Menopausal and sexual symptoms following radiotherapy in survivors of advanced cervical cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15518-e15518
Author(s):  
Kameshwarachari Pushpalatha ◽  
Dayanand Sharma ◽  
Pramod Kumar Julka ◽  
Sunesh Kumar ◽  
G K Rath
Keyword(s):  
Cervical Cancer ◽  
Cancer Survivors ◽  
Hot Flushes ◽  
Advanced Cervical Cancer ◽  
Health Issues ◽  
Cross Sectional ◽  
Vaginal Dryness ◽  
Sexual Symptoms ◽  
Vaginal Health ◽  
Loss Of Libido

e15518 Background: With ever-increasing number of cancer survivors nearing 12 million, a majority of women will face vaginal health issues related to their disease and/or treatment. Hypothesis is that there is direct damage to ovarian follicles as a result of ionizing radiation leading to follicular atrophy and decrease in ovarian follicular reserve. Cancer treatment with radiotherapy induces menopause-causing estrogen-deprivation symptoms. Hence this study was conducted to investigate the frequency of radiation-induced menopausal and sexual symptoms in cervical cancer survivors Methods: A cross-sectional study was conducted between Feb-June 2011 on cohort of 55 advanced cervical cancer patients treated with pelvic radiation of 50.4 Gy in 28 fractions over 5.5 weeks and concurrent Cisplatin, followed by intracavitary boost of 15 Grays. Women aged 55 or older and/or postmenopausal at the time of the survey were excluded. By using a questionnaire, frequency of menopause was tried to elicit along with associated sexual symptoms like hot flushes, vaginal dryness, mood swings, dyspareunia, loss of libido, botheration. Results: The average age and parity were 38.8 years and 3.6 respectively. Amenorrhoea was found in all patients. 27 (49%) patients were asymptomatic. Among 28 (50.9%) symptomatic patients, we found hot flushes in 21 (38.2%), vaginal dryness in 38 (69%), mood swings in 12 (21.8%), dyspareunia in 27 (49%), loss of libido in 26 (47.2%), bothersome in 28 (50.9%). Conclusions: Menopausal symptoms were associated with other health-related issues known to compromise the quality of life. These results highlight the need to better acknowledge and define the utility of hormonal therapy in this population. Recommendations need to be provided to treating gynaecologists and Oncologists to identify, treat and promote vaginal health. Vaginal health issues can be reduced by dedicating a small duration of time to educate the cancer survivors on hormonal/non-hormonal vaginal health strategies.

scholarly journals A cross-sectional assessment of symptom burden among patients with advanced cervical cancer

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tolcha Kebebew ◽  
Azwihangwisi Helen Mavhandu-Mudzusi ◽  
Annah Mosalo
Keyword(s):  
Cervical Cancer ◽  
Palliative Care ◽  
Addis Ababa ◽  
Symptom Burden ◽  
Advanced Cervical Cancer ◽  
Patient Anxiety ◽  
Emotional Symptoms ◽  
Cross Sectional ◽  
Limited Mobility ◽  
Patient Reported

Abstract Background The increasing burden of chronic non-communicable diseases in developing countries is driving attention to palliative care services. Identification of disease-specific symptoms of concern and their prevalence will guide designing, monitoring, and evaluating palliative care programmes. This study assessed the burden of symptoms and problems among patients with advanced cervical cancer. Methods This research followed a cross-sectional study design to quantitatively review the symptom burden among patients diagnosed with advanced cervical cancer attending treatment at Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia from January to July 2019. Symptoms were assessed using a patient-reported, seven-day recall Integrated Palliative Care Outcome Scale (IPOS) version III. Frequency, median and mean scores with a standard deviation were used in the descriptive analysis whereas t-test and one-way analysis of variance were used for comparisons. Results There were 385 patients with advanced cervical cancer, stage IIB-IVB, successfully interviewed. The median age was 50 years, the majority were illiterate (63.1%) and in marital union (62.3%). Over 50% of the patients experienced pain, weakness, poor appetite, constipation, limited mobility, and dry mouth. The burdens of emotional symptoms such as patient anxiety, family anxiety, and patient depression were also prevalent at 79.7%, 82.3%, and 47.0%, respectively. Patients who are illiterate, at a higher stage of the disease, not currently in marriage, and who received palliative radiotherapy bear a higher symptom burden. Conclusion Patients with advanced cervical cancer bear a high symptom burden. Early initiation of palliative care is recommended to alleviate the concerning symptoms, and to improve patients’ quality of life.

Radiotherapy- or Radical Surgery–Induced Female Sexual Morbidity in Stages IB and II Cervical Cancer

2014 ◽  
Vol 24 (4) ◽  
pp. 800-805 ◽  
Author(s):  
Yuko Harding ◽  
Takuma Ooyama ◽  
Tomoko Nakamoto ◽  
Akihiko Wakayama ◽  
Wataru Kudaka ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Sexual Function ◽  
Cancer Survivors ◽  
Radical Surgery ◽  
Cross Sectional Study ◽  
Control Group ◽  
Female Sexual Function ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

ObjectiveThe objective of this study was to evaluate the sexual function in cervical cancer survivors after radiotherapy (RT) or radical surgery (RS).MethodsThis was an observational and cross-sectional study. The Female Sexual Function Index (FSFI) self-reported questionnaires were distributed to 175 patients after RT (RT group) or RS (RS group) and 521 healthy women (control) between 2011 and 2012. Sexual functions were compared among these 3 groups.ResultsEligible 92 patients (46 in RT group, 46 in RS group) and 148 control subjects were included for analysis. There was a significant difference in median (range) FSFI total score of 5.5 (3.6–34.7) in the RT group, 18.9 (3.4–31.2) in the RS group, and 22.1 (2–34.2) in the control group (P < 0.001). The median FSFI total score in the RT group was significantly lower than that in the control group (P < 0.001). Six sexual domains (desire, arousal, lubrication, orgasm, satisfaction, pain) were all significantly affected in the RT group, and no significant differences, except pain, were observed in the RS group as compared with the control group.ConclusionsInterventions involving counseling and rehabilitation for female sexual function should be provided in cervical cancer survivors, especially after RT.

Long-term cervical cancer survivors suffer from pelvic floor symptoms: A cross-sectional matched cohort study

2010 ◽  
Vol 117 (2) ◽  
pp. 281-286 ◽  
Author(s):  
M.H. Hazewinkel ◽  
M.A.G. Sprangers ◽  
J. van der Velden ◽  
C.H. van der Vaart ◽  
L.J.A. Stalpers ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Pelvic Floor ◽  
Cancer Survivors ◽  
Matched Cohort ◽  
Cross Sectional ◽  
Matched Cohort Study ◽  
Pelvic Floor Symptoms

scholarly journals An Assessment of Sleep Duration and Determinants of Health in a Cross-Sectional Sample of Gynecologic Cancer Survivors in Los Angeles County

2020 ◽  
Vol 17 (2) ◽  
pp. 13-25
Author(s):  
Ma’at Hembrick ◽  
Makala Conner ◽  
Heather Tarleton
Keyword(s):  
Physical Activity ◽  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Los Angeles ◽  
Cancer Survivors ◽  
Sleep Duration ◽  
Los Angeles County ◽  
Menopausal Status ◽  
Cancer Type ◽  
Cross Sectional

Cancer survivors have an increased risk of treatment-related deficits in physical health and low health-related quality of life. In this cross-sectional study, a health questionnaire was mailed to women from the Los Angeles County Cancer Surveillance Program aged 45-70 and diagnosed with cervical, endometrial, or ovarian cancer in 2005-2014. Of the 5,941 surveys with valid postal addresses, 586 (10%) were completed and returned. The average age of respondents was 66 years old, and 36% identified as non-white. Non-white respondents were less likely to have a college degree (p<0.001), more likely to sleep for less than seven hours each night (p<0.001), experience bodily pain (p<0.001), and have a diagnosis of cervical cancer (p=0.002), when compared to white respondents. Health behaviors and determinants were examined across cervical, endometrial, and ovarian cancer cases. Cervical cancer survivors reported sleeping less than 7 hours per night, on average (p=0.015). Race was associated with sleep duration among endometrial (p=0.002) and ovarian (p=0.003) cancer survivors. Menopausal status was associated with the relationship between race and sleep duration (p<0.001). Depression was inversely related to sleep duration (p = 0.022) but was not associated with race, menopausal status, time since treatment, physical activity, or cancer type. Postmenopausal cervical cancer survivors reported a moderate concern about fall risk compared to their premenopausal counterparts (p=0.048). Physical activity levels increased as time since treatment increased (p=0.003) regardless of cancer type. Race, menopausal status, depression, and cancer type impacted the sleep duration. KEYWORDS: Health Disparities; Sleep Duration; Depression; Gynecologic Cancers; Survivorship Care

Perceived versus measured functional vaginal capacity in cancer patients with sexual function concerns.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 170-170
Author(s):  
Vanessa Amy Kennedy ◽  
Stacy Tessler Lindau ◽  
Seiko Diane Yamada ◽  
Kristen Wroblewski ◽  
Emily Abramsohn ◽  
...  
Keyword(s):  
Sexual Function ◽  
Cancer Survivors ◽  
Sexual Activity ◽  
Gynecologic Cancer ◽  
Male Partner ◽  
Cross Sectional ◽  
Patient Reported ◽  
Sexual Concerns ◽  
Vaginal Dilators ◽  
Loss Of Libido

170 Background: Actual and perceived loss of vaginal capacity can be a source of distress among female cancer survivors. The objective of this study was to assess perceived (PC) versus measured (MC) functional vaginal capacity in patients presenting with sexual function concerns. Methods: This was a cross-sectional registry-based study of women seen at the Program in Integrative Sexual Medicine for Women and Girls with Cancer (PRISM) Clinic. During the visit, patients were presented with graduated vaginal dilators and asked to select the largest dilator they perceived could be inserted without pain (PC) and the dilator representing their desired functional capacity (DC) (for patients with a male partner, this was the size closest to the partner’s erect penis). Two models of dilators were offered. Dilators were numbered 1-24 in order of increasing volume. If the patient could accommodate the dilator chosen as PC without pain, she was examined with dilators of gradually increasing size until the patient reported discomfort. The largest dilator tolerated without pain was MC. Differences between PC and MC, and between DC and MC were calculated. The association between penetrative sexual activity in the prior 4 weeks and accuracy of PC was assessed using the Mann-Whitney U test. Results: Mean patient age was 46 years (range 21-80, N=69). Most patients had breast (43%) or a gynecologic cancer (16%); 29% had benign disease. Nearly half reported two or more sexual concerns; painful intercourse (81%), vaginal complaints (21%), and loss of libido (19%) were most common. Median PC was 50cm3 (IQR 35-65cm3), median MC was 81cm3 (IQR 60-90cm3), and median DC was 90cm3 (IQR 81-132cm3). PC equaled MC in 22%. PC was less than MC in 75% and less than DC in 81% of patients. Of patients with PC less than DC, 41% had MC equal to or larger than DC. PC was closer to MC in patients reporting penetrative sexual activity in the prior 4 weeks (p=0.02). Conclusions: In this single-site study, many cancer survivors seeking care for sexual concerns underestimate their functional vaginal capacity. Further study is needed to determine whether correcting patient perception of capacity lessens distress and improves function.

Vaginal Dilator Use to Promote Sexual Wellbeing After Radiotherapy in Gynaecological Cancer Survivors: A Prospective Observational Study

2021 ◽  
Author(s):  
Dimitra Charatsi ◽  
Polyxeni Vanakara ◽  
Michail Nikolaou ◽  
Aikaterini Evaggelopoulou ◽  
Dimitrios Korfias ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Survivors ◽  
External Beam Radiotherapy ◽  
Sexual Life ◽  
P Value ◽  
Sexual Rehabilitation ◽  
Vaginal Stenosis ◽  
Sexual Symptoms ◽  
Radiation Induced ◽  
Vaginal Dilators

Background: Since continuing advances in radiotherapy technology broaden the role of radiotherapy in the treatment of gynaecologic malignancies, the use of vaginal dilators has been introduced in order to mitigate the risk of vaginal stenosis. The main aims of this study were to investigate the vaginal dilator use efficacy in the treatment of radiation-induced vaginal stenosis and the vaginal dilator effect on sexual quality of life. Methods: We studied fifty-three patients with endometrial or cervical cancer. The participants were treated with radical or adjuvant external beam radiotherapy and/or brachytherapy. They were routinely examined at four time points post-radiotherapy when also they were asked to fill in a validated sexual function-vaginal changes questionnaire. A p-value less than 0.05 was considered statistically significant. Results: The vaginal stenosis grading score was decreased and the size of the vaginal dilator comfortably insertable was gradually increased throughout the year of vaginal dilator use while radiation-induced vaginal and sexual symptoms were improved throughout the year of VD use. All patients with initial grade 3 showed vaginal stenosis of grade 2 after 12 months of vaginal dilator use and 65.8% of the patients with grade 2 initial vaginal stenosis demonstrated final vaginal stenosis grade 1 while 77.8% of the participants with initial 1st size of vaginal dilators reached the 3rd vaginal dilator size after 12 months. Starting time of dilator therapy <= 3 months after the end of radiotherapy was associated with a significant decrease in vaginal stenosis. Additionally, there was an overall upward trend regarding patients’ satisfaction with their sexual life. Conclusion: Endometrial and cervical cancer survivors should be encouraged to use vaginal dilators for the treatment of vaginal stenosis and sexual rehabilitation after radiotherapy.

The effect and safety of Clino-san on vaginal symptoms in breast cancer survivors: A randomized, controlled study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20525-e20525
Author(s):  
J. Kim ◽  
Y. Lee ◽  
N. Park ◽  
Y. Song ◽  
S. Kang
Keyword(s):  
Breast Cancer ◽  
Treatment Group ◽  
Cancer Survivors ◽  
Endocrine Therapy ◽  
Breast Cancer Survivors ◽  
Controlled Study ◽  
Health Index ◽  
Vaginal Symptoms ◽  
Vaginal Dryness ◽  
Vaginal Health

e20525 Background: The purpose of this study was to determine the effect of Clino-san on vaginal symptoms and atrophy in breast cancer survivors treated with chemotherapy or endocrine therapy. Methods: A randomized, double-blind, placebo-controlled study. Breast cancer survivors who experienced menopause after chemotherapy or endocrine therapy were enrolled voluntarily and randomly applied vaginal topical lactic acid, Clino-san or placebo three times per week for 12 weeks. Vaginal dryness and dyspareunia measured by visual analogue scale, vaginal health index, vaginal pH, and the effect on endometrium or ovary were evaluated. Results: Among 89 enrolled women, 81 were evaluated. Forty-two received Clino-san treatment, and the remaining 39 received placebo. Vaginal dryness and dyspareunia in Clino-san treatment group improved compared with placebo group (p=0.012). Clino-san increased vaginal health index, however it is not statistically significant (p=0.058). Vaginal pH decreased more in Clino-san treatment group (p=0.025). There was no significant difference of adverse effects between two groups other than mild irritation at the early time of Clino-san use. Conclusions: Vaginal topical Clino-san could relieve the vaginal symptoms and improve the vaginal health in breast cancer survivors who experienced menopause after cancer treatment. No significant financial relationships to disclose.

Perceived versus measured functional vaginal capacity in cancer patients with sexual function concerns.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9528-9528
Author(s):  
Vanessa Kennedy ◽  
Emily Abramsohn ◽  
Lisa Asiedu ◽  
Jennifer Makelarski ◽  
Kristen Wroblewski ◽  
...  
Keyword(s):  
Sexual Function ◽  
Cancer Survivors ◽  
Sexual Activity ◽  
Gynecologic Cancer ◽  
Male Partner ◽  
Cross Sectional ◽  
Common Mean ◽  
Patient Reported ◽  
Sexual Concerns ◽  
Loss Of Libido

9528 Background: Actual and perceived loss of vaginal capacity can be a source of distress among female cancer survivors. The objective of this study was to assess perceived (PC) versus measured (MC) functional vaginal capacity in patients presenting with sexual function concerns. Methods: This was a cross-sectional registry-based study of women seen at the Program in Integrative Sexual Medicine for Women and Girls with Cancer (PRISM) Clinic. During the visit, patients were presented with graduated vaginal dilators and asked to select the largest dilator they perceived could be inserted without pain (PC) and the dilator representing their desired functional capacity (DC) (for patients with a male partner, this was the size closest to the partner’s erect penis). Two models of dilators were offered. Dilators were numbered 1-24 in order of increasing volume. If the patient could accommodate the dilator chosen as PC without pain, she was examined with dilators of gradually increasing size until the patient reported discomfort. The largest dilator tolerated without pain was MC. Differences between PC and MC, and between DC and MC were calculated. The association between penetrative sexual activity in the prior 4 weeks and accuracy of PC was assessed using the Mann-Whitney U test. Results: Mean patient age was 46 years (range 21-80, N=69). Most patients had breast (60%) or a gynecologic cancer (23%). Nearly half reported two or more sexual concerns; painful intercourse (81%), vaginal complaints (21%), and loss of libido (19%) were most common. Mean PC was 16.9 (SD 5.2, range 3-24), mean MC was 20.8 (SD 3.4, range 10-24), and mean DC was 21.8 (SD 3.4, range 6-24). PC equaled MC in 22%. PC was less than MC in 75% and less than DC in 81% of patients. Of patients with PC less than DC, 41% had MC equal to or larger than DC. PC was closer to MC in patients reporting penetrative sexual activity in the prior 4 weeks (p=0.03). Conclusions: In this single-site study, many cancer survivors seeking care for sexual concerns underestimate their functional vaginal capacity. Further study is needed to determine whether correcting patient perception of capacity lessens distress and improves function.

scholarly journals Self‐reported cognitive impairment in cervical cancer survivors: A cross‐sectional study

2021 ◽  
Author(s):  
Elisabeth Wang Areklett ◽  
Elisabeth Fagereng ◽  
Kjersti Bruheim ◽  
Stein Andersson ◽  
Kristina Lindemann
Keyword(s):  
Cervical Cancer ◽  
Cognitive Impairment ◽  
Cancer Survivors ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional
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