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

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.

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

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.9528 ◽

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.

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Sexual Dysfunction in Breast Cancer Survivors: Cross-Cultural Adaptation of the Sexual Activity Questionnaire for Use in Portugal

Acta Médica Portuguesa ◽

10.20344/amp.7389 ◽

2016 ◽

Vol 29 (9) ◽

pp. 533 ◽

Cited By ~ 1

Author(s):

Filipa Alves Da Costa ◽

Manuel Castro Ribeiro ◽

Sofia Braga ◽

Elisabete Carvalho ◽

Fátima Francisco ◽

...

Keyword(s):

Breast Cancer ◽

Sexual Function ◽

Cancer Survivors ◽

Sexual Activity ◽

Breast Cancer Survivors ◽

Test Validity ◽

Future Research ◽

P Value ◽

Patient Reported ◽

Activity Questionnaire

Introduction: The increasing survivor population of breast cancer has shifted research and practice interests into the impacts of the disease and treatment in quality of life aspects. The lack of tools available in Portuguese to objectively evaluate sexual function led to the development of this study, which aimed to cross-culturally adapt and validate the Sexual Activity Questionnaire for use in Portugal.Material and Methods: The questionnaire was translated and back-translated, refined following face-to-face interviews with seven breast cancer survivors, and then self-administered by a larger sample at baseline and a fortnight later to test validity and reliability.Results: Following cognitive debriefing (n = 7), minor changes were made and the Sexual Activity Questionnaire was then tested with 134 breast cancer survivors. A 3-factor structure explained 75.5% of the variance, comprising the Pleasure, Habit and Discomfort scales, all yielding good internal consistency (Cronbach’s α > 0.70). Concurrent validity with the FACt-An and the BCPT checklist was good (Spearman’s r > 0.65; p-value < 0.001) and reliability acceptable (Cohen’s k > 0.444). The Sexual Activity Questionnaire allowed the identification of 23.9% of sexually inactive women, for whom the main reasons were lack of interest or motivation and not having a partner.Discussion: Patient-reported outcomes led to a more comprehensive and improved approach to cancer, tackling areas previously abandoned. Future research should focus on the validation of this scale in samples with different characteristics and even in the overall population to enable generalizability of the findings.Conclusion: The adapted Sexual Activity Questionnaire is a valid tool for assessing sexual function in breast cancer survivors in Portugal.

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Patient-reported sexual function of breast cancer survivors with genitourinary syndrome of menopause after fractional CO2 laser therapy

Menopause ◽

10.1097/gme.0000000000001738 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Allison M. Quick ◽

Filadelfiya Zvinovski ◽

Catherine Hudson ◽

Andrew Hundley ◽

Cynthia Evans ◽

...

Keyword(s):

Breast Cancer ◽

Sexual Function ◽

Cancer Survivors ◽

Laser Therapy ◽

Co2 Laser ◽

Breast Cancer Survivors ◽

Genitourinary Syndrome Of Menopause ◽

Fractional Co2 Laser ◽

Patient Reported ◽

Genitourinary Syndrome

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Intracavitary Brachytherapy is Not Associated with Significant Change Ii Sexual Function: A Cross Sectional Study in Gynecologic Cancer Patients

Brachytherapy ◽

10.1016/j.brachy.2018.04.013 ◽

2018 ◽

Vol 17 (4) ◽

pp. S17

Author(s):

Christine M. Fisher ◽

Tyler Robin ◽

Dina M. Flink ◽

Marisa Moroney ◽

Saketh R. Guntupalli

Keyword(s):

Sexual Function ◽

Cancer Patients ◽

Gynecologic Cancer ◽

Cross Sectional Study ◽

Intracavitary Brachytherapy ◽

Sectional Study ◽

Cross Sectional ◽

Significant Change

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

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000112 ◽

2014 ◽

Vol 24 (4) ◽

pp. 800-805 ◽

Cited By ~ 6

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.

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Physical Impairments, Sensory Disturbance and Functional Ability in Cancer Patient With and Without Chemotherapy-induced Peripheral Neuropathy Symptoms

10.21203/rs.3.rs-1054284/v1 ◽

2021 ◽

Author(s):

Nida Rattanakrong ◽

Noppawan Promma ◽

Chanatsupang Saraboon ◽

Pooriput Waongenngarm

Keyword(s):

Peripheral Neuropathy ◽

Cancer Survivors ◽

Functional Ability ◽

Sensory Disturbance ◽

Cross Sectional ◽

Physical Impairments ◽

Eyes Closed ◽

Patient Reported ◽

Romberg Test ◽

Abc Scale

Abstract ObjectiveThe present study examined the objective and patient-reported measures of physical impairments, sensory disturbance and functional ability between cancer patients with and without chemotherapy-induced peripheral neuropathy (CIPN) symptoms.Methods41 cancer survivors exposed to neurotoxic chemotherapies were conveniently recruited and completed a single cross-sectional assessment of patient-reported outcomes (VAS for pain intensity and ABC scale) and objective assessments (SWM test, TUG test, 5xSTS test, Romberg test with eyes open and eyes closed, 6MWT, and FAB scale).ResultsCancer patients who had undergone chemotherapy with CIPN symptoms did significantly worse in the SWM test, TUG test, 5xSTS test, Romberg test with eyes closed, 6MWT, FAB scale, and ABC scale (p<0.05) when compared with cancer survivors without CIPN symptoms.ConclusionCancer survivors with CIPN symptoms have lower physical performance, sensory perception, and functional ability, which may increase the risk of falling and disability. These findings further emphasize the need for effective rehabilitation and interventions to treat CIPN symptoms and related physical impairment and functional deficits.

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Associations of the dietary World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations with patient-reported outcomes in colorectal cancer survivors 2–10 years post-diagnosis: a cross-sectional analysis

British Journal Of Nutrition ◽

10.1017/s0007114520003487 ◽

2020 ◽

pp. 1-13

Author(s):

Marlou-Floor Kenkhuis ◽

Bernadette W. A. van der Linden ◽

Jose J. L. Breedveld-Peters ◽

Janna L. Koole ◽

Eline H. van Roekel ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Research ◽

Cancer Survivors ◽

Physical Functioning ◽

Patient Reported Outcomes ◽

Fruit And Vegetables ◽

Research Fund ◽

American Institute ◽

Cross Sectional ◽

Patient Reported

Abstract The World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) advise cancer survivors to follow their lifestyle recommendations for cancer prevention. Adhering to these recommendations may have beneficial effects on patient-reported outcomes after a cancer diagnosis, but evidence is scarce. We aimed to assess associations of the individual dietary WCRF/AICR recommendations regarding fruit and vegetables, fibre, fast foods, red and processed meat, sugar-sweetened drinks and alcohol consumption with patient-reported outcomes in colorectal cancer (CRC) survivors. Cross-sectional data of 150 stage I–III CRC survivors, 2–10 years post-diagnosis, were used. Dietary intake was measured by 7-d dietary records. Validated questionnaires were used to measure health-related quality of life (HRQoL), fatigue and neuropathy. Confounder-adjusted linear regression models were used to analyse associations of each WCRF/AICR dietary recommendation with patient-reported outcomes. Higher vegetable intake (per 50 g) was associated with better global QoL (β 2·6; 95 % CI 0·6, 4·7), better physical functioning (3·3; 1·2, 5·5) and lower levels of fatigue (−4·5; −7·6, −1·4). Higher fruit and vegetables intake (per 100 g) was associated with better physical functioning (3·2; 0·8, 5·5) and higher intake of energy-dense food (per 100 kJ/100 g) with worse physical functioning (−4·2; −7·1, −1·2). No associations of dietary recommendations with neuropathy were found. These findings suggest that adhering to specific dietary WCRF/AICR recommendations is associated with better HRQoL and less fatigue in CRC survivors. Although the recommendations regarding healthy dietary habits may be beneficial for the well-being of CRC survivors, longitudinal research is warranted to gain insight into the direction of associations.

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Financial toxicity in gynecologic cancer survivors and its impact on quality of life.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.53 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 53-53

Author(s):

Akhil Mehta ◽

Jukes P. Namm ◽

Ellen D'Errico ◽

Eric Lau ◽

Linda Hong ◽

...

Keyword(s):

Quality Of Life ◽

Side Effects ◽

Cancer Survivors ◽

Cancer Care ◽

Uterine Cancer ◽

Gynecologic Cancer ◽

Financial Toxicity ◽

Patient Reported ◽

The Continuum

53 Background: Financial toxicity (FT) is a critical concern for cancer survivors. There is limited data about the relationship between FT throughout the continuum of cancer care, demographics, disease factors, and quality of life (QoL) indicators in gynecologic cancer survivors. Methods: Gynecologic cancer survivors who received treatment from 2015 to 2019 at Loma Linda University Cancer Center were invited to complete an anonymous online survey. A modified version of the comprehensive score for financial toxicity (COST) survey was used to assess FT at baseline and after treatment. The patient-reported outcomes measurement information system (PROMIS) survey was used to assess QoL. Demographic data were summarized using descriptive statistics. Associations between disease factors and FT measured at baseline and after treatment were analyzed using univariable linear regression. Lower COST score coefficients indicate greater FT. Correlations between FT and QoL were evaluated using the Pearson correlation. Results: A total of 252 surveys were sent to gynecologic cancer survivors who met study criteria, of whom 28% responded. Amongst 70 patients included in this analysis, the median age was 64 (IQR 56, 70), 47% were white (n = 33), 20% were unemployed, 22% had a high school or lower level of education, and 50% had an annual income < $60,000. With respect to cancer subtype, 63% had uterine cancer (n = 44), 20% had cervical cancer (n = 14), and 17% had ovarian cancer (n = 12). The mean COST score at baseline and after treatment was 21.2 ± 9.2 and 12.9 ± 7.8, respectively. The following characteristics were associated with significantly greater FT at baseline: Hispanic ethnicity (-5.5; 95% CI: -1 to -10), Black race (-14.4; 95% CI: -3.4 to -25.4), household number > 4 (-6.9; 95% CI: -2.6 to -16.4), Medicare insurance (-6.5; 95% CI: -1.7 to -11.2), and Medicaid insurance (-11.2; 95% CI: -4.3 to -17.9) (p < 0.05). Patients who received combined modality surgery, chemotherapy, and radiation had significantly higher FT (-5.6; 95% CI: -1.3 to -9.8, p < 0.05) compared to those who received single-modality treatment. Likewise, patients with 5 or more treatment-related side effects had significantly higher FT (-6.3; 95% CI -1.13 to -11.4, p < 0.05) compared to those who reported no side effects. During treatment, 24% of patients turned down or skipped treatment, 38% quit their job, and 28% reported family members quit their job. Finally, COST scores measured after treatment correlated positively with physical and mental health (Pearson coefficient 0.57 and 0.56 respectively, p < 0.001). Conclusions: These findings support the need for assessing FT at baseline and throughout the continuum of cancer care to provide individualized assistance to patients facing financial strain. FT affects compliance to treatment which can adversely affect cancer-related outcomes and QoL. Additional policies are needed to address the increasing cost of cancer care.

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