Review of interventions from a sexual health program in an oncology patient population

Abstract

8170 Background: Sexual problems are common concerns for oncology patients. As treatments for cancer improve and patients live longer, clinicians will encounter more patients with sexual complaints. Re-establishing healthy sexual functioning is an important step towards restoring patients' sense of normalcy. Thus, programs focused on addressing these issues have developed. Methods: A retrospective review was performed using 70 sequential charts of patients who attended the Sexual Health Program at Memorial Sloan-Kettering Cancer Center (MSKCC). Patients were seen from March through September of 2003 and were evaluated by a gynecologist and a psychologist. Results: The median age at the initial visit was 53 (22–76) and the majority of patients were menopausal (90%). The most common cancer diagnoses were breast (31%), endometrial (10%), cervical (10%) and ovarian (9%). Forty patients (57%) had prior pelvic surgery and nineteen (27%) had pelvic irradiation. Non-malignant co-morbidities seen included thyroid disease (21%), depression (20%), hypertension (13%), hyperlipidemia (10%) and diabetes (7%). The most frequent complaint seen was dyspareunia, with (17%) or without vaginal dryness (27%), decreased libido, with (4%) or without vaginal dryness (11%), vaginal dryness alone (8%) or all three complaints in combination (17%). Treatment recommendations consisted of hormonal therapy replacement alternatives such as vaginal moisturizers and lubricants (89%), minimally absorbed vaginal estrogen replacement therapy (49%), vaginal dilators (16%) and psychological counseling (41%). Conclusions: The Sexual Health Program at MSKCC is a multidisciplinary program where female oncology patients with sexual concerns can be evaluated and treated. Patients are diverse in their demographic profiles, cancer therapies and sexual complaints. Current therapeutic options include vaginal lubricants and moisturizers, local hormonal replacement, skilled exercise and psychosexual counseling. Further research is under way to investigate the impact of cancer treatments on the sexual functioning of oncology patients. No significant financial relationships to disclose.