Women with breast cancer want more education about sexual health during treatment

Although most women with breast cancer report adverse sexual health effects from treatment, many also report that their oncologist pays less attention to discussing these effects during consultation.

The findings, published in Annals of Surgical Oncologysuggest that women prefer a multimodal strategy of education versus a one-size-fits-all approach and multiple options targeting different breast cancer patient populations that match their life stage and sexual needs, the researchers noted.

Background and methods

“Since 2019, we have collected patient-reported outcome studies for breast cancer patients and noted that of the four quality-of-life domains we measure, sexual well-being was lowest when we first saw women with breast cancer,” Sarah Youdr, assistant professor of surgical oncology at the University of Colorado School of Medicine, told Healio. “When patients go through treatment, sexual well-being deteriorates even more. This led us to conduct this mixed-methods study to better understand the prevalence of symptoms in our patient population and to ask women what education they wish they had received during treatment.”

Tevis and colleagues sought to characterize the education that breast cancer patients received about the potential effects of treatment on sexual health.

The study included 87 patients (44.8% aged 45 to 65; 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 assess sexual health symptoms experienced during treatment.

Sixteen women participated in additional semi-structured individual interviews (n = 3) or focus group discussions (n ​​= 13) that included questions about sexual health education provided by the oncology team and patient preferences for content, format, and timing of education delivery. .

Key findings

Researchers found that 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.

In addition, 75% of women reported that sexual health symptoms affected their mental health and relationships with partners.

Among the 16 patients who participated in the follow-up interview process, few reported receiving information about potential sexual effects of the treatment, but those who did reported focusing more on menopausal symptoms or fertility symptoms relative to sexual function.

“Women wanted sexual health resources early and often during treatment, and they especially wanted information about coping strategies, sexual function, partner dating and intimacy, and body image changes,” Tevis said.

Consequences

Patients in focus groups indicated that discussing sexual health at the time of initial diagnosis, when developing treatment plans, was not optimal and would be overwhelming, Tevis said. However, they expressed a desire for sexual health effects to be discussed early and often during treatment, she said.

“After the initial visit, we don’t have a specific time point or a specific person to track things like 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 survival plan, but it’s important to talk about it early in treatment.”

Tevis said an educational video series is being developed in collaboration with patients.

“We plan to tell patients about the videos during diagnosis and remind them about the videos during treatment,” she said. “We hope that the videos will not only provide much-needed education for our patients that they can access when they are interested and focus on topics that are relevant to them, but will also enable patients to start those conversations with their health care team.”

For more information:

Sarah Tevis, Ph.D, can be reached at sarah.tevis@cuanschutz.edu.