Sex and sexuality are issues central to women's health. Despite the important nature of this topic, sexual concerns have often been overlooked by health care providers during the treatment and post-treatment surveillance of women with gynecologic cancer. Although it has been demonstrated at least since the early 1980s that sexual dysfunction is perhaps the most significant morbidity of treatment for cervical cancer, little progress has been made in specifying the impact of surgery vs. radiotherapy, or in studying the broader impact of sexual dysfunction on the quality of life (QOL) of cervical cancer survivors. Virtually all studies have excluded non-English speaking patients. This study will evaluate the sexual outcomes of therapy for cervical cancer and the relationship of these issues to QOL. We will prospectively study 144 women receiving treatment and follow-up surveillance for cervical cancer.
The aims of the study are: 1.) To assess the entire range of sexual functioning (desire, arousal, orgasmic capacity, dyspareunia, and sexual satisfaction) over the course of treatment and early follow-up in patients with local and locally advanced cervical cancer; 2.) To assess general cancer-related QOL over the course of treatment and early follow-up in patients with local and locally advanced cervical cancer; 3.) To characterize the relationship between sexual dysfunction and overall cancer-related QOL over time; and 4.) To identify factors that may predict better sexual function outcomes in patients treated for cervical cancer. At baseline, and at 1, 2, and 4 months post-treatment, women will fill out standardized questionnaires measuring sexual function and satisfaction, relationship happiness, health-related QOL, and cancer-related QOL. At each assessment, a clinician will use a vaginal probe to assess length and caliber of the vaginal canal. Through completion of questionnaires and measurement of vaginal length and compliance, we plan to develop culturally sensitive, short-term interventions to improve sexual functioning and QOL of cervix cancer survivors. Our long-term goal is to evaluate the effectiveness of such interventions in randomized trials. Ultimately, we hope to integrate our findings into daily clinical practice.
