Cull A, Cowie V J, Farquharson D I, Livingstone J R, Smart G E, Elton R A
ICRF Medical Oncology, Western General Hospital, Edinburgh, UK.
Br J Cancer. 1993 Dec;68(6):1216-20. doi: 10.1038/bjc.1993.507.
Eighty-three women, mean age 45 years, successfully treated by surgery (S) or radiotherapy (RT) for stage 1b cervical cancer were assessed a mean of 97 weeks post treatment. Forty to 50% reported persistent tiredness, lack of energy and weight gain. Sixty per cent had not resumed their full premorbid functional status. Mean scores for anxiety and depression were higher than general population means and this sample scored higher for psychological distress than published data quoted for disease free cancer patients. These women reported many concerns about cervical cancer, most commonly fear of recurrent disease (91%). More than one-third blamed themselves for the disease. There were no significant differences in functional outcome or psychological status between treatment groups or by age or time since treatment. Psychological distress scores were significantly correlated with physical complaints (P < 0.001) and functional outcomes (P < 0.02). For the 61 women who were sexually active, sexual function post-treatment was rated as significantly poorer than subjectively recalled premorbid sexual function (P < 0.005). RT treated patients were more likely to report pain on intercourse and loss of enjoyment. Psychological as well as physical problems were highly correlated with sexual outcome (P < 0.01) 44% were unable to talk adequately with their partners about their experience. The majority felt they needed more information about cervical cancer, its treatment and how to help themselves rehabilitate. Forty-nine per cent would have liked to have had counselling. Even with the same physical morbidity the functional, emotional and sexual status of these women could be improved by giving more attention to their psychological and sexual concerns.
83名平均年龄为45岁的女性，因I期b宫颈癌成功接受了手术（S）或放疗（RT），在治疗后平均97周接受了评估。40%至50%的人报告有持续疲劳、精力不足和体重增加的情况。60%的人尚未恢复到病前的全部功能状态。焦虑和抑郁的平均得分高于一般人群的平均水平，且该样本在心理困扰方面的得分高于无病癌症患者的已发表数据。这些女性报告了许多关于宫颈癌的担忧，最常见的是害怕疾病复发（91%）。超过三分之一的人自责患病。治疗组之间、按年龄或治疗后的时间来看，在功能结局或心理状态方面没有显著差异。心理困扰得分与身体不适（P < 0.001）和功能结局（P < 0.02）显著相关。对于61名有性生活的女性，治疗后的性功能被评为明显比主观回忆的病前性功能差（P < 0.005）。接受放疗的患者更有可能报告性交时疼痛和失去愉悦感。心理和身体问题与性结局高度相关（P < 0.01），44%的人无法与伴侣充分谈论自己的经历。大多数人觉得他们需要更多关于宫颈癌、其治疗方法以及如何帮助自己康复的信息。49%的人希望能得到咨询。即使身体发病率相同，通过更多关注这些女性的心理和性方面的担忧，她们的功能、情感和性状态也可以得到改善。
