Barbera L, Zwaal C, Elterman D, McPherson K, Wolfman W, Katz A, Matthew A
Department of Radiation Oncology, University of Toronto, Toronto.
Program in Evidence-Based Care, Cancer Care Ontario, Hamilton.
Curr Oncol. 2017 Jun;24(3):192-200. doi: 10.3747/co.24.3583. Epub 2017 Jun 27.
Sexual dysfunction in people with cancer is a significant problem. The present clinical practice guideline makes recommendations to improve sexual function in people with cancer.
This guideline was undertaken by the Interventions to Address Sexual Problems in People with Cancer Expert Panel, a group organized by the Program in Evidence-Based Care (pebc). Consistent with the pebc standardized approach, a systematic search was conducted for existing guidelines, and the literature in medline and embase for the years 2003-2015 was systematically searched for both systematic reviews and primary literature. Evidence found for men and for women was evaluated separately, and no restrictions were placed on cancer type or study design. Content and methodology experts performed an internal review of the resulting draft recommendations, which was followed by an external review by targeted experts and intended users.
The search identified 4 existing guidelines, 13 systematic reviews, and 103 studies with relevance to the topic. The present guideline provides one overarching recommendation concerning the discussion of sexual health and dysfunction, which is aimed at all people with cancer. Eleven additional recommendations made separately for men and women deal with issues such as sexual response, body image, intimacy and relationships, overall sexual functioning and satisfaction, and vasomotor and genital symptoms.
To our knowledge this clinical practice guideline is the first to comprehensively evaluate interventions for the improvement of sexual problems in people with cancer. The guideline will be a valuable resource to support practitioners and clinics in addressing sexuality in cancer survivors.
癌症患者的性功能障碍是一个重大问题。当前的临床实践指南提出了改善癌症患者性功能的建议。
本指南由癌症患者性问题干预专家小组制定,该小组由循证护理项目(pebc)组织。按照pebc的标准化方法,对现有指南进行了系统检索,并对2003年至2015年期间Medline和Embase数据库中的文献进行了系统检索,以查找系统评价和原始文献。分别对男性和女性的证据进行评估,对癌症类型或研究设计不设限制。内容和方法专家对最终的推荐草案进行了内部评审,随后由目标专家和预期用户进行了外部评审。
检索确定了4项现有指南、13项系统评价和103项与该主题相关的研究。本指南提供了一项关于讨论性健康和性功能障碍的总体建议,适用于所有癌症患者。另外还分别针对男性和女性提出了11项建议,涉及性反应、身体形象、亲密关系和人际关系、整体性功能和满意度以及血管舒缩症状和生殖器症状等问题。
据我们所知,本临床实践指南是首个全面评估改善癌症患者性问题干预措施的指南。该指南将成为支持从业者和诊所解决癌症幸存者性问题的宝贵资源。