Improvement in sexual function after ovarian cancer: Sexual therapy and rehabilitation after treatment for ovarian cancer (START-OC).

Abstract

210 Background: Sexual dysfunction is a distressing long-term effect after ovarian cancer (OC), affecting up to 90% of survivors for years. Despite its prevalence, treatment-related sexual dysfunction is underrecognized and undertreated for OC survivors. We developed and tested a brief, psychoeducational intervention for managing sexual dysfunction after OC. Methods: 45 OC survivors with sexual dysfunction received a single half-day group intervention that included sexual health education, relaxation and cognitive behavioral therapy (CBT) skills to address sexual symptoms and a single tailored telephone booster call 4 weeks post-group. Assessment measures were completed at 4 time points: Baseline 1, Baseline 2 (after an 8 week no-treatment run-in period), and 2 and 6 months post-intervention. The Female Sexual Function Index (FSFI) assessed sexual functioning and the Brief Symptom Inventory (BSI-18) captured psychological distress. Results: Analyses examined changes from Baseline 1 to subsequent time points. Between Baseline 1 and 2 there were no significant changes on study measures, indicating no natural improvement during the run-in period. In contrast, Total FSFI scores improved significantly from Baseline 1 to the 2 month (n = 45, p < .005) and 6 month (n = 35, p < .05) follow-ups. Effect sizes were moderately large indicating a significant improvement in women’s sexual function post- intervention (d = .5) that was sustained for at least 6-months (d = .4). BSI-18 scores were also significantly improved at the 2 -month (p < .005) and 6 month (p < .01) time-points, compared to Baseline 1. Conclusions: Improvements in overall sexual functioning and psychological distress were observed 2 months post-intervention and maintained at 6 month follow-up, suggesting preliminary efficacy of the intervention in reducing sexual dysfunction in OC survivors. Next steps include collection of additional follow-up data on participants. A randomized trial of START-OC is warranted. Clinical trial information: NCT02287519.