Patient support during sexual rehabilitation for gynaecological cancer survivors after intensive radiation therapy

  • Auteur Rinske M. Bakker, Moniek M. ter Kuile, Jan Willem M. Mens, Carien L. Creutzberg
  • Pdf openbaar Yes

In the current research, we developed a sexual rehabilitation program for gynaecological cancer survivors after treatment with radiotherapy aiming to improve survivors’ vaginal dilator use and sexual rehabilitation. Subsequently, the program’s clinical feasibility and acceptability was investigated. First, the Delphi-method was used to seek consensus regarding the instructions and support that gynaecological cancer survivors should receive during sexual rehabilitation and vaginal dilator use. This study was conducted among thirty gynaecological oncologists, radiation oncologists and oncological nurses. Secondly, thirty gynaecological cancer patients were interviewed after treatment with radiotherapy to investigate which factors determined long-term and regular dilator use. Thirdly, a sexual rehabilitation program, that was developed based on
the previous studies and executed by nurses, was investigated for its feasibility and acceptability among twenty survivors. Experts agreed that sexually active women treated with external and internal radiotherapy for cervical- or vaginal cancer, should be advised to use dilators starting four weeks after treatment, two to three times a week and during a period of nine to twelve months. Of the survivors, 75% was not able to maintain dilator use according to these instructions and reported negative emotions regarding dilator use and/or resuming sexual activity. During the sexual rehabilitation program, participants’ sexual functioning improved up to their level of functioning from before being diagnosed with cancer and most of them maintained longterm regular dilator use. The nurses reported feeling skilled enough to support patients during sexual rehabilitation. The sexual rehabilitation program proved to be feasible and applicable in improving sexual rehabilitation of gynaecological cancer patients after treatment with radiotherapy. Its cost-effectiveness will be investigated in a randomized controlled multicentre trial in collaboration with all Dutch gynaecological oncology centres.

Gepubliceerd in 2017, Volume 41, Issue 4