Peleg-Nesher Sharon, Yachini Brurya, Inbar Moshe
Tel Aviv Medical Center.
Harefuah. 2009 Sep;148(9):634-40, 656, 655.
Sexuality is a basic need for every human being as long as he or she is alive, irrespective of age or health status. Approximately 23,500 individuals are diagnosed with cancer each year in Israel and join the 120,000 cancer patients currently living in Israel. The results of cancer treatments are traditionally assessed and based on the outcome regarding mortality versus survival. An equally important aspect to be addressed in this assessment must relate to quality of life. One of the more painful insults to the quality of life of cancer patients relates to the deleterious effects on sexuality. This article aims to present physicians with the spectrum of sexuality-related issues which are encountered by cancer patients and their partners, starting from the moment of diagnosis, throughout the various stages of treatment and to provide basic knowledge. Many individuals contracting cancer have difficulty dealing with the issue of sexuality. They are typically embarrassed and feel uneasy when asking health care providers about such a non-life threatening issue. Partners similarly feel both shame and guilt. In many cases sexuality, intimacy and emotional attachment are important aspects and may be essential for survival. Addressing these issues during treatment can provide patients with a sense of security, avoiding embarrassment and further exacerbation of such problems. Unfortunately, little has been done to develop an optimal interventional program, although standard sexual treatments have often been applied. Prospective clinical research and outcomes are missing. The physician can use the well-known PLISSIT model (1978): to provide sexuality involvement on different levels. The very new BETTER model (2004) can help emphasize that cancer treatment and the disease have an influence on intimacy and sexuality.
性是每个人只要活着就有的基本需求,无论年龄或健康状况如何。在以色列,每年约有23500人被诊断患有癌症,并加入目前生活在以色列的12万癌症患者行列。传统上,癌症治疗的结果是根据死亡率与生存率的结果来评估的。在这种评估中必须解决的一个同样重要的方面必须与生活质量有关。对癌症患者生活质量更痛苦的侮辱之一与对性的有害影响有关。本文旨在向医生介绍癌症患者及其伴侣从诊断时刻开始,在治疗的各个阶段所遇到的一系列与性相关的问题,并提供基本知识。许多患癌症的人在处理性问题上有困难。当他们向医疗服务提供者询问这样一个不危及生命的问题时,通常会感到尴尬和不安。伴侣同样会感到羞耻和内疚。在许多情况下,性、亲密关系和情感依恋是重要的方面,可能对生存至关重要。在治疗期间解决这些问题可以给患者一种安全感,避免尴尬和此类问题的进一步恶化。不幸的是,尽管经常应用标准的性治疗方法,但在制定最佳干预方案方面做得很少。前瞻性临床研究和结果缺失。医生可以使用著名的PLISSIT模型(1978年):在不同层面提供性方面的介入。非常新的BETTER模型(2004年)可以帮助强调癌症治疗和疾病对亲密关系和性有影响。