Sexual Function, Quality of Life, and Experiences of Women with Ovarian Cancer: A Mixed-Methods Study

Abstract

Introduction: Ovarian cancer impacts approximately 1 in 75 women. Sexual health is receiving increasing attention as a critical aspect of gynecologic cancer treatment and a component of quality of life. Therefore, investigating how women with ovarian cancer experience and express sexuality is an important area of inquiry. Aims: To evaluate how women with ovarian cancer experience and express sexuality, a major determinant of quality of life, in the context of their illness. Methods: In a mixed-methods approach, 6 validated self-report questionnaires (n ¼ 64) and an in-depth focus group (n ¼ 3) were used to gather data. Results: The quantitative phase of the study showed that women with ovarian cancer have a poorer quality of life and higher rates of sexual dysfunction and sexual distress compared with published norms from the general population. They also have lower levels of relationship satisfaction and increased rates of depression. The qualitative phase of the study revealed 6 themes: (i) changes to relationship satisfaction; (ii) sexual difficulties; (iii) challenges with body image; (iv) gaps in communication with healthcare providers; (v) feelings of guilt, grief, resentment, anxiety, and fear; and (vi) strategies used for coping. Conclusions: Ovarian cancer impacts women's lives beyond mere survival, including their sexual function and quality of life. Healthcare providers are urged to prepare women with ovarian cancer for these challenges and offer information and resources to help improve their quality of life and sexuality.

Psychosexual morbidity in women with ovarian cancer

“…A likely factor contributing to reduced sexual activity in women with epithelial ovarian cancer is the higher levels of sexual distress compared with published general population values (18% vs 12%, respectively). 25 Questionnaires were able to separate sexual distress into distinct categories. The only quality of life questionnaire specifically validated for women with epithelial ovarian cancer is the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Ovarian Cancer (EORTC QLQ-OV28).…”

“…Depression rates were higher in women with epithelial ovarian cancer than those published for the general population, and depression correlated with sexual problems in patients and their partners. 25 37 Over half of women with epithelial ovarian cancer are at risk of clinically significant anxiety and over a third are vulnerable to depression (compared with 19.8% depression prevalence in the general public). 25 29 In particular, younger women with epithelial ovarian cancer with relationship concerns are particularly vulnerable to anxiety (p<0.05), 29 and anxiety and fear are associated with pain during sex (dyspareunia) leading to reduced intimate touching.…”

“… 25 37 Over half of women with epithelial ovarian cancer are at risk of clinically significant anxiety and over a third are vulnerable to depression (compared with 19.8% depression prevalence in the general public). 25 29 In particular, younger women with epithelial ovarian cancer with relationship concerns are particularly vulnerable to anxiety (p<0.05), 29 and anxiety and fear are associated with pain during sex (dyspareunia) leading to reduced intimate touching. 25 Unfortunately, no study evaluated how treatment of such anxiety and depression might improve psychosexual morbidity.…”

The decline in sexual function, psychological disorders (anxiety and depression) and life satisfaction in older men: A cross‐sectional study in a hospital‐based population

“…Sexual desire and sexual behaviours/activities, two of the main components of sexuality, have been widely studied and proven to be associated with other diseases such as cardio‐cerebrovascular diseases, psychological and psychiatric diseases, chronic metabolic diseases and several kinds of malignant tumours, as well as with the male death rate generally (Brody & Preut, 2003; Costa & Brody, 2012; Ebrahim et al, 2002; Fischer, Marguerie, & Brotto, 2019; Holloway & Wylie, 2015; Lee, Nazroo, O’Connor, Blake, & Pendleton, 2016; Mütsch et al, 2019; Palmore, 1982; Rider et al, 2016; Smith, Frankel, & Yarnell, 1997; White et al, 2012; Yang, Lu, Song, Chen, & Liu, 2019; Yang, Song, et al, 2019).…”

Percutaneous microwave ablation versus surgical resection for ovarian cancer liver metastasis

“…Ovarian cancer (OC) is the sixth most commonly occurring cancer among women globally and one of the prominent reasons for cancer-associated fatality [1,2]. Despite advancements in both diagnosis and treatments, including surgical resection (SR) and chemotherapy, the number of deaths continues to increase in a stepwise manner due to tumor progression and metastasis [3]. Extraovarian metastasis through the intraperitoneal route of dissemination has been validated as the most typical pattern of extraovarian tumor spread.…”