Female Cancer Survivors Lack Frank Sex Talk From Docs

Three out of four women treated for genital tract cancer feel their doctors should initiate more conversations about the cancer's impact on their sexual health, new research finds.

"We found that these women valued sexuality and participated in sexual relationships and activities at a rate similar to women who had not been through cancer treatment, but they were not adequately prepared for the sexual issues that their cancer or its treatment introduced," study author Dr. Stacy Lindau said in a prepared statement. The sexual problems included pain and limited lubrication.

Two out of three women whose reproductive and sexual organs were severely compromised by the treatment also reported that their doctors never brought up sex, according to the study.
Writing in the August issue of Gynecologic Oncology, University of Chicago Medical Center researchers expressed concern that if doctors are not discussing the impact of medical treatment on sexuality under these circumstances, sexual health was even less likely to be discussed in other situations, particularly with older women. Previous studies have shown that patients are themselves reluctant to bring up sexual issues.

The research team surveyed 219 women aged 40 to 50 years old who had been treated for a rare form of vaginal or cervical cancer. The women were all members of a registry for people who might have been exposed to synthetic hormones while in their mother's womb. Most of the women had been treated with surgery or radiation therapy when they were in their late teens or 20s and had survived more than two decades after their diagnosis. The researchers then compared the responses from these women with race- and age-matched controls selected from a 1992 national study on sexual norms.

The cancer survivors reported more sexual problems and four times more health problems that interfered with sex all or most of the time, but they were just as likely to be married as the comparison group. Fifty percent of the survivors reported three or more sexual problems, compared to 15 percent of their peers. They were also seven times more likely to feel pain during intercourse and three times more likely to have difficulty lubricating.
More than one out of three survivors complained about the scars from their treatment as well as frequent bladder infections and incontinence.

Those of the survivors who reported a conversation with their physician about the sexual impact of treatment were the women who were more likely to have three or more sexual problems at the same time.