Objective:Prior research examining sexual and intimacy concerns among metastatic breast cancer (MBC) patients and their intimate partners is limited. In this qualitative study, we explored MBC patients’ and partners’ experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences.Methods:We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews with intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software.Results:Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: (1) the heavy disease/treatment burden leads to significant, long-term sexual concerns (e.g., loss of interest and vaginal dryness/discomfort) and consequent heightened emotional distress for both patients (e.g., guilt around not being able to engage in intercourse) and partners (e.g., guilt around pressuring the patient to engage in sexual activity despite pain/discomfort); (2) viewing the relationship as having “an expiration date” (due to expected earlier mortality) influences patients’ and partners’ concerns related to sex/intimacy and complicates coping efforts; and (3) information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences.Conclusion:Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients’ and partners’ perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients’ health and quality of life.
11029 Background: Sexual and reproductive health (SRH) concerns are important areas of health and quality of life for patients with cancer that should be included in routine cancer care, according to clinical guidelines. Yet, oncologists often hesitate to raise SRH with their patients due to lack of training. We conducted a national survey of hematology/oncology fellowship program directors (PDs) in the U.S. to understand the state of current fellowship education on three key SRH subjects: fertility, sexual health, and safe sex practices. We assessed rates of provision of formal/informal instruction and endorsement of barriers to formal instruction. Methods: A 13-item survey of education on fertility, sexual health, and safe sex practices in adult hematology/oncology programs was sent to all PDs in the U.S. via an online link or paper survey. PD’s received a $5 gift card for participating. Descriptive statistics and McNemar tests were used. Results: One hundred-twelve PDs responded to the survey (63% response rate). Of these, 75% of PDs reported their programs offered >1 hour of formal instruction on fertility, 42% on sexual health, and 31% on safe sex practices; formal instruction was more common for fertility than either other subject (p’s < .001). Male and female fertility preservation was addressed in 62% and 59% of programs, respectively. Cancer-related sexual side effects for women and men were covered in less than one-quarter of programs (23% and 20%, respectively). Regarding informal instruction, > 73% of programs reported using clinical experience to train fellows in SRH; other informal instruction methods (i.e., case-based methods, webinars, journal clubs, grand rounds) were less common. Lack of experts/resources was the most widely endorsed barrier to providing education about fertility (55%), sexual health (75%), and safe sex practices (69%) and was more widely endorsed for sexual health and safe sex practices compared to fertility (p’s < .01). Lack of space in the curriculum and the topic not being required were also commonly endorsed barriers. Conclusions: Data from this national survey of fellowship program directors show that training in SRH is rare, particularly for sexual health. Barriers to training, especially difficulties in finding content experts, may be leading to a heavy reliance on informal methods of instruction, which are both variable and incomplete. Concerted efforts to integrate SRH into fellowship training, including novel educational curricula, are needed if SRH is to be addressed in routine cancer care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.