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Balint N, Woopen H, Richter R, Pirmorady-Sehouli A, Pietzner K, Sehouli J. Sexuality as a Prognostic Factor-Results of an Individual Patient Data NOGGO (North-Eastern German Society of Gynecological Oncology)-Meta-Analysis of 644 Recurrent Ovarian Cancer Patients Prior to Chemotherapy. Cancers (Basel) 2024; 16:811. [PMID: 38398202 PMCID: PMC10886503 DOI: 10.3390/cancers16040811] [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: 01/09/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The aim of this study was to analyze the associations between sexuality, quality of life, treatment discontinuation, and survival in recurrent ovarian cancer (OC). METHODS Raw data from various phase II/III studies, including the questionnaires EORTC-QLQ-C30 and QLQ-OV28, were included. Data from the meta-analysis were calculated using logistic and Cox regression. RESULTS Data on sexuality were available for 644 patients. A total of 162 patients had an interest in sex and were sexually active (Group A). A total of 45 patients had an interest in sex and were sexually not active (Group I) and 437 patients had no interest in sex and were not sexually active (Group N). Group A was younger in median age (age at randomization), at 57 years, than Group I, at 60 years, and Group N, at 65 years (p < 0.001). Group A had a better ECOG performance status and fewer recurrences (all p < 0.001). FIGO stage, grading, and BMI were not associated with interest in sex and sexual activity. Group A showed higher scores in role, body, and social function (all p < 0.001), emotional functionality (p < 0.002), and body image (p = 0.012). In addition, Group A reported less pain, less peripheral neuropathy, and less fatigue (all p < 0.001). There was no association with the premature discontinuation of chemotherapy. Group A showed better survival rates compared to group N (22.3 months vs. 17.4 months, p < 0.001). CONCLUSIONS Physicians should routinely address the topic of sexuality with ovarian cancer patients. Sexuality appears to be a marker for quality of life as well as overall survival.
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Affiliation(s)
- Nicole Balint
- Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany (R.R.); (K.P.); (J.S.)
| | - Hannah Woopen
- Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany (R.R.); (K.P.); (J.S.)
| | - Rolf Richter
- Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany (R.R.); (K.P.); (J.S.)
| | - Adak Pirmorady-Sehouli
- Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany;
| | - Klaus Pietzner
- Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany (R.R.); (K.P.); (J.S.)
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany (R.R.); (K.P.); (J.S.)
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Membrilla-Beltran L, Cardona D, Camara-Roca L, Aparicio-Mota A, Roman P, Rueda-Ruzafa L. Impact of Cervical Cancer on Quality of Life and Sexuality in Female Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3751. [PMID: 36834444 PMCID: PMC9961044 DOI: 10.3390/ijerph20043751] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
Cervical cancer is the fourth most frequent cancer in women worldwide, and the 11th most frequent neoplasm in Spain. Despite the optimization of treatments and a 5-year survival rate of 70%, side effects and sequelae are described after treatment. The treatments have physical, psychological and sociocultural consequences that deteriorate the quality of life of patients. One of the sequelae that worries patients is the impairment of sexual function and satisfaction, considered a fundamental dimension of the human being. The aim of this study was to examine quality of life and sexual function and satisfaction among Spanish cervical cancer survivors. A retrospective case-control study was conducted between 2019 and 2022. The sample consisted of 66 patients who completed the Female Sexual Function Index, the Golombok Rust Sexual Satisfaction Inventory and European Organization for Research and Treatment of Cancer quality of life questionnaire. The control group consisted of women without cervical cancer and gynecological pathologies obtained using the so-called online virtual sampling method. The patient group consisted of women with cervical cancer who completed treatment. Cervical cancer survivors reported sexual dysfunction and impaired sexual satisfaction in almost half of the domains. Quality of life was also affected, with pain and fatigue being the most frequent symptoms in these patients. Our results indicate that there is dysfunction, sexual dissatisfaction and a lower level of quality of life in cervical cancer survivors than in healthy women without pathology.
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Affiliation(s)
| | - Diana Cardona
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
- Health Research Center, University of Almería, 04120 Almería, Spain
| | | | - Adrian Aparicio-Mota
- Andalusian Public Foundation for Biomedical Research in Eastern Andalusia (FIBAO), University Hospital Torrecárdenas, 04009 Almería, Spain
| | - Pablo Roman
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
- Health Research Center, University of Almería, 04120 Almería, Spain
| | - Lola Rueda-Ruzafa
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
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Boding S, Russell H, Knoetze R, Wilson V, Stafford L. 'Sometimes I can't look in the mirror': Recognising the importance of the sociocultural context in patient experiences of sexuality, relationships and body image after ovarian cancer. Eur J Cancer Care (Engl) 2022; 31:e13645. [PMID: 35790894 PMCID: PMC9787468 DOI: 10.1111/ecc.13645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Ovarian cancer (OC) can significantly change the way women feel about their body. However, personal accounts regarding these changes are lacking in the literature. Therefore, the aim of this study was to gain an understanding of the ways in which OC can affect relationships, sexuality, womanhood and body image. METHODS Ninety-eight Australian women aged 18 and over diagnosed with OC completed an online survey that invited narrative responses to open-ended questions about relationships, sexuality, body image and womanhood following OC treatment. Responses were analysed thematically while applying a sociocultural lens. RESULTS Three themes and two subthemes were identified: Failure and Loss of Femininity and Womanhood, Internalising Public Perception of Body and Illness and Altered Relationships which comprised two subthemes, Loss of the Sexual Self and Relationship Burden. These themes suggest women view themselves and their relationships in comparison with sociocultural understandings of body normalcy. Women often questioned their self-worth, their relationships and place within society due to changes in fertility, sexuality and bodily functioning. CONCLUSION These results highlight a need for health care professionals to open dialogue with women about sexuality and ensure information and support is given to reduce stigma and positively influence self-perception and increase body acceptance.
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Affiliation(s)
- Sally‐Anne Boding
- University of South Australia, Justice and SocietyAdelaideSAAustralia
| | | | - Ricki Knoetze
- University of South Australia, Justice and SocietyAdelaideSAAustralia
| | - Victoria Wilson
- University of South Australia, Justice and SocietyAdelaideSAAustralia
| | - Lesley Stafford
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneVICAustralia
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The Relationship Between Sexual Satisfaction and Marital Satisfaction in Women With Ovarian Cancer and Their Spouses. Cancer Nurs 2022; 45:473-480. [PMID: 36265070 DOI: 10.1097/ncc.0000000000001072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Ovarian cancer can have long-term physical and psychosexual effects on survivors. The post-ovarian cancer sexuality concerns of women can cause sadness and anxiety and negatively impact sexual and marital satisfaction in these women and their spouses. OBJECTIVE The aim of this study was to investigate the relationship between sexual satisfaction and marital satisfaction of women with ovarian cancer and their spouses. METHODS This study was designed retrospectively. This study was conducted with 172 participants: 86 women with ovarian cancer and 86 spouses. Data were collected over 6 months from July 2019 to December 2019. Sexual satisfaction levels were assessed using the Golombok Rust Inventory of Sexual Satisfaction. Marital satisfaction levels were assessed using the Golombok Rust Inventory of Marital State. RESULTS Spouses' sexual satisfaction (mean, 8.10) was worse than that of the women (mean, 5.60). The women's marital satisfaction (mean, 47.39) was worse than that of their spouses (mean, 40.75). CONCLUSIONS As the sexual satisfaction of the women increased, the marital satisfaction of the women (r = 0.346, P = .001) and spouses (r = 0.308, P = .001) increased. As the sexual satisfaction of the spouses increased, the marital satisfaction of the women (r = 0.512, P = .001) and spouses (r = 0.409, P = .001) increased. IMPLICATIONS FOR PRACTICE Nurses and healthcare teams need to be aware of post-ovarian cancer sexual and marital satisfaction problems of women and their spouses and organize activities at education and couple counseling on these problems.
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Nho J, Kim SR, Choi WK. Relationships among sexual function, marital intimacy, type D personality and quality of life in patients with ovarian cancer, with spouses. Eur J Cancer Care (Engl) 2022; 31:e13760. [DOI: 10.1111/ecc.13760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/26/2022] [Accepted: 10/09/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Ju‐Hee Nho
- College of Nursing, Research Institute of Nursing Science Jeonbuk National University Jeonju Republic of Korea
| | - Sung Reul Kim
- College of Nursing, Institute of Nursing Research Korea University Seoul Republic of Korea
| | - Won Ku Choi
- Research Institute of Clinical Medicine of Jeonbuk National University‐Biomedical Research Institute of Jeonbuk National University Hospital, Department of Obstetrics and Gynecology Jeonbuk National University Medical School Jeonju Republic of Korea
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Pergialiotis V, Sotiropoulou IM, Liatsou E, Liontos M, Frountzas M, Thomakos N, Rodolakis A, Haidopoulos D. Quality of life of ovarian cancer patients treated with combined platinum taxane chemotherapy: a systematic review of the literature. Support Care Cancer 2022; 30:7147-7157. [PMID: 35459954 DOI: 10.1007/s00520-022-07053-y] [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: 12/01/2021] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Chemotherapy is the cornerstone of adjuvant therapy in ovarian cancer. Its impact on the quality of life (QoL) has been addressed in several studies; however, several misperceptions concerning this affect patient counseling and physicians' ability to overcome patient fears. In the present systematic review, we sought to accumulate current evidence in the field in order to help establish robust information that will help physicians answer patients' questions. METHODS The present systematic review is based on the PRISMA guidelines. Studies that evaluated patient QoL pre-, during, and post-chemotherapy with the use of the QLQC-30 were selected for inclusion. Their methodological quality was assessed with the before-after studies tool that is proposed by the National Institute of Health (NIH). RESULTS Ten studies that involved 5181 patients were included in the present systematic review. The risk of bias and methodological quality of included studies was of good and fair overall quality. Retrieved data suggest there is substantial evidence that points toward improved global QoL among ovarian cancer patients treated with taxanes-platinum combination therapy. Individual outcomes evaluated with the QLQ-C30 also provide positive results, although underreporting was noted. CONCLUSION Despite the significant heterogeneity in outcome reporting, the findings of this study reveal the significant benefit of combined platinum taxane chemotherapy on the QoL of ovarian cancer patients and can be used for patients counseling in order to reduce refusals that arise from fear of adverse effects that may negatively affect QoL. Graphical abstract.
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Affiliation(s)
- Vasilios Pergialiotis
- 1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece. .,Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, 6, Danaidon Str., 15232, Halandri, Greece.
| | - Ioanna Myrto Sotiropoulou
- Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, 6, Danaidon Str., 15232, Halandri, Greece
| | - Efstathia Liatsou
- Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, 6, Danaidon Str., 15232, Halandri, Greece
| | - Michalis Liontos
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maximos Frountzas
- Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, 6, Danaidon Str., 15232, Halandri, Greece
| | - Nikolaos Thomakos
- 1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Rodolakis
- 1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Haidopoulos
- 1st Department of Obstetrics and Gynecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Pelvic floor disorders and sexuality in women with ovarian cancer: A systematic review. Gynecol Oncol 2021; 161:264-274. [PMID: 33516528 DOI: 10.1016/j.ygyno.2021.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 01/20/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Pelvic floor disorders (PFD) are common conditions impacting quality of life and sexuality may worsen after ovarian cancer therapies. Our objective was to describe the prevalence of PFD and sexuality in women with ovarian cancer (OC). METHODS We reviewed articles indexed in the MEDLINE database until June 2020 and selected articles assessing UI, POP, FI and sexual dysfunction in a population of women with OC. RESULTS Of 360 articles, 18 were included: four assessed UI, two assessed POP, three FI, and 13 sexual dysfunction. PFD findings were highly heterogeneous due to the definitions used and the populations studied. The prevalence of any type of UI in patients with OC before treatment is around 50%, and about 17% report feeling a bulge in their vagina. These rates are similar to those reported in women without cancer. Similarly, the main post-treatment UI scores were not significantly different from women without cancer. Fecal incontinence has been less studied in women with OC but reported as affecting 4% of patients preoperatively and 16% postoperatively. About half of the women are sexually active after surgical treatment with high reported rates of dyspareunia (40-80%) and vaginal dryness (60-80%). Compared with healthy women, some authors found that OC patients had greater problems with loss of desire and poorer sexual function scores; other authors did not find a significant difference. CONCLUSIONS While PFD seem to be common in women after treatment for OC, the rates are not higher than in the general population. Overall, there is a higher prevalence of UI and sexual dysfunction compared with bowel dysfunction. More prospective studies are needed to explore the impact of gynecologic cancers and their treatments on pelvic floor function and pelvic health-related quality of life.
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Logue CA, Pugh J, Jayson G. Psychosexual morbidity in women with ovarian cancer. Int J Gynecol Cancer 2020; 30:1983-1989. [PMID: 33115791 PMCID: PMC7788483 DOI: 10.1136/ijgc-2020-002001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022] Open
Abstract
Increasing numbers of women are surviving for longer with epithelial ovarian cancer. Consequently, there is increased focus on long-term quality of life in national guidance. Psychosexual morbidity including vaginal dryness, pain during intercourse (dyspareunia), reduced libido, and negative perceived body image exacerbate stress and anxiety and impact intimate relationships. Although a priority for women with epithelial ovarian cancer, clinicians seldom discuss sexual problems. Therefore, psychosexual morbidity and the associated distress remain unaddressed. We synthesize evidence from primary qualitative and quantitative research studies exploring psychosexual morbidity in women with epithelial ovarian cancer to identify potential risk factors and common symptoms, to facilitate the identification and management of sexual problems in clinic. Literature (2008–19) from 10 databases identified 29 suitable publications (4116 patients). The papers were assessed to answer the question: “What are the key potential risk factors and presentations of psychosexual morbidity in women with epithelial ovarian cancer?” Current literature lacks consensus in defining clinically significant psychosexual morbidity in women with epithelial ovarian cancer. Discrepancies in measurement tools, questionnaires, and primary outcome measures confound result interpretation, limiting wider application. Key potential risk factors identified included: younger age (<53 years); pre-menopausal status at diagnosis; aim of treatment; extent of surgery; more courses of chemotherapy; cardiovascular co-morbidities; and anxiety and depression. Up to 75% of women with epithelial ovarian cancer reported adverse changes in their sex lives following diagnosis and, of the sexually active, vaginal dryness affected 81–87% and pain 77%. Other prevalent symptoms included: reduced sexual desire and activity, impaired orgasm, diminished perceived body image, and reduced partner intimacy. Psychosexual morbidity represents a significant unmet need for women with epithelial ovarian cancer. Effective treatment necessitates a multimodal approach encompassing medical, psychoeducational, and physiotherapy-based strategies. Future studies need agreement in their questionnaires, definitions, thresholds, and primary outcome measures for meaningful interstudy comparisons to be drawn.
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Affiliation(s)
- Chloe Alice Logue
- Gynaecological Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK
| | - Julia Pugh
- Gynaecological Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Gordon Jayson
- Gynaecological Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK .,Division of Cancer Sciences, University of Manchester Faculty of Biology, Manchester, UK
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Le retentissement du cancer utérin et ses traitements sur la sexualité. SEXOLOGIES 2020. [DOI: 10.1016/j.sexol.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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10
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Uysal N, Ünal Toprak F, Soylu Y, Kaya B. Evaluation of Sexual Life in Patients with Gynecologic Cancer Undergoing Radiotherapy. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09658-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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11
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Armbrust R, Alavi S, Pirmorady A, Chen F, Colombo N, Gultekin M, Hierro C, Lemley B, Mirza MR, Urkmez E, Fotopoulou C, Vinzent J, Gonzalez Martin A, Krull A, Heepe J, Rose M, Sehouli J. Results of the interprofessional and interdisciplinary Berlin round table on patient-reported outcomes, quality of life, and treatment expectations of patients with gynecological cancer under maintenance treatment. Int J Gynecol Cancer 2020; 30:1603-1607. [PMID: 32817309 DOI: 10.1136/ijgc-2019-001070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Patients' reported outcomes and their perspectives around their therapeutic management is a field of continuously increasing relevance in gynecological oncology. We report the results of the Berlin dialog on seven patient-reported parameters and outcomes concerning chemotherapy and maintenance treatment in patients with gynecological cancer. METHODS Key opinion leaders in gynecological oncology from different European counties and representatives of leading patients' advocate groups in Berlin held a consensus meeting in Berlin on April 6, 2019. Seven topics of interest were identified in advance around quality of life, iatrogenic toxicity, treatment decision-making processes, sexuality, participation in clinical trials, second opinion, and long-term survivors with the the following standard operating procedure for processing and discussion: (1) agreement on its relevance; (2) literature review, and (3) discussion and consensus statements. RESULTS All main topics reached a consensus approval. The defined statements emphasized the importance of patients' role in incorporating and establishing quality of life as an outcome parameter in clinical trials. Furthermore, discussants raised the importance of identifying new tools for reflecting patient-reported iatrogenic toxicity as well as emphasizing patients' rights in providing personal information, access to second opinion in the decision-making process, and their participation in clinical trials. CONCLUSION The results of this round table meeting could help redefine perspectives on the discussed topics and the importance for therapeutic management as well as for trial designs.
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Affiliation(s)
- Robert Armbrust
- Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Sara Alavi
- Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Adak Pirmorady
- Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Frank Chen
- Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Nicoletta Colombo
- Medical Gynecologic Oncology Unit, University of Milan Bicocca; European Institute of Oncology, Milan, Italy
| | - Murat Gultekin
- Cancer Control Department, Turkish Ministry of Health, Ankara, Turkey
| | - Charo Hierro
- Asociación de Afectados por Cáncer de Ovario, Barcelona, Spain
| | | | - Mansoor Raza Mirza
- Department of Oncology, Rigshospitalet; Copenhagen University Hospital, Copenhagen, Denmark
| | - Esra Urkmez
- European Society of Gynaecological Oncology-European Network of Gynecological Cancer Advocacy Groups (ESGO-ENGAGe) Chair, Geneva, Switzerland.,Kanserle Dans, Ankara, Turkey
| | | | | | | | - Andrea Krull
- Eierstockkrebs Deutschland e.V, Neumünster, Germany
| | - Judith Heepe
- Department of Nursery, Charité University Hospital Berlin, Berlin, Germany
| | - Mathias Rose
- Department of Psychosomatic Medicine, Charité University Hospital Berlin, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
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Valpey R, Kucherer S, Nguyen J. Sexual dysfunction in female cancer survivors: A narrative review. Gen Hosp Psychiatry 2019; 60:141-147. [PMID: 31030966 DOI: 10.1016/j.genhosppsych.2019.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/25/2019] [Accepted: 04/01/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Due to improvements in earlier detection and expansions in available treatments, the number of individuals surviving with cancer is steadily increasing. Sexual dysfunction is a common and often persistent complication for cancer survivors, affecting >60% of women diagnosed with cancer. Although highly prevalent, issues related to sexual health are often not addressed among survivors, with women reporting less discussion with providers compared to men. METHODS In this narrative review, we present a case series of three women seen in a psycho-oncology clinic who experienced sexual dysfunction following a cancer diagnosis. We then review existing literature on the presentation and management of sexual issues associated with cancer and its treatment. RESULTS The three cases highlight different mechanisms of sexual dysfunction after cancer, including anatomic changes, hormonal alterations, psychiatric conditions and medication side effects. The literature review includes discussion of the prevalence and course of sexual dysfunction in female cancer survivors. Tools for screening and assessment are then reviewed, as well as contributing factors and common presenting symptoms. We conclude with a discussion of both pharmacologic and non-pharmacologic approaches to management. CONCLUSIONS Despite its high prevalence and considerable impact on quality of life, the complication of sexual dysfunction after cancer diagnosis and treatment is still under recognized and undertreated. Improving awareness, communication, and screening, as well as appropriate referral to treatment, could have a profound impact on the ever growing number of women surviving with cancer with sexual health concerns.
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Affiliation(s)
- Robin Valpey
- University of Pittsburgh Medical Center, United States of America.
| | - Shelly Kucherer
- University of Pittsburgh Medical Center, United States of America
| | - Julia Nguyen
- University of Pittsburgh School of Medicine, United States of America
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Changes in Sexual Function of Patients with Cancer in Turkey. SEXUALITY AND DISABILITY 2019. [DOI: 10.1007/s11195-019-09579-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Cianci S, Tarascio M, Rosati A, Caruso S, Uccella S, Cosentino F, Scaletta G, Gueli Alletti S, Scambia G. Sexual function and quality of life of patients affected by ovarian cancer. Minerva Med 2019; 110:320-329. [PMID: 31081305 DOI: 10.23736/s0026-4806.19.06080-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The sexual function (SF) in patients affected by malignancies represents an important aspect influencing the quality of life (QoL). The most frequent symptoms reported are the decreased sexual desire, dyspareunia, and/or problems with arousal or achieving orgasm. The present study is aimed at analyzing the available scientific evidence regarding the QoL and especially SF of patients affected by ovarian cancer who underwent surgical and medical treatment. EVIDENCE ACQUISITION A preliminary research was conducted using Pubmed database with specific keywords combinations regarding SF, QoL and ovarian cancer. The principal findings considered in the present review were: the study design, the number of patients included in each study, the information about the malignancy (histology and stage of disease), the questionnaires administered and the principal findings concerning SF and QoL. EVIDENCE SYNTESIS The studies selected were 5 prospective series and 3 case control cross-sectional studies. The scores used were focused on SF, QOL, fatigue and psychological aspects. All studies reported a decreased SF and QOL. Different factors coexist in the influence on outcomes such as physical, hormonal, psychological, self body image, and mechanic outcomes. CONCLUSIONS SF represents a fundamental aspect strictly related with QoL. Patients with ovarian cancer (as well all oncological patients) experience a reduction in their SF after diagnosis of malignancy and they should receive adequate counseling regarding this aspect.
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Affiliation(s)
- Stefano Cianci
- Division of Gynecologic Oncology, Department of Women and Children's Health, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy -
| | - Mattia Tarascio
- Division of Gynecologic Oncology, Department of Women and Children's Health, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy
| | - Andrea Rosati
- Division of Gynecologic Oncology, Department of Women and Children's Health, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy
| | - Salvatore Caruso
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, Catania, Italy
| | - Stefano Uccella
- Division of Obstetrics and Gynecology, Nuovo Ospedale degli Infermi, Biella, Italy
| | | | - Giuseppe Scaletta
- Division of Gynecologic Oncology, Department of Women and Children's Health, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy
| | - Salvatore Gueli Alletti
- Division of Gynecologic Oncology, Department of Women and Children's Health, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy
| | - Giovanni Scambia
- Division of Gynecologic Oncology, Department of Women and Children's Health, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy.,Division of Gynecologic Oncology, Sacred Heart Catholic University, Policlinico A. Gemelli Foundation, Rome, Italy
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Sutter B, Fehr M, Hartmann C, Schmid S, Zitzmann M, Stute P. Androgen receptor gene polymorphism and sexual function in midlife women. Arch Gynecol Obstet 2019; 299:1173-1183. [DOI: 10.1007/s00404-019-05052-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/05/2019] [Indexed: 12/25/2022]
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Mayer S, Iborra S, Grimm D, Steinsiek L, Mahner S, Bossart M, Woelber L, Voss PJ, Gitsch G, Hasenburg A. Sexual activity and quality of life in patients after treatment for breast and ovarian cancer. Arch Gynecol Obstet 2018; 299:191-201. [PMID: 30386993 DOI: 10.1007/s00404-018-4922-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 09/27/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Sexual activity (SA) and functioning (SF) are important factors influencing quality of life (QoL). Anticancer treatment can cause or promote sexual dysfunctions. In this study we analyzed the SA, SF and QoL in patients after completion of treatment for breast cancer (BC) and ovarian cancer (OC). METHODS In this retrospective multicenter study 396 BC patients and 93 OC patients aged between 18 and 70 years were surveyed at least 24 months after cancer diagnosis and compared to 60 healthy women. Data were collected through validated questionnaires (Sexual Activity Questionnaire, Female Sexual Function Index-d, EORTC Quality of Life Questionnaire-C30). RESULTS 45.9% of BC patients and 56.5% of OC patients reported SA. SF and well-being of sexually active BC patients were not influenced by the type and radicality of surgery or the administration of chemotherapy. Patients who received antihormonal therapy at the time of evaluation showed a lower frequency of SA (p = 0.007), less satisfaction (p = 0.003) and more discomfort during SA (p = < 0.001) compared to healthy controls but no differences in experiencing orgasms, health status, QoL and global health status. In contrast, BC patients without antihormonal therapy showed only a higher discomfort score (p = 0.028) than healthy controls and estimated their health status and QoL significantly better than patients who received antihormonal therapy (p = 0006). In general, SA was associated with a better health status (p = 0.007), a better QoL (p = 0.004) and a better global health status (p = 0.004) in BC patients. Sexually active OC patients showed no significant differences in SF, QoL and health status compared to healthy controls. CONCLUSIONS Compared to healthy controls BC patients showed limitations in SF with a lower SA rate and more discomfort. Antihormonal therapy was an important factor influencing SF and well-being. Breast and OC survivors reported good physical and psychical health without differences in QoL and health status compared to controls. This might be explained by a change of perspective on life difficulties and altered priorities through a life threatening disease.
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Affiliation(s)
- Sebastian Mayer
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Freiburg, Germany
| | - Severine Iborra
- Department of Obstetrics and Gynecology, University Medical Center Aachen, Aachen, Germany
| | - Donata Grimm
- Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lisa Steinsiek
- Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Michaela Bossart
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Freiburg, Germany
| | - Linn Woelber
- Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pit Jacob Voss
- Department of Oral and Maxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany
| | - Gerald Gitsch
- Department of Obstetrics and Gynecology, University Medical Center Freiburg, Freiburg, Germany
| | - Annette Hasenburg
- Department of Gynecology and Obstetrics, University Medical Center Mainz, Mainz, Germany.
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Whicker M, Black J, Altwerger G, Menderes G, Feinberg J, Ratner E. Management of sexuality, intimacy, and menopause symptoms in patients with ovarian cancer. Am J Obstet Gynecol 2017; 217:395-403. [PMID: 28411144 DOI: 10.1016/j.ajog.2017.04.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 12/19/2022]
Abstract
Issues of sexuality, intimacy, and early menopause significantly impact the quality of life of patients following the diagnosis and treatment of ovarian cancer. These are undertreated problems. Successful treatment requires the provider's awareness of the problem, ability to identify it, and willingness to treat it. Unfortunately many providers do not address these issues in the pretreatment or perioperative period. Furthermore, patients do not often alert their providers to their symptoms. While systemic hormone therapy may improve many of the issues, they are not appropriate for all patients given their action on estrogen receptors. However, other nonhormonal treatments exist including selective serotonin reuptake inhibitors, antiepileptics, natural remedies, and pelvic floor physical therapy. In addition psychological care and the involvement of the partner can be helpful in managing the sexual health concerns of these patients. At the time of diagnosis or at initial consultation, women should be informed of the potential physiologic, hormonal, and psychosocial effects of ovarian cancer on sexuality and that there is a multimodal approach to dealing with symptoms.
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Affiliation(s)
- Margaret Whicker
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Jonathan Black
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT.
| | - Gary Altwerger
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Gulden Menderes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Jacqueline Feinberg
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Elena Ratner
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
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18
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Williams NF, Hauck YL, Bosco AM. Nurses' perceptions of providing psychosexual care for women experiencing gynaecological cancer. Eur J Oncol Nurs 2017; 30:35-42. [PMID: 29031311 DOI: 10.1016/j.ejon.2017.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 05/11/2017] [Accepted: 07/04/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE To gain insight into how Western Australian nurses conceptualise the provision of psychosexual care for women undergoing gynaecological cancer treatment and how this aligns with nurses globally. METHODS A qualitative descriptive design was chosen to facilitate insight into nurses' perspectives of their reality. Seventeen nurses working at a tertiary women's hospital in Western Australia participated in one-on-one interviews and were asked to describe their perceptions and identify factors that facilitate or challenge psychosexual care provision. RESULTS Data analysis revealed five themes affecting the provision of psychosexual care: (1) Nurses use strategies to aid the conversation (subthemes: supporting the woman, facilitating engagement); (2) Women have unique psychosexual needs (subthemes: diversity, receptiveness); (3) Nurses are influenced by personal and professional experience and values (subthemes: confidence, values, making assumptions); (4) Systems within the health service affect care (subthemes: being supported by the system, working as a team); and (5) Society influences attitudes around sexuality. Nurses' views differed around whether these factors had a positive or negative impact on the conversation required to provide this care. CONCLUSIONS Factors influencing nurses' provision of psychosexual care are multifaceted and differ amongst nurses. Recommended strategies to improve service provision include guidelines and documentation to integrate assessment of psychosexual issues as standard care, encouraging shared responsibility of psychosexual care amongst the multidisciplinary team and implementing education programs focussed on improving nurses' confidence and communication skills.
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Affiliation(s)
- Natalie F Williams
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, PO Box 134, Subiaco, Western Australia, 6904, Australia; School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Yvonne L Hauck
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, PO Box 134, Subiaco, Western Australia, 6904, Australia; School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia
| | - Anna M Bosco
- School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia
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Cook O, McIntyre M, Recoche K, Lee S. Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:2087-2112. [PMID: 28800057 DOI: 10.11124/jbisrir-2016-003126] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. OBJECTIVES This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. INCLUSION CRITERIA TYPES OF PARTICIPANTS This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. PHENOMENA OF INTEREST Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. TYPES OF STUDIES Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. CONTEXT Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. SEARCH STRATEGY A three-step search strategy was utilized in this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by a comprehensive search using all identified keywords and index terms across all included databases. The reference lists of all identified reports and articles were hand searched for additional studies. METHODOLOGICAL QUALITY Each paper was independently assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute the Qualitative Assessment and Review Instrument. When disagreement arose between the reviewers, the given paper was independently appraised by a third reviewer. DATA EXTRACTION Data were extracted from papers included in the review using the standardized data extraction tool from Joanna Briggs Institute the Qualitative Assessment and Review Instrument. Data extraction was completed independently by two reviewers. DATA SYNTHESIS Extracted findings from seven included papers were grouped according to similarity in meaning from which 11 categories were developed. These categories were then subjected to a meta-synthesis that produced a set of three synthesized findings. RESULTS Key findings were extracted from six included papers and classified as unequivocal (U) or credible (C). A total of 30 findings were extracted and aggregated into 11 categories based on similarity in meaning. From the 11 categories, three synthesized findings were developed: i) Tailored care: specialist nurses play a role in understanding and meeting the individual needs of women with gynecological cancer; ii) Accessible care: specialist nurses guide women with gynecological cancer along the continuum of care and are an easily accessed source of knowledge and support; iii) Dependable expertise: women with gynecological cancer express trust and reassurance in the experience and expertise of the specialist nurse. CONCLUSIONS This systematic review synthesized the findings of seven studies that captured the experiences of women with gynecological cancer who received care from a specialist nurse. The specialist nurse offers tailored, accessible and expert care to women with gynecological cancer. From the synthesis it is recommended that women with gynecological cancer have access to the services of a specialist nurse at key points on the continuum of care, that specialist nurses provide information to patients on their disease and treatment in the form preferred by the patient and ensure that this information has been understood, and that specialist nurses are afforded time to spend with patients to enable greater exploration and identification of patient needs and the provision of personalized care. Further study that considers other key stakeholders in the specialist nurse role in gynecological oncology is recommended in order to gain a full understanding of specialist nurses' contribution to the care of women with gynecological cancer. Additionally, it is recommended that further studies be conducted to seek the perspectives of women with gynecological cancer from culturally and linguistically diverse backgrounds and Indigenous populations on specialist nursing care as they appear to be under-represented in current research.
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Affiliation(s)
- Olivia Cook
- 1School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia 2The Centre for Chronic Disease Management: a Joanna Briggs Institute Centre of Excellence, Melbourne, Australia
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20
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Shao Z, Zhu T, Zhang P, Wen Q, Li D, Wang S. Association of financial status and the quality of life in Chinese women with recurrent ovarian cancer. Health Qual Life Outcomes 2017; 15:144. [PMID: 28716032 PMCID: PMC5512840 DOI: 10.1186/s12955-017-0714-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 06/27/2017] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Very few studies have examined the association between financial status and the quality of life (QOL) of patients with specific cancers. Ovarian cancer survivors frequently suffer repeat recurrence and subsequent treatment and, as a result, a significant added financial burden. Financial burdens disproportionally affect patients of low income. This study examines the association between financial status, based upon family income and expenses, and QOL in Chinese women with recurrent ovarian cancer. METHODS We assessed baseline and follow-up (3-month) QOL of Chinese women with recurrent ovarian cancer using the European Organization for Research and Treatment of Cancer 30-Item Core Quality of Life Questionnaire (EORTC QLQ-C30), and the Quality of Life Ovarian Cancer 28 Questionnaire (QLQ-OV28). Financial status was stratified based upon self-reported disposable income. Linear or logistic regression models were applied to determine the relationship between QOL in each financial status category, and key demographic and clinical factors. RESULTS Among all 473 ovarian cancer patients, 123 of them met enrollment criteria were recruited to this study and completed baseline questionnaires; 95 of these patients completed the 3-month follow-up questionnaires. Our results showed that low financial status was significantly associated with worse QOL on all functioning domains and several symptom domains. QOL deteriorated during the follow-up. A significantly greater number of patients with low financial status experienced deteriorating QOL in several domains. Occupation and insurance type, two factors related to financial status, were significantly associated with QOL as well, but to a lesser extent. Education, recurrence interval, age and BMI were also significantly related to certain domains of QOL. CONCLUSIONS Financial status is associated with QOL of Chinese women with recurrent ovarian cancer. These patients showed worsening QOL during active chemotherapy. Lower financial status is associated with a higher risk of deteriorating QOL in several domains.
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Affiliation(s)
- Zhuyan Shao
- Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China
| | - Tao Zhu
- Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China.
| | - Ping Zhang
- Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China
| | - Qiang Wen
- Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China
| | - Dan Li
- Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 1 Banshan East Road, Hangzhou, Zhejiang, 310022, China
| | - Shihua Wang
- Department of Cancer Biology, Wake Forest School of Medicine, Winston Salem, NC, USA
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21
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Teo I, Cheung YB, Lim TYK, Namuduri RP, Long V, Tewani K. The relationship between symptom prevalence, body image, and quality of life in Asian gynecologic cancer patients. Psychooncology 2017; 27:69-74. [DOI: 10.1002/pon.4457] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 05/11/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care; Duke-NUS Medical School; Singapore
- Department of Psychosocial Oncology; National Cancer Centre Singapore; Singapore
| | - Yin Bun Cheung
- Centre for Quantitative Medicine; Duke-NUS Medical School; Singapore
- Center for Child Health Research; University of Tampere and Tampere University Hospital; Tampere Finland
| | | | | | | | - Komal Tewani
- Department of Gynaecology Oncology; KK Women's and Children's Hospital; Singapore
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Domenici L, Palaia I, Giorgini M, Piscitelli VP, Tomao F, Marchetti C, Di Donato V, Perniola G, Musella A, Monti M, Muzii L, Benedetti Panici P. Sexual Health and Quality of Life Assessment among Ovarian Cancer Patients during Chemotherapy. Oncology 2016; 91:205-210. [PMID: 27513866 DOI: 10.1159/000447403] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 06/01/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND During the last decades many successful efforts have been made in order to increase life expectancy in ovarian cancer (OC) patients. However, just a few studies have investigated the impact of OC on quality of life (QoL) and sexual function in OC cases during treatment. OBJECTIVE The aim of this study was to evaluate the QoL and sexual function of OC patients during chemotherapy (CT). PATIENTS AND METHODS Forty-nine subjects were enrolled and filled in the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-OV28, Female Sexual Function Index (FSFI) and Female Sexual Distress Scale (FSDS) questionnaires. The results were evaluated globally and consequently stratified into several groups: single surgery versus multiple surgeries, age ≤48 years versus >48 years, and first-line CT versus multiple lines of CT. RESULTS Menopause-related symptoms, body image and attitude toward the disease were significantly worse during first-line CT (p = 0.018, p = 0.029 and p = 0.006, respectively). Sexual outcomes resulted in better scores in younger patients in all questionnaires (FSFI: p = 0.001; FSDS: p = 0.048; specific EORTC QLQ-OV28 items: p = 0.022). Scores concerning body image, attitude toward the disease and CT-associated symptoms resulted worse in patients after the first surgery (p = 0.017, p = 0.002 and p = 0.012, respectively). CONCLUSION Our study confirms that OC has a detrimental impact on QoL and intimacy, particularly in younger patients, during the first course of CT and after the first cytoreductive surgery.
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Affiliation(s)
- Lavinia Domenici
- Department of Gynaecology, Obstetrics and Urological Sciences, University 'Sapienza' of Rome, Rome, Italy
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Health-related quality of life in ovarian cancer survivors: Results from the American Cancer Society's Study of Cancer Survivors - I. Gynecol Oncol 2016; 141:543-549. [PMID: 27072805 DOI: 10.1016/j.ygyno.2016.04.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/28/2016] [Accepted: 04/03/2016] [Indexed: 12/31/2022]
Abstract
OBJECTIVE There are limited data on outcomes and predictors of health-related quality of life (HRQOL) of ovarian cancer survivors. Therefore, we examined the trajectory and predictors of HRQOL one- and two-years post-diagnosis in this population. METHODS 365 ovarian cancer survivors, a subset of participants in the longitudinal American Cancer Society's Study of Cancer Survivors-I, completed questionnaires at one-year post-diagnosis on sociodemographics, clinical factors, and HRQOL (SF-36). 284 women had HRQOL data at two-years post-diagnosis. In this secondary data analysis, we examined HRQOL at both time points, changes in HRQOL and predictors of HRQOL with univariate and multivariate linear regression. RESULTS Mean mental and physical HRQOL scores one-year post-diagnosis were 49.37 (SD±11.59) and 45.96 (SD±10.89), respectively. Older age, lower income, higher disease stage, more comorbidities and greater symptom burden were associated with poorer physical functioning one year post-diagnosis. Younger age, higher stage, having an existing mental health issue, greater symptom burden, and not receiving chemotherapy were associated with poorer mental functioning. Disease recurrence between one- and two-years post-diagnosis and greater symptom burden were predictors of declining physical functioning from one- to two-years post-diagnosis. Mental functioning did not change significantly between assessments. CONCLUSIONS Overall mental and physical functioning of these ovarian cancer survivors was similar to the general population. However, lower HRQOL was associated with a number of variables, including disease recurrence, treatment status, symptom burden, age, and number of comorbidities. These findings can help health care providers identify survivors who may benefit from relevant interventions.
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Lee Y, Lim MC, Kim SI, Joo J, Lee DO, Park SY. Comparison of Quality of Life and Sexuality between Cervical Cancer Survivors and Healthy Women. Cancer Res Treat 2016; 48:1321-1329. [PMID: 26875196 PMCID: PMC5080809 DOI: 10.4143/crt.2015.425] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/22/2016] [Indexed: 12/31/2022] Open
Abstract
Purpose The purpose of this study is to compare quality of life (QoL) and sexual functioning between sexually active cervical cancer survivors and healthy women. Materials and Methods In this cross-sectional study, propensity-score-matched cervical cancer survivors (n=104) and healthy women (n=104) were compared. All women had engaged in sexual activity within the previous 3 months, and cervical cancer survivors showed no evidence of disease after primary treatment. QoL and sexual functioning were assessed using three questionnaires; the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), Cervical Cancer Module (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI). Results Significantly higher scores for lymphedema were observed in the cervical cancer survivors group compared with the healthy women group (mean, 20.2 vs. 12.2; p < 0.05). Sexuality, both in terms of sexual activity, sexual enjoyment, and sexual worry (EORTC QLQ-CX24), and in terms of desire, arousal, lubrication, orgasm, satisfaction, and pain (FSFI) were similar between the groups. When the scale of sexual/vaginal functioning in EORTC QLQ-CX24 was divided into individual questions, cervical cancer survivors reported shorter vaginal length than the control group, but without statistical significance (mean, 80.6 vs. 85.4; p=0.077). Conclusion Compared with healthy women, sexuality was not impaired in cervical cancer survivors who showed no evidence of disease after primary treatment and engaging in sexual activity. Further prospective cohort studies are warranted to confirm this finding.
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Affiliation(s)
- Yumi Lee
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Myong Cheol Lim
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Department of Cancer Control, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Se Ik Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Jungnam Joo
- Department of Cancer Control, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.,Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Dong Ock Lee
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Sang-Yoon Park
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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