Improvement in sexual function after ovarian cancer: Effects of sexual therapy and rehabilitation after treatment for ovarian cancer

Abstract

BACKGROUND: Sexual dysfunction is a distressing long-term effect after gynecological cancer and affects the majority of survivors for years after the completion of therapy. Despite its prevalence, treatment-related sexual dysfunction is underrecognized and undertreated for survivors. Thus, the aim of this study was to develop and test a brief psychoeducational intervention for managing sexual dysfunction for women who have undergone treatment for ovarian cancer (OC). METHODS: Forty-six OC survivors with documented, treatment-related sexual dysfunction received a single half-day group intervention that included sexual health education and rehabilitation training, relaxation and cognitive behavioral therapy skills to address sexual symptoms, and a single tailored booster telephone call 4 weeks after the group. Assessment measures were completed at the baseline (baseline 1), after an 8-week no-treatment run-in period (baseline 2), and then again 2 and 6 months after the intervention. The Female Sexual Function Index (FSFI) was used to assess sexual functioning, and the Brief Symptom Inventory 18 (BSI-18) was used to capture psychological distress. RESULTS: Between baseline 1 and baseline 2, there were no significant changes in the study measures, and this indicated no natural improvement during the run-in period. In contrast, the total FSFI scores improved significantly from baseline 1 to the 2-(n 5 45; P <.0005) and 6-month time points (n 5 42; P <.05). The BSI-18 scores were also significantly improved at the 2-(P <.005) and 6-month time points (P <.01) in comparison with baseline 1. CONCLUSIONS: This brief behavioral intervention led to significant improvements in overall sexual functioning and psychological distress that were maintained at the 6-month follow-up. The results demonstrate the feasibility of this brief, low-intensity behavioral intervention and support the development of a larger randomized controlled trial. Cancer 2018;124:176-82. V C 2017 American Cancer Society.KEYWORDS: gynecological cancer and sexual dysfunction, ovarian cancer, quality of life and cancer, sexual health. INTRODUCTIONFemale cancer survivors often face distressing and severe sexual side effects related to their disease and its treatments. [1][2][3] For gynecological cancer survivors, sexual dysfunction has been identified as one of the core set of quality-of-life domains that is profoundly disrupted after treatment. 4 Common detrimental problems include diminished arousal, vaginal dryness, a loss of sexual desire, and decreased satisfaction. In addition to the physiological impact of gynecological cancer treatment, women suffer from a range of related psychological consequences such as a perceived loss of femininity, negative body image, and psychological distress. 5 With advances in chemotherapy and surgical techniques over the past decade, nearly 50% of women diagnosed with ovarian cancer (OC) can expect to live for many years after the diagnosis. 6-9 However, treatment regimens for OC are intensive and often include multiple ...

Pilot study of a multimodal intervention to enhance sexual function in survivors of hematopoietic stem cell transplantation

“…Second, although the findings of the current study are promising, the lack of a control group limited our ability to conclude definitively that improvements in sexual function were not due merely to the passage of time. However, prior research has shown that time alone does not ameliorate sexual dysfunction . Nonetheless, randomized controlled trials are needed to demonstrate the efficacy of the multimodal intervention in enhancing sexual function, QOL, and mood in HCT survivors.…”

“…From September 20, 2015, to January 30, 2017, we screened 151 allogeneic HCT recipients and subsequently enrolled 47 of them at Massachusetts General Hospital (MGH) (http://ClinicalTrials.gov identifier NCT02492100). We chose to use a single‐arm pilot design because prior research has shown that sexual dysfunction does not resolve with the passage of time without intervention . A research assistant screened the weekly transplant clinic schedule to identify potentially eligible patients.…”

“…10,[23][24][25] In addition, sexual counseling interventions for other cancer survivors generally have been extremely resource-and time-intensive, thereby limiting their potential for dissemination. 25,26 Therefore, a personalized approach that addresses the biologic, interpersonal, psychological, and social aspects of sexual dysfunction in HCT survivors in a feasible, patient-centered, and scalable manner within the outpatient oncology setting is critically needed. 10,14,15 We conducted a single-arm pilot study to assess the feasibility, acceptability, and preliminary efficacy of a multimodal intervention to address sexual dysfunction in HCT survivors.…”

Farklı kültürlerde jinekolojik ve meme kanserli kadın hastaların seksüaliteye bakış açıları ve yaşadıkları sorunlar

“…[52] Jinekolojik kanser sonrasında cinsel işlev bozuklukları ortaya çıkmakta, tedaviden yıllar sonra bile sağ kalanların çoğunu olumsuz olarak etkilemektedir. [53] Bu nedenle kişilerin cinsel işlev bozukluklarının erken evrede belirlenmesi ve müdahalelerinin yapılması önemlidir. Çinli kadınlar arasında jinekolojik kanser sonrasında yaşanan cinsel işlev bozukluğunun önemli bir endişe kaynağı olduğu ve bu kadınlarda %70,5 gibi yüksek bir oranda cinsel disfonksiyon görüldüğü belirtilmiştir.…”

Comparação da disfunção do assoalho pélvico com função sexual e qualidade de vida em sobreviventes ao câncer ginecológico

“…Alguns estudos sugerem que mulheres com disfunções do assoalho pélvico como dispareunia, atrofia vaginal (VAZ et al, 2011b;ZHOU et al, 2016;HUFFM AN et al, 2016;SEKSE;HUFTHAMMER;VIKA, 2017) e insatisfação sexual (BRETSCHNEIDER et al, 2017), apresentaram redução da qualidade de vida. A abordagem das disfunções do assoalho pélvico nas sobreviventes ao câncer ginecológico é cada vez mais frequente, entretanto, não há um padrão de tratamento indicado (BOBER et al, 2018), sendo necessário conhecer o real impacto destas disfunções na função sexual para um melhor direcionamento das intervenções terapêuticas (WHICKER et al, 2017).…”