The Predictors of Sexual Satisfaction among Iranian Women with Breast Cancer

A two-tool assessment of the quality of life of patients with breast cancer using generic and disease-specific tools in a Nigerian teaching hospital

Assessing the quality of life (QoL) of breast cancer (BC) patients using a triangulation of tools is crucial for understanding their well-being and tailoring specific interventions to improve their overall experience. The study assessed the QoL of BC patients using a combination of generic and disease-specific validated questionnaires. The study utilized a self-administered questionnaire-based cross-sectional design among BC patients attending the Oncology clinic in a Nigerian teaching hospital. The 23-item EORTC-BR23 questionnaire and the 15-item HRQoL 15D questionnaire were provided to consenting eligible respondents for data collection. Descriptive (e.g., frequency, percentages, mean, median, etc.) and inferential (T-test and one-way ANOVA) statistical analyses were conducted on the cleaned data, with significant p values set at less than 0.05. A total of 60 female BC patients participated in the study. Respondents that were aged 41-50 years and 50-60 years were 20 (33.3%) and 19 (31.7%) respectively. Patients who were diagnosed with BC one year ago before the study were 22 (39.3%) with 51 (85%) reporting no positive family history of BC. Patients who had undergone surgery, radiotherapy, hormonal therapy, and chemotherapy were 52 (86.7%), 27 (45.0%), 14 (24.1%), and 54 (90%) respectively. The patients scored 30.00 ± 4.67% and 72.36 ± 2.93% for future perspective and body image, respectively, in the functional scales of the EORTC-BR23 with a maximum possible score of 100%. On the symptom scale, they scored 47.46 ± 2.52% and 63.40 ± 5.03% for side effects of therapy and being upset about hair loss, respectively. The patients' quality of life utility score in the 15-D tool was 0.79 ± 0.02. With p values less than 0.005, age, time since diagnosis, and cancer stage were influential determinants of patients' QoL. The QoL of the participants based on the HRQoL-15D was determined to be high. For the EORTC-BR23, respondents reported high quality of life for body image and sexual function but low quality of life for both sexual enjoyment and future perspective in terms of the functional scale. The symptom scale of EORTC-BR23 showed high symptoms for only the domain of upset by hair loss resulting in low QoL. Socio-demographic factor that affects the QoL of BC patients were age, number of years since diagnosis and stage of BC.

Breast cancer survivorship and sexual dysfunction: a population-based cohort study

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.

Breast Conserving Surgery is Better for Sexual Satisfaction Compared to a Modified Radical Mastectomy for Breast Cancer

PURPOSE

This study aimed to determine the difference between the level of sexual satisfaction in breast cancer patients with Modified Radical Mastectomy (MRM) and Breast Conserving Surgery (BCS).

METHODS

This study used a cross-sectional study using a validated Female Sexual Function Index questionnaire. This study was conducted from 2020 until 2021. Data were collected and analyzed using the chi-square test for bivariate variables and logistic regression for multivariate variables.

RESULTS

Patients with BCS were more satisfied with their sexual activity than patients undergoing modified radical mastectomy (p = 0.0001, OR 6.25, CI = 2.78 - 14.01). Other factors having effect on sexual satisfactions were: age that showed a statistically effect on sexual satisfaction (patients <55 years were more satisfied than patients ≥55 years ( p = 0.004, OR = 3.23, CI 1.44 - 7.22), the period after operation (<5 years vs >5 years) showed a statistically significant difference in sexual satisfaction ( p = 0.087, OR=0.53, CI = 0.25-1.10), Having chemotherapy treatment showed statistically significant risk for sexual satisfaction (p = 0.003, OR=7.39, CI= 1.62-33.83). Factors having no statistically significant effect on sexual satisfactions were: Radiotherapy treatment (p = 0.133, OR=1.75 and CI = 0.84 -3.64), length of marriage as defined with <10 years and > 10 years (p = 0.616, OR=1.39 and CI = 0.38-5.09), marital status (p = 0.082, OR =0.39, CI=0,13 - 1.16), educational status (p = 0.778, OR = 1.18, CI = 0.37 - 3.75), and work at home vs outside home (p = 0.117, OR=1.8, and CI = 0.86 - 3.78).

CONCLUSION

BCS as surgical therapy option is the most dominant factor related to sexual satisfaction followed by age group, and chemotherapy group.

Quality of sexual life and associated factors: a cross-sectional survey of Chinese breast cancer patients

PURPOSE

This study aimed to explore Chinese breast cancer patients' quality of sexual life (QSL) and factors associated with QSL.

METHODS

The questionnaires in this cross-sectional study include the general information questionnaire, cognition and assessment of sexual health questionnaire, Self-acceptance Questionnaire (SAQ), Medical Coping Modes Questionnaire (MCMQ), and Quality of Sexual Life Questionnaire (QSLQ); 201 breast cancer patients were required to complete the questionnaires assessing characteristic information, cognition and assessment of sexual health, QSL, self-acceptance, and coping style. Finally, hierarchical regression was used to analyze the factors associated with QSL in Chinese breast cancer patients.

RESULTS

The mean age (at the time of the survey) of the breast cancer patients was 48.31±9.15. The mean score of the QSLQ (range 28-140) was 75.14±16.57. Hierarchical regression analysis showed that the associated factors of breast cancer patients' QSL included age (at the time of the survey), education level, type of surgery, cognition and assessment of sexual health, self-acceptance, and avoidance and acceptance-resignation coping styles, that independent variables explained 60.4% of the variance.

CONCLUSION

The QSL among Chinese breast cancer patients needs to be improved. Our findings indicated that breast cancer patients with older age, lower education level, or modified radical mastectomy have poor QSL. Breast cancer patients learn correct information about sexual health, enhance self-acceptance, and reduce acceptance-resignation, and avoidance coping could be intervention strategies to improve their QSL.

Sexuality after breast cancer, how to provide a global and contemporary approach

Patients' sexuality is one of the major and most neglected impact of breast cancer (BC) and its treatment. Even though research is ongoing on the subject, sexuality issues are rarely taken into account and efficiently dealt with in clinical practice. The objective is to review the impact of BC and its treatment on modern women sexuality. In the literature, a heterogeneous level of advancement is notable in the different publishing countries depending on the cultural background; some countries simply do not publish on the matter, others mainly discuss the male partners and practicians experience, and lastly, the most progressive countries have moved up to studying niches of patients such as sexual and gender minorities. A multidisciplinary approach, including pharmacologic and nonpharmacologic management, appears most efficient. There is a need for greater inclusion of partners and for providing a specific training to first-line health care providers. This review provides a general contemporary worldwide overview of the state of the art in sexuality issues in BC patients and survivors.

Sexual Function in Women with Breast Cancer: An Evidence Map of Observational Studies

Breast cancer (BC) is the leading cause of cancer in women, and has implications for sexual function (SF). In this study, we used an evidence map to identify, describe, and organise the current available evidence regarding SF in women with BC. We searched the MEDLINE, PsycINFO, and CINAHL databases for observational studies assessing SF in women with BC published in English, Spanish, Portuguese, and French between 2000 and 2021 (sample ≥ 50 women). Of the 64 included studies (13,257 women with BC), 58 were published since 2010. Women who were married, partnered, or in relationships represented 74.1% of the entire sample. Only a single study was conducted on women representing a sexual minority. We identified 22 assessment instruments and 40 sexual dysfunction (SdF) domains. The number of publications on SF in women with BC has increased in the last 10 years, but still remains low. Some groups of women are underrepresented, and some SdF domains are underdiagnosed, with the assessment instrument used affecting which domains are studied. Women with BC need to be better screened, as their quality of life (QoL) is affected by SdF.

Design, implementation, and evaluation of self-care program in the prevention of breast cancer among women in Isfahan: a community-based participatory action research protocol

Introduction

Breast cancer is one of the most prevalent cancers among women in Isfahan, Iran; however, its prevention is not desirable in this city. This disease poses several health, social and economic challenges for women. To promote women's self-care in breast cancer prevention, this study aims to design, implement and evaluate a self-care program among women in Isfahan through using a community-based participatory action research method.

Methods

The present study is based on a community-based participatory action research approach. In this study, the participatory action research includes four general phases of organizing, action planning, action, and rethinking. These phases are summarized as follows: In the organizing phase, the needs of the participants and the action research settings are examined. This means that the current situation is identified and the views of the process owners are assessed. In the action planning phase, using the results of the first phase, some strategies are designed to promote self-care behaviors in the prevention of breast cancer among women in Isfahan. In the implementation phase, the selected strategies are implemented with the help of the process owners. Finally, in the rethinking phase, the results of the implementation of the strategies are monitored and evaluated. This cycle continues until the intended results are achieved.

Discussion

Changing the role of individuals from a passive status to an aware and active status in the care process requires motivation, responsibility, and active participation of individuals in the disease control process. Moreover, many cultural and social factors affect the active participation of Iranian women. Therefore, individuals can be involved in promoting their health using a community-based participatory action research approach.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40695-022-00077-8.

The Efficacy of Time Perspective Therapy in Reducing Symptoms of Post-traumatic Stress, Anxiety, and Depression in Females with Breast Cancer

Background: Breast cancer is the biggest risk factor that endangers women's health. It is considered the highest stress-causing disease due to the unpleasant effects of disease on different aspects of patients’ life. Breast cancer is commonly associated with the symptoms of post-traumatic stress and its comorbidities such as anxiety and depression. It appears that time perspective therapy (TPT), as a new psychological treatment, can reduce the symptoms of post-traumatic stress, anxiety, and depression in females with breast cancer. Methods: This is a randomized controlled trial conducted from February to September 2019. A total of 30 patients with breast cancer were selected through a convenience sampling technique and were randomly divided into the control and treatment groups. The latter group attended 6-week sessions (each session lasted 90 minutes long) to receive TPT. To conduct pretest and posttest, all participants in the two groups were asked to fill out the following questionnaires: (1) Zimbardo Time Perspective Inventory (ZTPI); (2) The Post-traumatic Stress Disorder Checklist (PCL); (3) Beck Anxiety Inventory (BAI); and (4) the second version of Beck Depression Inventory (BDI-II). The analysis of covariance (ANCOVA) was used to evaluate the effects of treatment. A P-value smaller than 0.05 was considered significant. Results: Data analysis of 28 patients from the experimental and control groups showed that TPT significantly reduced the symptoms of post-traumatic stress, anxiety, and depression in the treatment group (P < 0.001 for symptoms of post-traumatic stress and anxiety, and P = 0.002 for depression). Such a difference was not seen in the control group. Conclusions: TPT may be an effective approach to reduce symptoms of post-traumatic stress, anxiety, and depression in Iranian women with breast cancer. Further investigations are required to confirm these findings, which may in turn help heath care professionals use TPT to promote the mental health of females with breast cancer.

Young Women with Breast Cancer in Resource-Limited Settings: What We Know and What We Need to Do Better

Young women with breast cancer (YWBC) account for a variable proportion of patients diagnosed with breast cancer around the globe, with a higher prevalence in resource-limited settings than in high-income countries. This group represents a unique population that warrants special attention due to specific biological considerations and age-specific supportive care issues. This review aims to explore existing knowledge regarding YWBC's needs, particularly in resource-restricted settings. To date, scarce information regarding the care of YWBC in resource-constrained countries is available, with most reports describing suboptimal care in terms of survivorship needs. Health care providers should implement actions to improve endocrine treatment adherence, referrals for fertility counseling and preservation, contraceptive use compliance, timely body image and sexual function interventions, comprehensive genetic risk assessments, and early quality of life and psychosocial health interventions. While high costs act as a barrier for optimal care in resource-limited settings, improving patient education represents a promising and cost-effective solution to improve patient care. Future research on developing tailored educational resources for YWBC in resource-limited settings should be considered a priority.

The Relationship Between Hope and Received Information About Cancer Among Women with Breast Cancer: A Descriptive-Correlational Study

Background: In Western culture, information about different aspects of cancer is directly provided to the individual, but in Eastern culture, health professionals and families do not prefer to inform the patient from diagnosis, treatment, test results, causes of the disease, and the effect of treatment on sexual intercourse in front of patients in order to maintain their hope. Objectives: This study aimed at investigating the relationship between hope and received information about cancer (RIAC) among patients with breast cancer. Methods: Using a descriptive-correlational design, this study was conducted from July to December 2019 on 200. Patients with breast cancer were consecutively recruited from 2 hospitals affiliated with the Iran University of Medical Sciences, Tehran, Iran. The participants completed a demographic and clinical characteristics questionnaire, the European Organization of Research and Treatment of Cancer Quality of Life Information module (EORTC QLQ-INFO25), and the Herth hope index. Results: The response rate was 100% and participants’ mean age was 49.0 ± 10.33. The mean scores of participants’ RIAC and hope were 40.17 ± 11.52 (in the possible range of 0 - 100) and 36.77 ± 4.61 (in the possible range of 12 - 48), respectively. The mean score of hope had significant positive relationships with the mean score of RIAC (r = 0.305; P < 0.001), and educational level (P = 0.004). Moreover, the mean score of RIAC had a significant positive relationship with educational level (0.049). Conclusions: Greater RIAC is associated with greater hope among patients with breast cancer. Therefore, healthcare providers need to establish effective communication with these patients and provide them with necessary education and information in order to promote their engagement in care plans, improve their self-efficacy, and boost their hope.