Open Journal of Obstetrics and Gynecology
Vol.4 No.8(2014), Article ID:46745,12 pages DOI:10.4236/ojog.2014.48069

The Impact of Cervical Cancer Treatment on Sexual Function and Intimate Relationships: Is Anyone Listening?

Jennifer L. Hunter

School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, USA

Email: hunterj@umkc.edu

Copyright © 2014 by author and Scientific Research Publishing Inc.

This work is licensed under the Creative Commons Attribution International License (CC BY).

http://creativecommons.org/licenses/by/4.0/

Received 5 April 2014; revised 2 May 2014; accepted 10 May 2014

ABSTRACT

The purpose of this research was to describe women’s narrative accounts of the impact of cervical cancer treatment on their sexual function and intimate relationships, and to evaluate what changes in care and education are needed to enhance quality of life and intimacy after treatment. The research approach was a narrative design, using semi-structured, in-depth interviews. Narratives were examined within and across interviews, and thematic content analysis completed. The study was done in a gynecologic oncology clinic at a public hospital in the Midwest United States. The sample consisted of twelve women, ranging in age from 27 to 59, who had completed the cervical cancer treatment with chemo-radiation or radiation and surgery, and were now followed by their gynecologic oncologists. Across narratives, five major themes were identified, including unexpected physical complications, not “getting back to normal,” emotional pain and isolation, lack of available information, and inadequate health care provider response to treatment complications and sexual relationship problems. Women’s stories reveal that sex and intimacy issues for cervical cancer survivors remain within a culture of silence. In many situations, health professionals did not provide information that realistically prepared women and partners for probable consequences of treatment, did not assess sexual issues before or after treatment, did not recognize various symptoms as being complications of cancer treatment, did not make referrals, and/or recognized complications, but accepted them as “normal” and without solution. Ethical implications for health professionals and the need for education, communication, and the development of new lines of research are discussed.

Keywords:Cervical Cancer Survivorship, Pelvic Radiotherapy, Sexual Dysfunction, Vaginalstenosis, Patient-Provider Communication

1. Introduction

In the US, standard treatment for women diagnosed with cervical cancer beyond very early stages includes chemotherapy with cysplatin, external beam radiation therapy (RT), and brachytherapy which involves implantation of the radiation source in the vagina, very close to the cervix tumor [1] . Although this treatment has excellent cura Rakowsky, E., Sulkes, A., Sulkes, J. and Fenig, E. (2001) Early Development of Vaginal Shortening During Radiation Therapy for Endometrial or Cervical Cancer. International Journal of Gynecological Cancer, 11, 234-235. http://dx.doi.org/10.1046/j.1525-1438.2001.01019.x

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