Women’s cancer care often ignores sexual issues

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Long-term survivors of vaginal and cervical cancer are as likely as other women to be sexually active, but they have a lot more sex-related problems and these are often not addressed by their doctors, researchers report.

“Many women value their sexuality as an important part of their health, even in the face of a life-threatening illness,” lead investigator Dr. Stacy Tessler Lindau of the University of Chicago told Reuters Health.

"Physicians can have a lasting positive impact on their patients,” she continued, “by initiating discussion about the impact of illness or its treatments on women’s sexuality. Women typically will not initiate discussion of sexual matters with their physician, but most feel that physicians should do so.”

As described in the medical journal Gynecologic Oncology, Lindau and her associates conducted a survey of 219 women who had survived vaginal or cervical cancer, and a comparison “control” group of similar women without cancer.

The survivors were 49 years old on average, and had been cured of cancer for an average of 27 years. Although survivors and controls reported similar levels of sexual activity, the survivors had more than twice as many sexual problems. These included difficulties such as being unable to climax, pain during intercourse, feeling unattractive because of scars, postcoital bleeding, or bladder incontinence following sex.

The survivors gave a rating of 8 on a 10-point scale for their cancer treatment. However, the corresponding score for satisfaction with the quality of care and information regarding their sexual health was 5.5.

Almost two-thirds of the women had apparently never talked to a doctor about the effect of their cancer on sexuality. Furthermore, survivors who had not discussed sexuality with their physicians were significantly more likely to have three or more concurrent sexual problems.

The investigators conclude that better communications between patients and doctors “may help maximize the experience of very long-term survivorship with gynecologic cancer.”

SOURCE: Gynecologic Oncology, August 2007.

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