after diagnosis, adjusting for age, sociodemographic, tumor, treatment, and clinical characteristics. RESULTS Nearly 78.1% among 7895 patients reported at least one sexual concern between diagnosis and 4 years' follow-up. Over time, the proportion of patients reporting sexual concerns either increased or remained constant with diagnosis. Less than half (46%, range 11.4-57) of the patients with sexual concerns reported the use of supportive care strategies, including gynecological or psychological consultations (range 11.4-57.4). Factors consistently associated with sexual concerns up to 4 years after diagnosis included already reporting the same concern at diagnosis [odds ratio (OR)poor body image 3.48 [95% confidence interval (CI) 3.11-3.89]; ORsexual inactivity 9.94 (95% CI 8.84-11.18), ORpoor sexual function 9.75 (95% CI 8.67-10.95), ORpoorsexual enjoyment 3.96 (95% CI 3.34-4.69)], endocrine therapy use [ORpoor body image 1.15 (95% CI 1.01-1.31); ORsexual inactivity 1.19 (95% CI 1.02-1.39), ORpoor sexual function 1.17 (95% CI 1.01-1.37), ORpoor sexual enjoyment 1.23 (95% CI 1.00-1.53)], and depression [ORpoor body image 2.00 (95% CI 1.72-2.34); ORsexual inactivity 1.66 (95% CI 1.40-1.97), ORpoor sexual function 1.69 (95% CI 1.43-2.00), ORpoor sexual enjoyment 1.94 (95% CI 1.50-2.51)]. Outcome-specific associations were also identified. CONCLUSIONS Sexual concerns seem frequent, persistent, and insufficiently addressed. Pretreatment concerns, endocrine therapy, and emotional distress are commonly associated factors. A proactive evaluation of sexual health across the care continuum is needed, to promptly identify patients suitable for multidisciplinary counseling, referral, and supportive interventions.
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Affiliation(s)
- M A Franzoi
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif.
| | - M Aupomerol
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - J Havas
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - D Soldato
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova; Gynecology Department, Policlinico San Martino, University of Genova, Genova; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova
| | - C Massarotti
- Physiopatology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Health (DiNOGMI department), School of Medicine, University of Genova, Genova, Italy
| | - H Hang
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - B Pistilli
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - L Fasse
- Interdisciplinary and Patient Pathway Department, Institut Gustave Roussy, Villejuif
| | | | - E Gillanders
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - F Joly
- Centre François Baclesse, Caen
| | | | | | - C Tarpin
- Institut Paoli Calmettes, Marseille
| | | | | | | | - A Di Meglio
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - I Vaz-Luis
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
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Turhal E, Koç Z. Sexual Function and Quality of Life Among Turkish Oncology Patients Receiving Chemotherapy. Semin Oncol Nurs 2023; 39:151401. [PMID: 36898936 DOI: 10.1016/j.soncn.2023.151401] [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: 11/02/2022] [Revised: 12/12/2022] [Accepted: 02/08/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE Sexual health and sexual function in oncology patients are inseparable elements of general quality of life and important indicators of emotional well-being. The aim of this study was to determine the relationship between the quality of life and sexual function of oncology patients receiving chemotherapy. DATA SOURCES This cross-sectional and correlational study was conducted within the chemotherapy unit of a university hospital between June 25, 2017, and June 21, 2018. A total of 410 oncology outpatients participated in this study. Data were collected using the FACT-G Quality of Life Evaluation Scale, the Arizona Sexual Experiences Scale, and the Edmonton Symptom Assessment Scale. CONCLUSION A negative and weak statistically significant relationship between the Arizona Sexual Experiences Scale total score and the FACT-G Quality of Life Evaluation Scale total score was found (r = -0.224, P < .01). The regression model where the FACT-G Quality of Life Evaluation Scale total scores (F = 3.263; P < .001) and Arizona Sexual Experiences Scale total scores (F = 8.937; P < .001) of the patients were taken as dependent variables and their sociodemographic and clinical characteristics were taken as independent variables was found to be statistically significant. IMPLICATION FOR NURSING PRACTICE Psychosocial and medical evaluation should be performed when a concern or problem regarding the sexual life of an oncology patient is detected. The sexual quality of life of oncology patients should be improved through sexual counseling and education. Patients and their families should be encouraged to participate in family support programs.
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Affiliation(s)
- Ebru Turhal
- Lecturer, Medical Simulation Center, Karadeniz Teknik University, Trabzon, Turkey
| | - Zeliha Koç
- Professor, Health Science Faculty, Ondokuz Mayıs University, Samsun, Turkey.
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Engstrom T, Tanner S, Lee WR, Forbes C, Walker R, Bradford N, Pole JD. Patient reported outcome measure domains and tools used among adolescents and young adults with cancer: A scoping review. Crit Rev Oncol Hematol 2023; 181:103867. [PMID: 36427770 DOI: 10.1016/j.critrevonc.2022.103867] [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: 09/27/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022] Open
Abstract
Adolescent and young adult (AYA) cancer patients and survivors are growing and face with distinct issues from paediatric and older cancer survivors. Hence it is important the issues they encounter are measured using appropriate Patient Reported Outcome Measures (PROMs). We searched PubMed, EMBASE, CINAHL, and PsycINFO for articles including: (1) AYAs (ages 15-39), (2) Malignant neoplasms, and (3) PROMs. This resulted in 3566 unique articles, 523 were included for full text review, of which 175 were included. These studies included 203 distinct tools to measure PROMs across 31 domains. Physical function was most frequently measured domain, followed by social, emotional and mental health. The most commonly used tools were the EORTC QLQ-C30, HADS and SF-36. PROMs used in AYA cancer patients is a complex topic, this comprehensive review serves as a useful reference for researchers, clinicians and health services who want to better understand, and improve, outcomes among their patients.
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Affiliation(s)
- Teyl Engstrom
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Sarah Tanner
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Wen Ray Lee
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Cheryl Forbes
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Rick Walker
- School of Medicine, The University of Queensland, Herston, QLD, Australia; Queensland Children's Hospital, Brisbane, QLD, Australia; Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Australia
| | - Jason D Pole
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia; The University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada.
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Maleki M, Mardani A, Ghafourifard M, Vaismoradi M. Changes and challenges in sexual life experienced by the husbands of women with breast cancer: a qualitative study. BMC Womens Health 2022; 22:326. [PMID: 35918700 PMCID: PMC9344622 DOI: 10.1186/s12905-022-01906-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/25/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breast cancer (BC) in women can bring various problems to their marital and family life. Sexual life based on the experiences of the husbands of women diagnosed with BC has not been fully understood. Therefore, this research aimed to explore changes and challenges in sexual life experienced by the husbands of women diagnosed with BC. METHODS A qualitative research was carried out on 18 men whose wives had been diagnosed with BC at reproductive age. They were selected using purposeful sampling and were interviewed using in-depth semi-structured interviews. Collected data were analyzed using the conventional content analysis method. RESULTS 'Sexual life suspension' was the main theme of this research. Also, 'unfulfilled sexual expectations', 'perceived barriers to satisfy sexual expectations', and 'efforts to adapt to sexual problems' were subthemes. CONCLUSIONS The husbands of women with BC need support to improve their sexual and marital relationships. Education and counseling about sexual life during the treatment of BC should be incorporated into the healthcare program.
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Affiliation(s)
- Maryam Maleki
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
- Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, University of Medical Sciences, Tehran, Iran
| | - Mansour Ghafourifard
- Department of Medical‐Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Chen B, Zhou B, Song G, Li H, Li R, Liu Z, Wei C, Wang T, Wang S, Ma D, Liu J, Yuan X, Liu X. Inflammatory bowel disease is associated with worse sexual function: a systematic review and meta-analysis. Transl Androl Urol 2022; 11:959-973. [PMID: 35958893 PMCID: PMC9360519 DOI: 10.21037/tau-22-190] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Several studies report that sexuality is often affected by inflammatory bowel diseases (IBD). The aim of this meta-analysis was to investigate the association between IBD and sexual function. Methods A literature search was conducted in PubMed, Web of Science, and EMBASE databases (up to September 1, 2020). Scores of sexual functions with a standard deviation and odds ratio (OR) or relative risk (RR) with a 95% CI were used to analysis the association between IBD and sexual function. Results Eleven studies with 7,018 male IBD cases and 1,803 female IBD cases were included in the meta-analysis. In male individuals, the pooled results revealed that IBD was significantly associated with impaired erectile function and poor sexual satisfaction (RR for erectile function =1.50, 95% CI: 1.22 to 1.84, P<0.0001; standard mean difference for sexual satisfaction =-0.24, 95% CI: -0.33 to -0.15, P<0.0001). And among female individuals, IBD had impact on most sub-domains of sexual function, except pains. Conclusions IBD is associated with worse sexual function. It has significant impact on erectile function and satisfaction for male individuals and has impact on most sub-domains of sexual function for female individuals.
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Affiliation(s)
- Bingliang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bingyan Zhou
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Center of Hirschsprung's disease and Allied Disorders, Wuhan, China
| | - Guoda Song
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Wei
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Delin Ma
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyi Yuan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaming Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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The mediating effect of pleasure and menopausal symptoms on sexual activity among young breast cancer survivors. Support Care Cancer 2022; 30:5085-5092. [PMID: 35218415 DOI: 10.1007/s00520-022-06923-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/15/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Young breast cancer survivors often go through a rapid change in menopause status due to cancer treatment and suffer from abrupt symptoms. This transition compels them to deal with unique medical and psychological side effects on their quality of life. One of the most affected quality of life domains is sexual functioning. This study explored the differences in frequency of sexual activity between young breast cancer survivors and young healthy women. It also examined whether this difference in sexual activity frequency was mediated by discomfort and/or pleasure during intercourse, both of which are affected by symptoms of premature menopause. METHODS A total of 97 young breast cancer survivors and 75 young healthy women completed a sociodemographic questionnaire: the Fallowfield's Sexual Activity Questionnaire (FSAQ) and the Menopausal Rating Scale (MRS). Additionally, the breast cancer participants completed a medical data questionnaire. RESULTS Findings revealed a significant direct effect between group and menopausal symptoms, menopausal symptoms and pleasure, and pleasure and frequency of sexual activity. Structural equation modeling explained the differences between the groups in frequency of sexual activity as mediated by menopausal symptoms and both pleasure and discomfort. CONCLUSIONS AND IMPLICATIONS These results highlight the impact of pleasure on the frequency of young breast cancer survivors' sexual activity, and its relation to menopausal symptoms. These young women should be provided with appropriate information and interventions that will help them experience increased pleasure during sexual activity despite their early and induced menopausal symptoms.
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Brajkovic L, Sladic P, Kopilaš V. Sexual Quality of Life in Women with Breast Cancer. Health Psychol Res 2021; 9:24512. [PMID: 34746481 DOI: 10.52965/001c.24512] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/06/2022] Open
Abstract
For women with breast cancer, sexual quality of life is one of the most disrupted aspects of life often associated with long-term physical and emotional difficulties. The main goal of this paper is to systematically review the literature to determine the level of sexual quality of life in women with breast cancer considering the individual and combined impact of grade, progression of the disease, type of treatment, body image, degree of depression, and anxiety, self-esteem, and social partner support and to determine whether the perception of the body, level of self-esteem and the presence of depressive and anxiety symptoms differ regarding different types of treatment or the level of partners' social support. Using the PRISMA method, all found literature published in electronic databases PubMed, EBSCO, and Hrcak were reviewed and resulted in 10 relevant scientific and review papers. The results showed that women with breast cancer reported disruption in their sexual quality of life. Among the types of treatment, mastectomy and chemotherapy proved to be the most important, while it is not possible to draw clear conclusions about degree and progression of the disease. Disturbed body image, depressive and anxiety symptoms, lower self-esteem, and inadequate social support of the partner are associated with a lower sexual quality of life. The discussion provides detailed explanations of these results and highlights implications for future research.
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Affiliation(s)
| | | | - Vanja Kopilaš
- Faculty of Croatian Studies, Department of psychology, University of Zagreb, Zagreb, Croatia; Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
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Purba DN, Setyowati S, Afiyanti Y. "DORLAN" Health Education in solving the physical and sexual problems of the gynecological cancer patients during chemotherapy. ENFERMERIA CLINICA 2021. [PMID: 33849165 DOI: 10.1016/j.enfcli.2020.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Gynecological cancer is one of the cancer types, which is deadly cancer among women. Chemotherapy is one of the medical treatment options to kill cancer cells. This study aimed to identify the effect of "DORLAN" Health Education on physical and sexual problems of gynecological cancer patients. Quasi-experimental pre-post-test with control group was used in this study. A sample of 94 women who were undergoing chemotherapy. Data collection was performed using demographic data questionnaires, a FACT-G questionnaire, a Sexual Satisfaction Scale for Women (SSS-W) questionnaire, and a Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire. The results of this study showed that the "DORLAN" Health Education Package significantly influenced the physical and sexual problems of gynecological cancer patients. "DORLAN" Health Education Package has a significant influence to solve the physical and sexual problems of women under chemotherapy treatment.
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Affiliation(s)
| | | | - Yati Afiyanti
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
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Cheng R, Kong X, Wang X, Fang Y, Wang J. Oncotype DX Breast Recurrence Score Distribution and Chemotherapy Benefit Among Women of Different Age Groups With HR-Positive, HER2-Negative, Node-Negative Breast Cancer in the SEER Database. Front Oncol 2020; 10:1583. [PMID: 33194568 PMCID: PMC7663955 DOI: 10.3389/fonc.2020.01583] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/22/2020] [Indexed: 11/16/2022] Open
Abstract
Objective: To explore the distribution of Oncotype DX Breast Recurrence Score (RS), the proportion of receiving chemotherapy, and the relationship between RS and chemotherapy benefit according to detailed age groups in women with hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-negative (HR+/HER2−/N0) breast cancer. Methods: This was an extensive, comprehensive, population-based retrospective study. Data on individuals with breast cancer were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program. The cohort was divided into five groups by age (≤ 35, 36–50, 51–65, 66–80, >80 years). RS distribution and chemotherapy proportion among different age groups were analyzed, and the overall survivals between patients receiving chemotherapy and those not/unknown were compared in each age group. Results: The study cohort comprised 49,539 patients and the largest age group was 51–65 years. The percentage of patients with low-risk RS (0–10) increased with age, whereas those with intermediate-risk RS (11–25) decreased with age (except for the group of 36–50 years, which had the highest rate of intermediate-risk RS). The age group ≤35 years has the greatest rate of high-risk RS (26–100). The proportion of receiving chemotherapy decreased with age in all RS risk categories. Overall survival was benefited by chemotherapy only in the age group of 66–80 years with intermediate- and high-risk RS, and chemotherapy seemed to do more harm than good for patients older than 80 years. Conclusions: In the present study, we identified the distribution of RS, the proportion of receiving chemotherapy, and the relationship between RS and chemotherapy benefit according to a detailed age grouping for women with HR+/HER2−/N0 breast cancer, which may help in making individualized clinical decisions.
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Affiliation(s)
- Ran Cheng
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyu Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Fang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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12
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Chovanec M, Vasilkova L, Petrikova L, Obertova J, Palacka P, Rejlekova K, Sycova-Mila Z, Kalavska K, Svetlovska D, Mladosievicova B, Mardiak J, Mego M. Long-term sexual functioning in germ-cell tumor survivors. BMC Cancer 2020; 20:779. [PMID: 32819309 PMCID: PMC7439516 DOI: 10.1186/s12885-020-07301-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 08/16/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Survivors of germ-cell tumors (GCT) may suffer from long-term adverse consequences. Our study was conducted to assess a long-term sexual functioning in GCT survivors. METHODS GCT survivors (N = 170) from the National Cancer Institute in Slovakia completed a Sexual Function Questionnaire that was modified from PROMIS Sexual Function and Satisfaction Questionnaire 9-year median follow up (range 5-32) as a primary exploratory aim. Study groups consisted of 17 survivors (10%) who had active surveillance (AS, controls), and 153 (90%) survivors who received treatment beyond orchiectomy (Tx), including cisplatin-based chemotherapy (CT, N = 132; 78%), radiotherapy to the retroperitoneal lymph nodes (RT, N = 12; 7%) or both (CTRT, N = 9; 5%). RESULTS In univariate analysis, treatment of any type resulted in difficulty to maintain erection during sexual intercourse compared to patients treated with AS (P = 0.04). Survivors who received CTRT had lower ability to achieve orgasm during sexual activities (P = 0.04) and they reported disappointment with their overall quality of sex life (P = 0.002). The number of attempts to initiate sexual intercourse did not differ. Sexual relationships caused none or mild anxiety and the desire to be sexually active was higher after CTRT (P = 0.05). Multivariable analysis confirmed that orgasmic dysfunction after ≥400 mg/m2 of cisplatin and issues in maintaining erection after Tx were independent of retroperitoneal lymph-node dissection (P = 0.03 and P = 0.04, respectively). Survivors were disappointed with the quality of sex life and had stronger desire to be sexually active independent of age, (P = 0.01 and P = 0.05, respectively). CONCLUSIONS This study identified an impairment in sexual function may represent an issue for long-term GCT survivors. Treatment with chemotherapy plus radiotherapy were associated with disappointment and stronger sexual desire, while a higher cumulative dose of cisplatin may be responsible for orgasmic dysfunction.
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Affiliation(s)
- M Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, Klenova 1, Bratislava, 833 10, Slovak Republic. .,2nd Department of Oncology, Faculty of Medicine, Translational Research Unit, Comenius University, Bratislava, Slovak Republic. .,Department of Medical Oncology, National Cancer Institute, Bratislava, Slovak Republic.
| | - L Vasilkova
- Department of Medical Oncology, National Cancer Institute, Bratislava, Slovak Republic.,Department of Psychology, Faculty of Philosophy, Comenius University, Bratislava, Slovak Republic
| | - L Petrikova
- Institute of Pathological Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic.,Department of Oncohematology I, Oncohematology Clinic, National Cancer Institute, Bratislava, Slovak Republic
| | - J Obertova
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, Klenova 1, Bratislava, 833 10, Slovak Republic.,Department of Medical Oncology, National Cancer Institute, Bratislava, Slovak Republic
| | - P Palacka
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, Klenova 1, Bratislava, 833 10, Slovak Republic.,Department of Medical Oncology, National Cancer Institute, Bratislava, Slovak Republic
| | - K Rejlekova
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, Klenova 1, Bratislava, 833 10, Slovak Republic.,Department of Medical Oncology, National Cancer Institute, Bratislava, Slovak Republic
| | - Z Sycova-Mila
- Department of Medical Oncology, National Cancer Institute, Bratislava, Slovak Republic
| | - K Kalavska
- 2nd Department of Oncology, Faculty of Medicine, Translational Research Unit, Comenius University, Bratislava, Slovak Republic
| | - D Svetlovska
- 2nd Department of Oncology, Faculty of Medicine, Translational Research Unit, Comenius University, Bratislava, Slovak Republic
| | - B Mladosievicova
- Institute of Pathological Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - J Mardiak
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, Klenova 1, Bratislava, 833 10, Slovak Republic.,Department of Medical Oncology, National Cancer Institute, Bratislava, Slovak Republic
| | - M Mego
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, Klenova 1, Bratislava, 833 10, Slovak Republic.,2nd Department of Oncology, Faculty of Medicine, Translational Research Unit, Comenius University, Bratislava, Slovak Republic.,Department of Medical Oncology, National Cancer Institute, Bratislava, Slovak Republic
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13
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Massarotti C, Scaruffi P, Lambertini M, Sozzi F, Remorgida V, Anserini P. Beyond fertility preservation: role of the oncofertility unit in the reproductive and gynecological follow-up of young cancer patients. Hum Reprod 2020; 34:1462-1469. [PMID: 31339999 DOI: 10.1093/humrep/dez108] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/26/2019] [Indexed: 12/31/2022] Open
Abstract
STUDY QUESTION Are there reasons that motivate young cancer survivors to ask for follow-up visits at an oncofertility unit? SUMMARY ANSWER Cancer survivors request oncofertility follow-up visits for the management of treatment-related side effects or ovarian reserve evaluation, even if not (or not yet) wishing for a pregnancy. WHAT IS KNOWN ALREADY Personalised oncofertility counselling before gonadotoxic therapies is considered standard of care for young women with newly diagnosed cancer. However, the long-term follow-up of these patients in an oncofertility unit is not described in the literature other than for the use of cryopreserved material. STUDY DESIGN, SIZE, DURATION We retrospectively examined rates and reasons for the first follow-up visits of 154 consecutive young female cancer patients (age range: 18-40 years) who underwent a pre-treatment consultation between January 2012 and June 2017. Demographic and clinical data were collected, as well as information about the chosen fertility preservation method, if any. PARTICIPANTS/MATERIALS, SETTING, METHODS Rates and reasons for follow-up visits were collected and expressed as percentages. Different reasons were examined in the whole cohort and stratified for type of malignancy. Possible predictive factors for return to the follow-up visit (age, nulliparity, presence of a partner, neoplasm, having cryopreserved material) were investigated through logistic regression. MAIN RESULTS AND THE ROLE OF CHANCE Out of 154 patients, 74 returned to the oncofertility unit (48.1%) for a follow-up visit. The first visit was requested mostly at the end of anticancer therapies (51.3% versus 40.5% during therapies and 8.1% after cancer relapse). Among these patients, only 10.8% returned for the first time because they were actively desiring a pregnancy. For the others, the most common reasons for consultations were management of gynecological adverse effects of therapies (29.7%) and evaluation of ovarian reserve not linked to an immediate desire for a pregnancy (39.2%). Other patients asked for contraception (4.1%), menopause counselling (5.4%), or new fertility preservation counselling because of cancer relapse (10.8%). None of the examined factors were significantly predictive of return to the oncofertility unit. LIMITATIONS, REASONS FOR CAUTION These findings represent the experience of a single centre. A longer duration of follow-up would be needed to provide more precise information on this regard. WIDER IMPLICATION OF THE FINDINGS The role of an oncofertility unit should not be limited to proposing fertility preservation procedures. In the management of young adult cancer patients, the reproductive medical specialist should be considered a key figure not only before but also during and after anticancer treatments to explore salient aspects of gynecological and reproductive health. STUDY FUNDING/COMPETING INTEREST(S) This research did not receive any specific funding. M.L. served as a consultant for Teva and received honoraria from Theramex outside the submitted work. The other authors declare no conflict of interest. TRIAL REGISTRATION NUMBER N.A.
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Affiliation(s)
- Claudia Massarotti
- Academic Unit of Obstetrics and Gynecology, DINOGMI Department, University of Genova, 16132, Genova, Italy
| | - Paola Scaruffi
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genova, Italy
| | - Matteo Lambertini
- Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, 16132, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, 16132, Genova, Italy
| | - Fausta Sozzi
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genova, Italy
| | - Valentino Remorgida
- Academic Unit of Obstetrics and Gynecology, DINOGMI Department, University of Genova, 16132, Genova, Italy
| | - Paola Anserini
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genova, Italy
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14
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Navigating sexual health in cancer survivorship: a dyadic perspective. Support Care Cancer 2020; 28:5429-5439. [PMID: 32157507 DOI: 10.1007/s00520-020-05396-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 03/04/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE This qualitative study examined how young adult breast cancer survivors (YABCS) and their partners appraised and managed their sexual health and intimate relationships after cancer. METHODS We conducted concurrent, individual telephone interviews with 25 YABCS and their male partners. We utilized a thematic, inductive analysis to examine individual interviews, followed by analysis within and across couples to identify dyadic themes. We explored how themes mapped on to the Theory of Dyadic Illness Management to build a conceptual model specific to the sexual health challenges of young adult couples living with cancer. RESULTS Our analysis revealed five interconnected themes: (1) shared understanding of physical and psychological challenges of sexual health after cancer, (2) navigating role shifts and changes to sexual relationship, (3) getting through it as a team, (4) maintaining open communication, and (5) need for services and support for partners/caregivers and couples. CONCLUSION Both survivors and their partners articulated physical (e.g., painful sex, decreased libido) and psychological (e.g., guilt, self-consciousness) challenges to their sexual health in survivorship. Our dyadic focus revealed a spectrum of ways that couples managed the changes to their relationships and sexual health, highlighting "open communication" and strategies for "working as a team" as critical. There is no "one size fits all" solution, as individuals and couples cope with and manage these challenges in different ways. Study results can inform couple-focused intervention strategies, such as creating shared understanding of sexual health after cancer and improving communication skills.
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15
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Newton HL, Friend AJ, Feltbower R, Hayden CJ, Picton HM, Glaser AW. Survival from cancer in young people: An overview of late effects focusing on reproductive health. Acta Obstet Gynecol Scand 2019; 98:573-582. [DOI: 10.1111/aogs.13584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/06/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Hannah L. Newton
- Reproduction and Early Development Group, Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine School of Medicine and Health, University of Leeds Leeds UK
- Leeds Institute of Health Research School of Medicine and Health University of Leeds Leeds UK
- Leeds Teaching Hospitals NHS Trust Leeds UK
| | - Amanda J. Friend
- Leeds Institute of Health Research School of Medicine and Health University of Leeds Leeds UK
- Leeds Teaching Hospitals NHS Trust Leeds UK
| | - Richard Feltbower
- Department of Clinical and Population Sciences, School of Medicine and Health University of Leeds Leeds UK
- Leeds Institute for Data Analytics University of Leeds Leeds UK
| | | | - Helen M. Picton
- Reproduction and Early Development Group, Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine School of Medicine and Health, University of Leeds Leeds UK
- Leeds Teaching Hospitals NHS Trust Leeds UK
| | - Adam W. Glaser
- Leeds Institute of Health Research School of Medicine and Health University of Leeds Leeds UK
- Leeds Teaching Hospitals NHS Trust Leeds UK
- Leeds Institute for Data Analytics University of Leeds Leeds UK
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