Objectives: To assess whether sexual distress among cervical cancer (CC) survivorsis associated with frequently reported vaginal sexual symptoms, other proposed biopsychosocial factors, and... Show moreObjectives: To assess whether sexual distress among cervical cancer (CC) survivorsis associated with frequently reported vaginal sexual symptoms, other proposed biopsychosocial factors, and whether worries about painful intercourse mediates the relation between vaginal sexual symptoms and sexual distress. Methods: A cross-sectional study was conducted among 194 sexually active partnered CC survivors aged 25-69 years. Sexual distress, vaginal sexual symptoms, sexual pain worry, anxiety, depression, body image concerns, and relationship dissatisfaction, and the socio-demographic variables age, time since treatment, and relationship duration, were assessed using validated self-administrated questionnaires. Results: In total, 33% (n = 64) of the survivors scored above the cut-off score for sexual distress. Higher levels of sexual distress were shown to be associated with higher levels of vaginal sexual symptoms, sexual pain worry, relationship dissatisfaction, and body image concerns. Furthermore, the results showed that sexual pain worry partly mediated the association between vaginal sexual symptoms and sexual distress, when controlling for relationship dissatisfaction and body image concerns. Conclusions: Appropriate rehabilitation programs should be developed for CC survivors, to prevent and reduce not only vaginal sexual symptoms, but also sexual pain worry, relationship dissatisfaction and body image concerns, in order to reduce sexual distress. Show less
PURPOSE\nAbout half of the gynecological cancer (GC) survivors suffer from sexual dysfunctions and report a need for professional psychosexual support. The current study assessed (1) health care... Show morePURPOSE\nAbout half of the gynecological cancer (GC) survivors suffer from sexual dysfunctions and report a need for professional psychosexual support. The current study assessed (1) health care professionals' (HCP) current psychosexual support practices, (2) barriers to providing psychosexual support, and (3) HCP needs for training and assistance.\nMETHODS\nSemistructured interviews were conducted with gynecological oncologists (n = 10), radiation oncologists (n = 10), and oncology nurses involved in the treatment of GC (n = 10).\nRESULTS\nThe majority of the professionals reported discussing sexuality at least once with each patient. An important reason for addressing sexual functioning was to reassure patients that it is normal to experience sexual concerns and give them an opportunity to discuss sexual issues. About half of the professionals provided specific suggestions. Patients were rarely referred to a sexologist. Barriers encountered by professionals in the provision of psychosexual support were embarrassment and lack of time. HCP suggestions for the facilitation of psychosexual support provision were skills training, an increased availability of patient information, and the standard integration of psychosexual support in total gynecological cancer care.\nCONCLUSION\nThe majority of the professionals reported discussing sexuality at least once with every patient, but discussions of sexual functioning were often limited by time and attention. The development of comprehensive patient information about sexuality after GC is recommended as well as a more standard integration of psychosexual support in GC care and specific training. Show less
Objective. The aim of this study is to investigate the impact of treatment policy changes in cervical cancer patients treated with adjuvant (chemo) radiotherapy.Methods. Between 1970 and 2007, 292... Show moreObjective. The aim of this study is to investigate the impact of treatment policy changes in cervical cancer patients treated with adjuvant (chemo) radiotherapy.Methods. Between 1970 and 2007, 292 patients received adjuvant radiotherapy after a radical hysterectomy with pelvic lymphadenectomy for early stage cervical carcinoma. All patients received pelvic radiotherapy (40 Gy-46 Gy in 1.8 Gy-2 Gy/fraction). Vaginal vault brachytherapy boost (10-14 Gy) was increasingly used for patients with high-risk factors, and since 1993 systematically applied in patients with at least 2 of the 3 risk factors: adenocarcinoma, nodal involvement and parametrial invasion. Cisplatin-based chemotherapy was introduced in this group of patients from 2000.Results. The 5-year cumulative risk of local recurrence (CRLR) was 13% (95%CI 9%-17%), resulting in an overall 5-year survival (OS) of 78% (95%CI 83%-73%). Since 1970, the OR for the 5-year locoregional recurrence risk (LRR) decreased from 2.5 to 1.15 (linear-OR = -0.02/year). The OR for the 5-year mortality risk reduced from 2.2 in 1970 to 1.0 in 2007 (linear-OR = -0.03/year). The largest risk reductions were observed before 1990 with a minor rise after 2002. The risk of severe late toxicity reduced from 1.8% to 1.5% (linear-OR = -0.03/year). The addition of concomitant adjuvant chemotherapy since 2000 may have benefited a subgroup of patients with squamous cell carcinoma, but not the patients with adenocarcinoma, and after introduction of chemotherapy the risk of severe late toxicity tripled from 2% to 7%.Conclusion. Since 1970, tumour recurrence risk and mortality have decreased, as radiation dose increased. The potential benefit of concomitant adjuvant chemotherapy could not be demonstrated in this nonrandomized study. (C) 2014 Elsevier Inc. All rights reserved. Show less
Arnold, M.; Liu, L.F.; Kenter, G.G.; Creutzberg, C.L.; Coebergh, J.W.; Soerjomataram, I. 2014
