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Barjasteh S, Lopez V, Farnam F. Group Sex Counseling Based on a Modified "Good Enough Sex" Model: A Randomized Trial on Sexual Health Variables among Breast Cancer Survivors in Iran. JOURNAL OF SEX & MARITAL THERAPY 2024:1-16. [PMID: 38818773 DOI: 10.1080/0092623x.2024.2357141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
A randomized controlled clinical trial conducted in Iran from April 2020-2021 involved 100 eligible breast cancer survivors (BCSs). The study examined the impact of sexual counseling using a modified "Good Enough Sex" (GES) model on BCSs' sexual health variables. The intervention group, consisting of BCSs and their spouses, participated in four weekly group counseling sessions lasting 90-120 min each. The control group attended routine medical checkups. The intervention was designed based on a previous qualitative study assessing sexual needs and concerns in BCSs, as well as the GES model. Sexual satisfaction, function, and communication were evaluated at baseline, two, and three months follow-ups. Most participants (77%) had undergone a mastectomy, with diagnoses typically occurring between ages 39-49 and 5-7 years post-diagnosis. Initially low sexual satisfaction and function significantly improved in the intervention group (p < 0.001), reaching high satisfaction and moderate function levels. After three months, significant differences in sexual health variables were observed between the intervention and control groups (p < 0.001), indicating substantial positive effects, particularly in sexual satisfaction (0.99). Given the challenges in improving sexual function due to cancer complications, sex education based on sexual dialogue and realistic expectations can promote sexual well-being. RCT Number: IRCT20120609009975N8, dated 2020-04-18, https://en.irct.ir/trial/42030.
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Affiliation(s)
- Samira Barjasteh
- Midwifery, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Violeta Lopez
- Nursing, Central Queensland University, Sydney, Australia
| | - Farnaz Farnam
- Reproductive Health and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Yang Y, Ye G, Qiu X. 3D sponge loaded with cisplatin-CS-calcium alginate MPs utilized as a void-filling prosthesis for the efficient postoperative prevention of tumor recurrence and metastasis. RSC Adv 2024; 14:7517-7527. [PMID: 38440275 PMCID: PMC10910265 DOI: 10.1039/d3ra07516h] [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] [Received: 11/03/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
Intraoperative bleeding is a pivotal factor in the initiation of early recurrence and tumor metastasis following breast cancer excision. Distinct advantages are conferred upon postoperative breast cancer treatment through the utilization of locally administered implant therapies. This study devised a novel 3D sponge implant containing cisplatin-loaded chitosan-calcium alginate MPs capable of exerting combined chemotherapy and hemostasis effects. This innovative local drug-delivery implant absorbed blood and residual tumor cells post-tumor resection. Furthermore, the cisplatin-loaded chitosan-calcium alginate MPs sustainably targeted and eliminated cancer cells, thereby diminishing the risk of local recurrence and distant metastasis. This hydrogel material can also contribute to breast reconstruction, indicating the potential application of the 3D sponge in drug delivery for breast cancer treatment.
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Affiliation(s)
- Yihong Yang
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, School of Basic Medical Science, Southern Medical University Guangzhou Guangdong 510515 P. R. China
| | - Genlan Ye
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, School of Basic Medical Science, Southern Medical University Guangzhou Guangdong 510515 P. R. China
| | - Xiaozhong Qiu
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, School of Basic Medical Science, Southern Medical University Guangzhou Guangdong 510515 P. R. China
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Masjoudi M, Keshavarz Z, Akbari ME, Kashani FL, Nasiri M, Mirzaei HR. Sexual function index adaptation for breast cancer patients (FSFI-BC)- translation and psychometric properties of Persian version. BMC Womens Health 2024; 24:66. [PMID: 38267968 PMCID: PMC10809462 DOI: 10.1186/s12905-023-02836-9] [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: 06/28/2022] [Accepted: 12/09/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Effective interventions to improve sexual dysfunction in breast cancer survivors need screening of these dysfunctions with a suitable instrument. The aim of present study was translation and identifying psychometric properties of Female Sexual Function Index - Adapted for Breast Cancer (FSFI-BC) which has been specifically developed for breast cancer survivors. METHOD This methodological study was performed between February 2017 and October 2018. 200 breast cancer survivors in stage 1 or 2 who were selected through convenience sampling method, completed the questionnaire. Reliability was assessed by Cronbach's alfa and test re-test analysis and construct validity was performed through confirmatory (CFA) and exploratory factor analysis( EFA). RESULTS Six factors were extracted in exploratory factor analysis (EFA). These factors explained 74.6% of the total variance in in NSA group and 0.821 in SA group. Reliability evaluation indicated high internal consistency and good test re-test reliability. Cronbach's alpha coefficient in all areas of the tool was above 0.7 (the lowest and the highest measures were 0.885 and 0.945, respectively), which is a good indicator for reliability of an instrument. Confirmatory factor analysis showed an acceptable fitness for seven factors of FSFI-BC questionnaire (Normed Fit Index or NFI = 0.9 for both groups, Comparative of Fit Index or CFI = 0.93 and 0.92, χ 2/df = 1.68 and 1.71 for SA(Sexually Active) and NSA(No Sexually Active) individuals, respectively) . CONCLUSION Study findings suggest that Persian version of FSFI-BC is a suitable instrument for sexual dysfunction screening in breast cancer survivors.
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Affiliation(s)
- Marzieh Masjoudi
- Midwifery Department, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Zohre Keshavarz
- Midwifery Department, Shahid Beheshti University of Medical Sciences (SBMU), Vali-Asr Ave, Niayesh Cross Road, Niayesh Complex, Tehran, 1985717443, Iran.
| | | | | | - Malihe Nasiri
- Basic Science Department, Shahid Beheshti University of medical sciences, Tehran, Iran
| | - Hamid-Reza Mirzaei
- Department of Radiotherapy, School of Medicine, Shohada-e-Tajrish Hospital Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Jehan M, Azam S, Taimuri MA, Sumbal A, Azhar A, Amir A, Oduoye MO, Zainab A, Ikram A, Ali T. Care for breast cancer survivors in Asian countries: A review of sexual dysfunction. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241237687. [PMID: 38481086 PMCID: PMC10938604 DOI: 10.1177/17455057241237687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/21/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024]
Abstract
Breast cancer accounts for one in three new cancer cases in women each year. Despite having a higher survival rate than other cancers, it is associated with various side effects, including anorgasmia, vaginismus, hair loss, and decreased libido. This review aims to explore trends in the incidence of sexual dysfunction in breast cancer survivors, the etiology of sexual dysfunction, and the role of factors such as family history, age, duration of marriage, and depression in predisposing patients. We summarize the limitations of the treatment modalities already used to cater to sexual dysfunction in breast cancer survivors and patients. The authors conducted searches on databases such as PubMed and Google Scholar using relevant search terms: sexual dysfunction, breast cancer, breast cancer survivors, chemotherapy, dyspareunia, vaginismus, and anorgasmia from 1997-2023. The inclusion criteria encompassed all types of articles with abstracts or titles indicating research on sexual dysfunction in breast cancer survivors in Asia. A total of 64 articles were included out of which 10 were systematic reviews and meta-analyses. The literature search yielded results showing high incidence rates of breast cancer in Asia (45.4%), with 31.6%-91.2% of breast cancer survivors likely to experience sexual dysfunction. Regional differences were noted, as female sexual dysfunction occurred in 74.1% of Asian breast cancer women. Further randomized controlled trials should be conducted to assess the effectiveness of treatment modalities. Personalized approaches should be tailored to address beliefs, such as the potential impact of sexual activity on disease recovery. Utilizing a family history of breast cancer as a preemptive tool can help reduce the risk of developing female sexual dysfunction in survivors, and factors such as age and depression should be considered when formulating solutions.
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Affiliation(s)
- Minal Jehan
- Karachi Medical and Dental College, Karachi, Pakistan
| | - Sumran Azam
- Karachi Medical and Dental College, Karachi, Pakistan
| | | | - Anusha Sumbal
- Dow University of Health Sciences, Karachi, Pakistan
| | - Ayesha Azhar
- Dow University of Health Sciences, Karachi, Pakistan
| | - Alina Amir
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Asra Zainab
- Dow University of Health Sciences, Karachi, Pakistan
| | - Areeba Ikram
- Dow University of Health Sciences, Karachi, Pakistan
| | - Tehreem Ali
- Dow University of Health Sciences, Karachi, Pakistan
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Haris I, Hutajulu SH, Astari YK, Wiranata JA, Widodo I, Kurnianda J, Taroeno-Hariadi KW, Hardianti MS, Purwanto I, Prabandari YS. Sexual Dysfunction Following Breast Cancer Chemotherapy: A Cross-Sectional Study in Yogyakarta, Indonesia. Cureus 2023; 15:e41744. [PMID: 37449290 PMCID: PMC10336330 DOI: 10.7759/cureus.41744] [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] [Accepted: 07/11/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Sexual dysfunction is rarely studied in Indonesian patients with breast cancer. We aimed to assess the prevalence of sexual dysfunction symptoms following chemotherapy, as well as the pattern and the associated factors. Methods This cross-sectional study included 135 female breast cancer patients receiving primary chemotherapy. The present study measured the prevalence of sexual dysfunction symptoms using an e-questionnaire containing Common Toxicity Criteria for Adverse Events (CTCAE) version 4 at different time points. Other data included sociodemography, clinicopathology, treatment, and other concurrent symptom characteristics. Bivariate and multivariate logistic regression tests were used to analyze any association among variables. Results In the whole panel, 86 (63.7%) of 135 cases experienced sexual dysfunction. The most common symptom was vaginal dryness (45.9%), followed by decreased libido (45.2%), dyspareunia (13.3%), delayed orgasm (11.1%), and anorgasmia (8.9%). When observed at five different time points, the frequency of symptoms increased during chemotherapy and persisted until six months after completing treatment. Chemotherapy duration of >120 days was associated with a higher probability of vaginal dryness (p=0.012) and decreased libido (p=0.033). Spouse age ≥55 years old and body mass index (BMI) ≥23 kg/m2 were associated with a reduced probability of decreased libido (p=0.033 and 0.025, respectively). The presence of comorbidity was associated with a reduced probability of delayed orgasm (p=0.034). Conclusions A significant proportion of patients with breast cancer had sexual dysfunction following chemotherapy. Vaginal dryness, decreased libido, and dyspareunia were the commonest symptoms observed. Duration of chemotherapy, spouse age, BMI, and comorbidity were associated with the risk of sexual dysfunction occurrence.
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Affiliation(s)
- Irfan Haris
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, IDN
| | - Susanna H Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, IDN
| | - Yufi K Astari
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Sardjito General Hospital, Yogyakarta, IDN
| | - Juan A Wiranata
- Department of Clinical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, IDN
| | - Irianiwati Widodo
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, IDN
| | - Johan Kurnianda
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, IDN
| | - Kartika W Taroeno-Hariadi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, IDN
| | - Mardiah S Hardianti
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, IDN
| | - Ibnu Purwanto
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, IDN
| | - Yayi S Prabandari
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, IDN
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Chang CP, Ho TF, Snyder J, Dodson M, Deshmukh V, Newman M, Date A, Henry NL, Hashibe M. Breast cancer survivorship and sexual dysfunction: a population-based cohort study. Breast Cancer Res Treat 2023; 200:103-113. [PMID: 37160510 PMCID: PMC10382144 DOI: 10.1007/s10549-023-06953-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/23/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Breast cancer is the most common non-skin cancer in women and an increasing number of people are living as breast cancer survivors. While the prognosis of breast cancer continues to improve, the rates of sexual dysfunction and the risk related to cancer treatments have not been well characterized in a population-based study. METHODS We identified a cohort of 19,709 breast cancer survivors diagnosed between 1997 and 2017 from the Utah Cancer Registry, and 93,389 cancer-free women who were matched by age and birth state from the Utah Population Database. Sexual dysfunction diagnoses were identified through ICD-9 and ICD-10 codes from electronic medical records and statewide healthcare facilities data. Cox proportional hazard models were used to estimate hazard ratios for risk of sexual dysfunction. RESULTS Breast cancer survivors were at higher risk of sexual dysfunction diagnosis (9.1% versus 6.9%, HR 1.60, 95% CI 1.51-1.70) compared to the general population. This risk increased 2.05-fold within 1 to 5 years after cancer diagnosis (95% CI 1.89-2.22) and 3.05-fold in individuals diagnosed with cancer at < 50 years of age (95% CI 2.65-3.51). Cancer treatments including endocrine therapy, chemotherapy and radiation therapy were associated with an increased risk of sexual dysfunction among breast cancer survivors. CONCLUSIONS Risk of sexual dysfunction in breast cancer survivors is higher than in the general population, but may be underdiagnosed in the clinical setting. Health care professionals should be encouraged to address the topic of sexual health early on in the treatment of breast cancer, and routinely screen patients for symptoms of sexual dysfunction.
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Affiliation(s)
- Chun-Pin Chang
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Tiffany F Ho
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - John Snyder
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - Mark Dodson
- Intermountain Healthcare, Salt Lake City, UT, USA
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Vikrant Deshmukh
- University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Michael Newman
- University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Ankita Date
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - N Lynn Henry
- Division of Hematology/Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
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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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Chan DNS, Chow KM, Anderson DJ, Porter-Steele J, Laing B, Ling WM, Lam CCH, Choi KC, Chan CWH, So WKW, McCarthy AL. Cultural Adaptation of the Younger Women's Wellness After Cancer Program for Younger Chinese Women With Breast Cancer: A Pilot Randomized Controlled Trial. Cancer Nurs 2023; Publish Ahead of Print:00002820-990000000-00107. [PMID: 36737859 DOI: 10.1097/ncc.0000000000001210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The incidence of breast cancer in younger women, that is, aged 50 years or younger, in Hong Kong is increasing. The Internet-based Younger Women's Wellness After Cancer Program (YWWACP) is a whole-lifestyle intervention that can help young women to manage their health and risks of chronic diseases. OBJECTIVES The study aimed to test the acceptability and feasibility of the culturally adapted YWWACP in Hong Kong (YWWACPHK) and to evaluate its preliminary effects in improving health-related quality of life, distress, sexual function, menopausal symptoms, dietary intake, physical activity, and sleep among younger Chinese women with breast cancer. INTERVENTION/METHODS Women aged 18 to 50 years with breast cancer were recruited from an oncology outpatient department. The participants in the intervention group received the 12-week YWWACPHK, whereas the control group received standard care. RESULTS Sixty women consented to participate. At 12 weeks after intervention completion, the intervention group showed a significant increase in the pain subscale scores of sexual function and more improvement in the level of physical activity than the control group, with Hedge g effect sizes 0.66 and 0.65, respectively. Nineteen intervention group participants reported that they were satisfied with the program and suggestions for improvement were provided. CONCLUSION The implementation of YWWACPHK is feasible. The preliminary findings suggest that YWWACPHK could increase the level of physical activity among the participants. IMPLICATIONS FOR PRACTICE Nurses could utilize YWWACPHK to support younger Chinese patients with breast cancer to maintain a healthy lifestyle, subject to wider confirmation of these results through a larger study.
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Affiliation(s)
- Dorothy Ngo Sheung Chan
- Author Affiliations: The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China (Drs Chan, Chow, Choi, Chan, and So); Faculty of Health, University of Technology Sydney, Sydney, Australia (Dr Anderson); The Wesley Hospital, Brisbane, Australia (Dr Porter-Steele); School of Nursing, Midwifery and Social Work, University of Queensland and Mater Health Services, Brisbane, Australia (Drs Porter-Steele and McCarthy); Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand (Dr Laing); and Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China (Mr Ling and Ms Lam)
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Kuan WC, Kong YC, Bustamam RS, Wong LP, Woo YL, Taib NA, Ho GF, Zaharah H, Yip CH, Bhoo-Pathy N. Sexual Wellbeing and Supportive Care Needs After Cancer in a Multiethnic Asian Setting: A Qualitative Study. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09772-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Intimate Partner Violence against Mastectomized Women: Victims' Experiences. Curr Oncol 2022; 29:8556-8564. [PMID: 36354734 PMCID: PMC9689691 DOI: 10.3390/curroncol29110674] [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: 09/18/2022] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 11/12/2022] Open
Abstract
Exposure to situations of domestic violence during the treatment for breast cancer may compromise the treatment and quality of life of women patients, so it is essential that health professionals act in tracking this phenomenon in the approach to and care of women with breast cancer. The purpose of this study was to examine experiences of violence against women by their intimate partners after mastectomy. This is an exploratory descriptive study, with a qualitative approach, carried out in the Rehabilitation Program for Mastectomized Women in a Brazilian reference hospital for oncological treatment. Semi-structured interviews were conducted with 16 mastectomized women. For data analysis, a content analysis technique was performed. The women interviewed were predominantly brown, with a minimum age of 44 years and maximum of 72 years. They presented with low education, were married, and had a mean period of five years of breast cancer diagnosis. The participants reported that after mastectomy, they experienced episodes of violence at a time when they were extremely vulnerable due to the various cancer treatments. Three major thematic categories emerged from interview data across the data collection: (1) experiences of psychological violence, (2) experiences of physical violence, and (3) experiences of sexual violence. Psychological violence took the form of humiliation and contempt for their condition. Physical violence involved assault and sexual violence in the form of forced sex by coercion. Violence was a phenomenon present after mastectomy, practiced in the domestic environment by the intimate partner. We emphasize the importance of health professionals in screening for this issue by listening to and welcoming women, recording cases, exposing this situation, and contributing to prevention.
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Che Ya SN, Muhamad R, Zakaria R, Mohd Zain N, Ishak A, Hassan II, Ab Hadi I, Low WY, Liamputtong P. "I Lost My Gift to Him": The Consequences of Female Sexual Dysfunction on Breast Cancer Survivors in Malaysia. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1625-1635. [PMID: 34750771 DOI: 10.1007/s10508-021-02051-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 04/26/2021] [Accepted: 05/15/2021] [Indexed: 06/13/2023]
Abstract
Sexuality is currently neglected in the medical care of cancer patients although female sexual dysfunction (FSD) and sexual problems are highly prevalent among breast cancer patients in Malaysia. This paper explores the consequences of breast cancer and its treatment on the sexuality and sexual health of women with breast cancer using a qualitative design and a phenomenological methodology. Fourteen married women with breast cancer who fulfill the criteria for FSD from Kelantan, Malaysia participated in two interviews: in-depth interview and followed by photo-elicitation interview after two weeks duration. The interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. We identified overlapping themes that can be explained by sexual script theory. Breast cancer treatments disturb the sex response cycle, leading to changes in sexuality, from intimacy in marriage to women preferring physical affection to intercourse. The women struggled with a perceived imperfection about symbol of femininity after noticing changes in their husbands' sexual performance and after experiencing their own sentiments of inadequacy as a wife. Fear and guilt surfaced as part of the journey, accompanied by frustration on the part of the spouse, or him becoming more attentive. This study highlights the problem of breast cancer and its treatment as regards the sexual well-being of patients and their spouses. Hence, recognizing and addressing sexual health will improve the overall experience for survivors.
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Affiliation(s)
- Siti Nuryati Che Ya
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia (USM), Kubang Kerian, Malaysia
| | - Rosediani Muhamad
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia (USM), Kubang Kerian, Malaysia.
- Breast Cancer Awareness & Research Unit (BestARi), Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, Kubang Kerian, Kelantan, Malaysia.
| | - Rosnani Zakaria
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia (USM), Kubang Kerian, Malaysia
| | - Norhasmah Mohd Zain
- Nursing Program, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Azlina Ishak
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia (USM), Kubang Kerian, Malaysia
| | - Intan Idiana Hassan
- Nursing Program, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Imisairi Ab Hadi
- Department of Surgery, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
| | - Wah Yun Low
- Faculty of Medicine and Asia-Europe Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Pranee Liamputtong
- Translational Health Research Institute (THRI), Western Sydney University, Locked Bag 1797, Campbelltown, Penrith, NSW, 2751, Australia
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