Sexual health and wellbeing among female pelvic cancer survivors following individualized interventions in a nurse-led clinic

Abstract

Purpose Treatment-induced sexual and intestinal dysfunctions coexist among women after pelvic radiotherapy. We aimed to explore if sexual health and wellbeing may be improved after radiotherapy following nurse-led interventions and if an association exists between improved intestinal health and sexual health. Methods A population-based cohort of women treated with pelvic radiotherapy underwent interventions at a nurse-led clinic at Sahlgrenska University Hospital, Sweden, from 2011 to 2017. Self-reported questionnaires were used, pre- and post-intervention, to compare self-reported changes in sexual health and wellbeing. A regression model was performed to explore the association between intestinal and wellbeing variables. Results Among the 260 female pelvic cancer survivors included in the study, more women reported increased than decreased satisfaction with overall sexual health post-intervention (26.0% vs. 15.3%, p = 0.035). They also reported significantly reduced superficial genital pain (25.8% vs. 13.1%, p ≤ 0.025), reduced deep genital pain (23.1% vs. 8.0%, p ≤ 0.001), increased QoL (42.7% vs. 22.4%, p < 0.001), and reduced levels of depression (43.1% vs. 28.0%, p = 0.003) or anxiety (45.9% vs. 24.4%, p < 0.001) post-intervention. We found a significant association between reduced urgency to defecate and improved satisfaction with overall sexual health (RR 3.12, CI 1.27–7.68, p = 0.004) and between reduced urgency to defecate with fecal leakage and reduced anxious mode (RR 1.56, CI 1.04–2.33, p = 0.021). Conclusion Sexual health and wellbeing can be improved by interventions provided in a nurse-led clinic focusing on physical treatment-induced late effects. Further research to optimize treatment strategies in female pelvic cancer survivors is needed.

Feasibility and effectiveness of communication tools for addressing intimacy and sexuality in patients with cancer: a systematic review

“…A statistically significant improvement was found over time in the patient’s sexual functioning in 11 studies, mostly in studies among individual patients. Of these, five studies based their intervention on PLISSIT [ 38 , 48 , 50 , 54 , 59 ]. One study among couples indicated improvement in female sexual functioning and little improvement in male sexual functioning, without providing information about significance [ 62 ].…”

“…In total, seven studies reported a statistically significant improvement over time in overall quality of life [ 38 , 42 , 51 , 54 , 56 , 57 , 66 ]. Of these, three studies based their intervention on PLISSIT, which was applied to individual patients [ 38 , 54 , 66 ]. The remaining ten studies did not report a significant difference in overall quality of life.…”

“…Of the 35 publications, eight studies focused on cancer survivors [ 38 , 39 , 47 , 50 , 51 , 54 , 59 , 65 ]. The interventions included in these studies were PLISSIT-based in four studies [ 39 , 50 , 54 , 59 ] and based on other tools in the remaining four studies [ 38 , 47 , 51 , 65 ].…”

“…Of the 35 publications, eight studies focused on cancer survivors [ 38 , 39 , 47 , 50 , 51 , 54 , 59 , 65 ]. The interventions included in these studies were PLISSIT-based in four studies [ 39 , 50 , 54 , 59 ] and based on other tools in the remaining four studies [ 38 , 47 , 51 , 65 ]. Furthermore, five of these eight studies involved individual cancer survivors [ 38 , 47 , 51 , 54 , 65 ], two studies involved groups of patients [ 39 , 59 ] and one study focused on couples [ 50 ].…”

“…The interventions included in these studies were PLISSIT-based in four studies [ 39 , 50 , 54 , 59 ] and based on other tools in the remaining four studies [ 38 , 47 , 51 , 65 ]. Furthermore, five of these eight studies involved individual cancer survivors [ 38 , 47 , 51 , 54 , 65 ], two studies involved groups of patients [ 39 , 59 ] and one study focused on couples [ 50 ]. Willingness to participate was reported in six studies and varied from 40.0% (individual patients) to 90.2% (group of patients) [ 38 , 39 , 47 , 51 , 54 , 59 ].…”