Stabile Cara, Goldfarb Shari, Baser Raymond E, Goldfrank Deborah J, Abu-Rustum Nadeem R, Barakat Richard R, Dickler Maura N, Carter Jeanne
Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Breast Cancer Medicine Service, Department of Medicine - Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Breast Cancer Res Treat. 2017 Aug;165(1):77-84. doi: 10.1007/s10549-017-4305-6. Epub 2017 May 25.
To assess sexual/vaginal health issues and educational intervention preferences in women with a history of breast or gynecologic cancer.
Patients/survivors completed a cross-sectional survey at their outpatient visits. Main outcome measures were sexual dysfunction prevalence, type of sexual/vaginal issues, awareness of treatments, and preferred intervention modalities. Descriptive frequencies were performed, and results were dichotomized by age, treatment status, and disease site.
Of 218 eligible participants, 109 (50%) had a history of gynecologic and 109 (50%) a history of breast cancer. Median age was 49 years (range 21-75); 61% were married/cohabitating. Seventy percent (n = 153) were somewhat-to-very concerned about sexual function/vaginal health, 55% (n = 120) reported vaginal dryness, 39% (n = 84) vaginal pain, and 51% (n = 112) libido loss. Many had heard of vaginal lubricants, moisturizers, and pelvic floor exercises (97, 72, and 57%, respectively). Seventy-four percent (n = 161) had used lubricants, 28% moisturizers (n = 61), and 28% pelvic floor exercises (n = 60). Seventy percent (n = 152) preferred the topic to be raised by the medical team; 48% (n = 105) raised the topic themselves. Most preferred written educational material followed by expert discussion (66%, n = 144/218). Compared to women ≥50 years old (41%, n = 43/105), younger women (54%, n = 61/113) preferred to discuss their concerns face-to-face (p = 0.054). Older women were less interested in online interventions (52%, p < 0.001), despite 94% having computer access.
Female cancer patients/survivors have unmet sexual/vaginal health needs. Preferences for receiving sexual health information vary by age. Improved physician-patient communication, awareness, and educational resources using proven sexual health promotion strategies can help women cope with treatment side effects.
评估有乳腺癌或妇科癌症病史女性的性健康/阴道健康问题及教育干预偏好。
患者/幸存者在门诊就诊时完成一项横断面调查。主要结局指标为性功能障碍患病率、性健康/阴道问题类型、对治疗的知晓情况以及偏好的干预方式。进行描述性频率分析,并按年龄、治疗状态和疾病部位进行二分法分析。
在218名符合条件的参与者中,109名(50%)有妇科癌症病史,109名(50%)有乳腺癌病史。中位年龄为49岁(范围21 - 75岁);61%已婚/同居。70%(n = 153)对性功能/阴道健康有些至非常担忧,55%(n = 120)报告有阴道干燥,39%(n = 84)有阴道疼痛,51%(n = 112)有性欲减退。许多人听说过阴道润滑剂、保湿剂和盆底肌锻炼(分别为97%、72%和57%)。74%(n = 161)使用过润滑剂,28%使用过保湿剂(n = 61),28%进行过盆底肌锻炼(n = 60)。70%(n = 152)希望由医疗团队提出该话题;48%(n = 105)自己提出过该话题。大多数人更喜欢书面教育材料,其次是专家讨论(66%,n = 144/218)。与50岁及以上女性(41%,n = 43/105)相比,年轻女性(54%,n = 61/113)更喜欢面对面讨论她们的担忧(p = 0.054)。尽管94%的老年女性可以使用电脑,但她们对在线干预的兴趣较低(52%,p < 0.001)。
女性癌症患者/幸存者的性健康/阴道健康需求未得到满足。接受性健康信息的偏好因年龄而异。利用经过验证的性健康促进策略改善医患沟通、提高知晓度并提供教育资源,可帮助女性应对治疗副作用。