Gynaecological Oncology, National Cancer Institute, Aviano, Italy
Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy.
Int J Gynecol Cancer. 2019 Mar;29(3):630-634. doi: 10.1136/ijgc-2018-000096. Epub 2019 Feb 13.
Sexual dysfunction in female cancer patients remains under-diagnosed and under-treated. As sexual dysfunction is becoming an increasingly common side effect of cancer treatments, it is imperative for healthcare providers and especially gynecologic oncologists to include a comprehensive evaluation of sexual health as a routine part of the workup of such patients. Although most oncologists are not experienced in treating sexual dysfunctions, simple tools can be incorporated into clinical practice to improve the management of these conditions. In this review, we propose a practical approach to selecting proper treatment for sexual dysfunctions in female cancer patients. This includes three main steps: knowledge, diagnosis, and sexual counseling. Knowledge can be acquired through a specific updating about sexual issues in female cancers, and with a medical training in female sexual dysfunctions. Diagnosis requires a comprehensive history and physical examination. Sexual counseling is one of the most important interventions to consider and, in some cases, it may be the only intervention needed to help cancer patients tolerate their symptoms. Sexual counseling should be addressed by oncologists; however, select patients should be referred for qualified psychological or sexological interventions where appropriate. Finally, a multidisciplinary team approach may be the best way to address this challenging issue.
女性癌症患者的性功能障碍仍然存在诊断不足和治疗不足的情况。由于性功能障碍是癌症治疗中越来越常见的副作用，医疗保健提供者，特别是妇科肿瘤学家，必须将全面的性健康评估作为此类患者检查的常规内容。尽管大多数肿瘤学家在治疗性功能障碍方面经验不足，但可以将简单的工具纳入临床实践，以改善这些疾病的管理。在这篇综述中，我们提出了一种针对女性癌症患者性功能障碍选择适当治疗的实用方法。这包括三个主要步骤：知识、诊断和性咨询。知识可以通过专门更新女性癌症中的性问题以及女性性功能障碍的医学培训来获得。诊断需要全面的病史和身体检查。性咨询是最重要的干预措施之一，在某些情况下，它可能是帮助癌症患者耐受症状所需的唯一干预措施。性咨询应由肿瘤学家提供；然而，适当情况下，应选择合适的患者进行合格的心理或性学干预。最后，多学科团队方法可能是解决这一具有挑战性问题的最佳途径。
