Women with breast cancer want more education on sexual health during treatment
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Although most women with breast cancer reported adverse sexual health effects of treatment, many also reported their oncologist paid less attention to discussion of these effects during consultation.
The findings, published in Annals of Surgical Oncology, suggested women preferred a multimodal strategy to education vs. a one-size-fits-all approach and multiple options geared toward various breast cancer patient populations that align with their stage of life and sexual needs, researchers noted.
Background and methods
“We collected patient-reported outcome surveys in patients with breast cancer since 2019 and noted that of the four domains of quality of life we measure, sexual well-being was the lowest when we first saw women with breast cancer,” Sarah Tevis, MD, assistant professor of surgical oncology at University of Colorado School of Medicine, told Healio. “As patients go through treatment, sexual well-being declines even further. This led us to perform this mixed methods study to better understand the prevalence of symptoms in our patient population and to ask women what education they wished they had received during treatment.”
Tevis and colleagues sought to characterize the education that patients with breast cancer received about potential sexual health effects of treatment.
The study included 87 patients (44.8% aged between 45 and 65 years; 82.8% white) with stage zero to stage IV breast cancer who received treatment at an academic breast center in December 2020. Patients completed questionnaires that assessed sexual health symptoms they experienced during treatment.
Sixteen women participated in additional semistructured individual interviews (n = 3) or focus group discussion (n = 13) that included questions on sexual health education provided by the oncology care team and patient preferences for content, format and timing of education delivery.
Key findings
Researchers found 93% of women reported at least one symptom affecting their sexual health. The most common symptoms included decreased sexual desire (69%), vaginal dryness (63%) and less energy for sexual activity (62%) during or after treatment.
Moreover, 75% of women reported that sexual health symptoms affected their mental health and relationships with partners.
Among the 16 patients who participated in the additional interview process, few reported receiving information about potential sexual effects of treatment, but those who did reported it focused more on menopausal symptoms or fertility symptoms vs. sexual function.
“Women wanted resources about sexual health early and often during treatment and particularly wanted information about mitigation strategies, sexual function, dating and partner intimacy, and changes to body image,” Tevis said.
Implications
Patients in the focus groups indicated that discussion of sexual health at the time of initial diagnosis when treatment plans are being developed is not an optimal and would be overwhelming, Tevis said. However, they expressed a desire for sexual health effects to be discussed early and often throughout treatment, she said.
“Following the initial visit, we don’t have a specific timepoint or point person for following up about things such as sexual health, and we know from the literature that women are unlikely to raise the topic of sexual health themselves,” Tevis said. “Sexual health should absolutely be part of any survivorship plan, but it is important to bring it up early in treatment.”
Tevis said an educational video series is under development in collaboration with patients.
“We plan to tell patients about the videos at the time of diagnosis and remind them of the videos throughout treatment,” she said. “We hope the videos will not only provide much needed education for our patients that they can access when they are interested and focus on the topics that are pertinent to them, but also empower patients to initiate these conversations with their health care team.”
For more information:
Sarah Tevis, MD, can be reached at sarah.tevis@cuanschutz.edu.
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Huynh V, et al. Ann Surg Oncol. 2022;doi:10.1245/s10434-022-12126-7.
Huynh V, et al. Ann Surg Oncol. 2022;doi:10.1245/s10434-022-12126-7.
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