Survivors of Gynecologic Cancer Want to Discuss Sexual Issues With Providers

Practitioners commonly treat women who have gynecologic cancer with radiation therapy to the pelvis, but it often comes at the expense of adverse events (AEs) that can disrupt sexual health.

Vaginal dryness, vaginal irritation, vaginal scar tissue, yeast infections, and infertility are some of the AEs that patients can experience, and all can affect sexual intimacy. However, these concerns are not always addressed by healthcare providers, despite the fact that patients want to talk about them.

To better understand communication and sexual dysfunction in women after radiation therapy, investigators surveyed 75 patients from the Department of Radiation Oncology at Michigan Medicine in Ann Arbor who had received a diagnosis of endometrial, cervical, uterine, vulvar, or vaginal cancer. Most of the women were white, married, heterosexual, and Christian. They were asked about their attitudes and beliefs surrounding sexual health, quality of life, and sexual function.

“The perception is that for patients [with gynecologic cancer], sexual health is not as important because they are just happy that their cancer has been dealt with,” Shruti Jolly, MD, associate professor, associate chair of community practices, and chief of brachytherapy services at Michigan Medicine, said in an interview with CURE®, a sister publication of Oncology Nursing News®. “I think more and more [people], especially women, are focused on long-term quality of life, and sexual health is a major part of that because it affects [not only] them but also their partner. They want to have these discussions, and if the provider isn’t open, then they don’t happen.”

The investigators found that 89.8% of women experienced sexual dysfunction and 78.7% felt that sexual function was an important part of overall health.

However, the survey results showed a lack of communication between providers and patients. Of women who saw a primary care physician, 58.7% reported never or almost never being asked about their sexual health. Only 4.0% reported always or almost always being asked. Among women who saw an obstetrician-gynecologist, 22.7% said they never or almost never were asked about their sexual health and 17.3% reported being asked always or almost always.

However, 62.8% of patients felt providers should inquire about sexual health regularly. Most women surveyed did not feel embarrassed to talk about sexual health—only 12.0% reported embarrassment about provider discussions.

Women should explain to their providers that sexual health is a major concern and try to have open communication with their healthcare team, Jolly explained. “This is a very common concern,” she said. “Providers aren’t routinely educated on how to talk about these issues, and that puts more pressure on the patient to bring up these discussions.”

The investigators concluded that educating patients and providers is a necessity. “Patients need to feel empowered to push these discussions forward,” Jolly said.