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Kyei KA, Daniels J, Broni R, Anim-Sampong S, Kitson-Mills D, Amoabeng KA, Odey Tackie JN, Obeng-Mensah T, Anoa Scott PA, Owusu AB. The sexuality of women with cervical cancer undergoing definitive radiotherapy in Ghana. Radiography (Lond) 2024; 30:332-339. [PMID: 38128249 DOI: 10.1016/j.radi.2023.11.024] [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: 02/19/2023] [Revised: 11/14/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION The purpose of this study was to assess the sexuality of cervical cancer patients undergoing radiotherapy at a major cancer treatment center in Ghana. This is an area of interest as globally; cervical cancer kills approximately 342,000 people per annum with an estimated number of 604,000 new cases in 2020. Acknowledging the World Health Organization's definition of sexual health as a state of physical, mental and social well-being in relation to sexuality, this paper sheds light on how these dimensions affect the quality of life of cervical cancer patients. METHODS This was a longitudinal study, which assessed the impact of radiotherapy on the sexuality of both premenopausal and postmenopausal cervical cancer patients presenting for primary treatment with chemoradiation from April to July, 2021 at a major cancer treatment centre in Ghana. The Female Sexual Function Index and Body Image Scale questionnaires were respectively used to evaluate the sexual functions scores among the cervical cancer patients, and to assess the impact of the treatment on their body image. MATLAB software was used for data analysis. RESULTS Most of the cervical cancer patients sampled were postmenopausal (57 %). About 79 % premenopausal and 96 % postmenopausal cervical cancer patients were sexually inactive during radiotherapy (day 15). Also, 48 % premenopausal and 24 % postmenopausal patients were very dissatisfied with their bodies at the onset of treatment. The frequency of orgasm in cervical cancer patients declined after treatment causing a deterioration in their sexual function. The patients' sexuality was influenced by age and menopausal status. The decreased sexual desire of the patients resulted in emotional distancing from their partners, which invariably induced changes in their partners' level of sexual interest. This study established significant differences between premenopausal and postmenopausal cervical cancer patients who were generally very dissatisfied with their sexual relationships with their partners on day 1 (p = 0.02) and on day 15 (p = 0.00) of treatment. CONCLUSION The majority of patients who presented for treatment for cervical cancer in this study were postmenopausal. Their interest in sexual activity was more influenced by their menopausal status than their antineoplastic treatment. This study indicates that cervical cancer patients are more likely to develop sexual health problems which could substantially worsen over the course of their treatment and beyond. IMPLICATION FOR PRACTICE The study will contribute within the oncology team by assisting personnel in putting in place measures that will guide the treatment of cervical cancer patients and improve quality of care.
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Affiliation(s)
- K A Kyei
- Dept. of Radiography, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana; National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, P.O. Box KB 369, Korle-Bu, Accra, Ghana
| | - J Daniels
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, P.O. Box KB 369, Korle-Bu, Accra, Ghana.
| | - R Broni
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, P.O. Box KB 369, Korle-Bu, Accra, Ghana
| | - S Anim-Sampong
- Dept. of Radiography, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana
| | - D Kitson-Mills
- Dept. of Radiography, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana; National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, P.O. Box KB 369, Korle-Bu, Accra, Ghana
| | - K A Amoabeng
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, P.O. Box KB 369, Korle-Bu, Accra, Ghana
| | - J N Odey Tackie
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, P.O. Box KB 369, Korle-Bu, Accra, Ghana
| | - T Obeng-Mensah
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, P.O. Box KB 369, Korle-Bu, Accra, Ghana
| | - P A Anoa Scott
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, P.O. Box KB 369, Korle-Bu, Accra, Ghana
| | - A-B Owusu
- University of Ghana Medical Centre, Legon, Ghana
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Zhao M, Pu X, Ma GY, Zhang MJ, Luo L, Gu RY, Gao MZ, Cai L. Quality of life in patients with cervical cancer between the Han nationality and ethnic minorities in the Yunnan Province of China. BMC Womens Health 2023; 23:217. [PMID: 37138235 PMCID: PMC10158006 DOI: 10.1186/s12905-023-02240-3] [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: 11/12/2022] [Accepted: 02/23/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Cervical cancer is the fourth most diagnosed cancer and the leading cause of cancer death, and it still poses a crippling threat to women's health. China launched the National Cervical Cancer Screening Program for Rural Women in 2009, and an increasing number of cervical cancer patients have been detected. Health-related quality of life is not only the end point of cancer research but is also related to socioeconomic and clinical factors and has received an increasing amount of attention. In light of the characteristics of the Yunnan nationality, we conducted cross-sectional research to assess and explore the health-related quality of life in both Han and ethnic minority patients. METHODS A cross-sectional study was conducted from January 2020 to May 2021 at the Third Affiliated Hospital of Kunming University/Yunnan Cancer Hospital. Patients, including 100 Han patients and 100 ethnic minorities, were interviewed using the FACT-Cx questionnaire within 3 months of receiving treatment. RESULTS Patients of Han ethnicity and ethnic minorities were comparable in both sociodemographic and clinical features. The total FACT-Cx scores were 139.38 ± 9.83 and 134.39 ± 13.63 in Han and ethnic minority patients, respectively (P < 0.05). Significant differences were shown in physical well-being, emotional well-being and the FACT-Cx subscale between the Han and ethnic minority groups. Independent predictors of the FACT-Cx scale were ethnicity, educational level, participation in the National Cervical Cancer Screening Program for Rural Areas (NCCSPRA) and clinical stage. CONCLUSIONS The results of our study imply that the HRQOL of Han patients is better than that of ethnic minority patients. Thus, clinicians and related health workers should pay more attention to the HRQOL of cervical cancer patients, especially for ethnic minority patients, and provide psychosocial interventions as much as possible to improve their HRQOL. Policies should also aim to strengthen health education regarding cervical cancer and expand the coverage of the NCCSPRA among those who are ethnic minorities, are older and have low educational levels.
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Affiliation(s)
- Min Zhao
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, 650500, China
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Xi Shan County, 519 Kun Zhou Road, Kunming, 650118, Yunnan, China
| | - Xin Pu
- Medical Records Statistics Department, The First Affiliated Hospital of Kunming Medical University, 295 Xi Chang Road, Kunming, 650032, Yunnan, China
| | - Guo-Yu Ma
- Yunnan Cancer Center Office, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Xi Shan County, 519 Kun Zhou Road, Kunming, 650118, Yunnan, China
| | - Meng-Jiao Zhang
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Xi Shan County, 519 Kun Zhou Road, Kunming, 650118, Yunnan, China
| | - Lei Luo
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Xi Shan County, 519 Kun Zhou Road, Kunming, 650118, Yunnan, China
| | - Rong-Yan Gu
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Xi Shan County, 519 Kun Zhou Road, Kunming, 650118, Yunnan, China
| | - Ming-Zhu Gao
- Medical Administration Department, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Xi Shan County, 519 Kun Zhou Road, Kunming, 650118, Yunnan, China
| | - Le Cai
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, 650500, China.
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Beltrán Ponce SE, Abunike SA, Bikomeye JC, Sieracki R, Niyonzima N, Mulamira P, Kibudde S, Ortiz de Choudens S, Siker M, Small C, Beyer KMM. Access to Radiation Therapy and Related Clinical Outcomes in Patients With Cervical and Breast Cancer Across Sub-Saharan Africa: A Systematic Review. JCO Glob Oncol 2023; 9:e2200218. [PMID: 36795990 PMCID: PMC10166435 DOI: 10.1200/go.22.00218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
PURPOSE To better understand the barriers to accessing standard-of-care radiation therapy (RT) for breast and cervical cancer in sub-Saharan Africa and their impact on outcomes. METHODS A comprehensive literature search was completed with a medical librarian. Articles were screened by title, abstract, and full text. Included publications were analyzed for data describing barriers to RT access, available technology, and disease-related outcomes, and further grouped into subcategories and graded according to predefined criteria. RESULTS A total of 96 articles were included: 37 discussed breast cancer, 51 discussed cervical cancer, and eight discussed both. Financial access was affected by health care system payment models and combined burdens of treatment-related costs and lost wages. Staffing and technology shortages limit the ability to expand service locations and/or increase capacity within existing centers. Patient factors including use of traditional healers, fear of stigma, and low health literacy decrease the likelihood of early presentation and completion of therapies. Survival outcomes are worse than most high- and middle-income countries and are affected by many factors. Side effects are similar to other regions, but these findings are limited by poor documentation capabilities. Access to palliative RT is more expeditious than definitive management. RT was noted to lead to feelings of burden, lower self-esteem, and worsened quality of life. CONCLUSION Sub-Saharan Africa represents a diverse region with barriers to RT that differ on the basis of funding, available technology and staff, and community populations. Although long-term solutions must focus on building capacity by increasing the number of treatment machines and providers, short-term improvements should be implemented, such as interim housing for traveling patients, increased community education to reduce late-stage diagnoses, and use of virtual visits to avoid travel.
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Affiliation(s)
| | - Sarah Adamma Abunike
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Jean C Bikomeye
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Rita Sieracki
- Medical College of Wisconsin Libraries, Milwaukee, WI
| | | | | | | | | | - Malika Siker
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Christina Small
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Kirsten M M Beyer
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
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Mvunta DH, August F, Dharsee N, Mvunta MH, Wangwe P, Ngarina M, Simba BM, Kidanto H. Quality of life among cervical cancer patients following completion of chemoradiotherapy at Ocean Road Cancer Institute (ORCI) in Tanzania. BMC Womens Health 2022; 22:426. [PMID: 36303143 PMCID: PMC9615158 DOI: 10.1186/s12905-022-02003-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Effective cancer treatment involves aggressive chemo-radiotherapy protocols that alter survivors' quality of life (QOL). This has recently aroused the attention not only to focus on clinical care but rather to be holistic and client-centered, looking beyond morbidity and mortality. The study assessed the QOL and associated factors among patients with cervical cancer (CC) after the completion of chemoradiotherapy. METHODS A cross-sectional analytical study was conducted at Ocean Road Cancer Institute (ORCI) from September to November 2020. A total of 323 CC patients were interviewed with a structured questionnaire of QOL, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and its cervical cancer module (EORTC QLQ-CX24). The QOL domains, socio-demographic and clinical variables were analyzed with Mann-Whitney and Kruskal-Wallis on SPSS version 23, and a P < 0.05 was considered significant. RESULTS More than half (54.8%) of the CC patients had a good overall QOL. Overall, QOL was affected by education (P = 0.019), smoking (0.044), sexual partner (P = 0.000), treatment modality (P = 0.018), and time since completion of treatment (P = 0.021). Patients who underwent external beam radiation suffered from significant side effect symptoms (P < 0.05) while those who underwent combined external beam radiation and brachytherapy had higher functioning in most domains (P < 0.05). CONCLUSIONS A significant improvement in QOL was observed after chemoradiotherapy and was affected by socio-demographic and clinical variables. Thus, calls for individualized care in addressing these distressing symptoms.
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Affiliation(s)
- David H. Mvunta
- grid.25867.3e0000 0001 1481 7466Department of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, 9 United Nations Road, Upanga West, P. O Box 65017, Dar es Salaam, Tanzania ,Department of Obstetrics and Gynecology, Mawenzi Regional Referral Hospital, P. O Box 3054, Moshi, Tanzania
| | - Furaha August
- grid.25867.3e0000 0001 1481 7466Department of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, 9 United Nations Road, Upanga West, P. O Box 65017, Dar es Salaam, Tanzania
| | - Nazima Dharsee
- grid.25867.3e0000 0001 1481 7466Department of Oncology, Muhimbili University of Health and Allied Sciences, 9 United Nations Road, Upanga West, P. O Box 65001, Dar es Salaam, Tanzania ,grid.489130.7Department of Oncology, Ocean Road Cancer Institute, Barack Obama Drive, P. O Box 3592, Dar es Salaam, Tanzania
| | - Miriam H. Mvunta
- grid.412898.e0000 0004 0648 0439Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical College, P. O Box 2240, Moshi, Tanzania
| | - Peter Wangwe
- grid.25867.3e0000 0001 1481 7466Department of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, 9 United Nations Road, Upanga West, P. O Box 65017, Dar es Salaam, Tanzania
| | - Matilda Ngarina
- grid.25867.3e0000 0001 1481 7466Department of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, 9 United Nations Road, Upanga West, P. O Box 65017, Dar es Salaam, Tanzania ,grid.416246.30000 0001 0697 2626Department of Obstetrics and Gynecology, Muhimbili National Hospital, Malik Road, Upanga West, P. O Box 65000, Dar es Salaam, Tanzania
| | - Brenda M. Simba
- grid.436289.20000 0004 8340 2426Department of Reproductive, Maternal, Child and Adolescent Health, Management and Development for Health (MDH), Mwai Kibaki Road, Mikocheni B, P. O Box 79810, Dar es Salaam, Tanzania
| | - Hussein Kidanto
- grid.473491.c0000 0004 0620 0193Department of Obstetrics and Gynecology, Aga Khan University, Ocean Road, P. O Box 38129, Dar es Salaam, Tanzania
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