Hannoun-Levi J M
Département de radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex, France.
Cancer Radiother. 2005 May;9(3):175-82. doi: 10.1016/j.canrad.2004.11.005. Epub 2005 Jan 18.
The analysis of the impact of breast and uterus cancer and their treatments on sexual function remains a tricky approach, especially due to some difficulties of communication between patient and medical staff. Some cultural, social, physiological and psychological considerations can change the evolution of sexual function during and after cancer treatment. For breast cancer, mastectomy or conservative approach, as well as radiotherapy and chemotherapy, can induce a modification of body image, femininity, power of seduction and sexuality. For uterus cancer, radio-surgical treatments can induce local (shrinking or vagina dryness,...) or general (early menopause) modifications leading to a decrease of sexual relations. The present analysis of the literature gives a better knowledge of the sexual function troubles according to the type, stage and treatment of the cancer as well as the context in which it appears, especially in regard to personal, family (couple relation before the disease occurrence), social and cultural considerations. A critical point is to introduce, as soon as possible, in the therapeutic program, a global approach including side effects on sexual function and to analyze very carefully the own ability of the patient to manage the difficulties occurring during the treatment.
分析乳腺癌和子宫癌及其治疗方法对性功能的影响仍然是一种棘手的方法，尤其是由于患者与医护人员之间存在一些沟通困难。一些文化、社会、生理和心理因素会改变癌症治疗期间及之后性功能的演变。对于乳腺癌，乳房切除术或保守治疗方法，以及放疗和化疗，都可能导致身体形象、女性特质、吸引力和性取向的改变。对于子宫癌，放射外科治疗可能会引起局部（如萎缩或阴道干燥等）或全身（如过早绝经）的变化，从而导致性关系减少。目前对文献的分析能让我们更好地了解根据癌症的类型、阶段和治疗方法以及出现的背景，尤其是在个人、家庭（疾病发生前的夫妻关系）、社会和文化因素方面，性功能所受到的困扰。关键在于尽快在治疗方案中引入一种全面的方法，包括对性功能的副作用，并非常仔细地分析患者自身应对治疗期间出现困难的能力。
