Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.
Harvard Medical School, Boston, MA, USA.
J Cancer Surviv. 2020 Feb;14(1):26-30. doi: 10.1007/s11764-019-00800-x. Epub 2019 Sep 3.
Each year, thousands of young breast cancer (BC) patients confront the difficult decision to medically suppress ovarian function and undergo abrupt, premature menopause to reduce risk of cancer recurrence. Unlike natural menopause, young women undergoing ovarian suppression (OS) face severe and disruptive side effects. Profound sexual dysfunction is one of the most prevalent, distressing side effects of OS treatment. Unmanaged sexual dysfunction is also a primary predictor of non-adherence to this potentially life-saving treatment. We developed and tested a brief, psychosexual intervention targeted to manage sexual dysfunction and psychological distress after OS in young BC survivors.
Twenty young BC survivors with sexual dysfunction received a single 4-h group intervention that included sexual health rehabilitation, body awareness exercises, and mindfulness-based cognitive therapy (MBCT) skills followed by a single tailored booster telephone call 1-month later. Assessment of female sexual function and psychological distress was completed at baseline and 2 months post-intervention.
Analyses examined changes pre- to post-intervention. Female sexual health improved significantly from baseline to follow-up (n = 19, p < 0.02). Anxiety was also significantly improved at the 2-month (p < 0.000) timepoint, compared with baseline 1. Moderate-to-large effect sizes were observed regarding changes in sexual function and psychological distress.
Significant improvements in sexual functioning and psychological distress were observed 2 months post-intervention.
These results demonstrate that delivery of a targeted intervention in brief, low-intensity group setting is a promising model for reducing distressing sexual dysfunction in young BC survivors on OS treatment.
每年,成千上万的年轻乳腺癌(BC)患者都面临着艰难的决定,即通过医学手段抑制卵巢功能并突然进入过早绝经以降低癌症复发的风险。与自然绝经不同,接受卵巢抑制(OS)的年轻女性会面临严重且具有破坏性的副作用。严重的性功能障碍是 OS 治疗最常见、最令人痛苦的副作用之一。未得到管理的性功能障碍也是导致患者不遵从此种可能挽救生命的治疗方法的主要因素之一。我们开发并测试了一种简短的心理性干预方法,旨在管理年轻 BC 幸存者 OS 后的性功能障碍和心理困扰。
20 名患有性功能障碍的年轻 BC 幸存者接受了单次 4 小时的小组干预,包括性健康康复、身体意识锻炼和基于正念的认知疗法(MBCT)技能,之后在 1 个月后进行单次定制的电话咨询。在基线和干预后 2 个月评估女性性功能和心理困扰。
分析检查了干预前后的变化。女性性功能从基线到随访显著改善(n=19,p<0.02)。与基线 1 相比,焦虑在 2 个月时也显著改善(p<0.000)。在性功能和心理困扰方面观察到中等至较大的变化效应量。
干预后 2 个月观察到性功能和心理困扰显著改善。
这些结果表明,在简短、低强度的小组环境中提供针对性的干预是一种很有前途的模式,可以减少接受 OS 治疗的年轻 BC 幸存者的痛苦性功能障碍。