Sexual concerns in guynae-oncology: meeting sexual health requirements in gynae-oncology
The diagnosis and clinical course of gynaecologic cancers can have immediate as well as lasting impact on the quality of a relationship, intimacy, sexuality and overall life of women and their partners. In spite of its rising awareness as an integral part of holistic health, sexual concerns in this isolated group are often neglected and underserved by the medical fraternity. Being the second most common type of cancer following carcinoma of the breast, gynaecological cancers have a devastating effect on both the physical as well as the emotional well-being of affected women.
The three subtypes of gynaecological cancers (uterine corpus, cervix and ovary) constitute about 15% of all-cancer risk in women. Studies indicate that sexual readjustment or rehabilitation is a major challenge with a collective prevalence of female sexual dysfunction (FSD) in about 15%–90% of women in this subpopulation. Classical forms of FSD comprising desire, arousal or orgasmic disorders may occur together with hormonal irregularities, fear, anxiety and stress before diagnosis, together with a likelihood of worsening of symptoms during and following therapy. Furthermore, patients may experience altered genital sensations ranging from pain to numbness; psycho-emotional issues would also result from body-image concerns and sexual role/relationship conflicts.
Further challenges may be imposed by therapy-mediated ovarian failure, hormonal derangements or premature menopause. Together with the recent advances in diagnosis and treatment, there is significant improvement in long-term survival and post-treatment life expectancy for these patients. It is therefore imperative for health care professionals to identify interventional measures that will succeed in providing quality life for the patient as well as her partner. Identified modalities should incorporate a systematic assessment, referral (if necessary), intervention and follow-up of sexual problems within the gynaecological setting for a meaningful/lasting improvement on the overall symptoms of cancer patients and their partners.
