Sexual health in women treated for cervical cancer: characteristics and correlates. Resilience, reflection, and residual stress in ovarian cancer survivorship: a gynecologic oncology group study. Women's experiences after a radical vaginal trachelectomy for early stage cervical cancer. A descriptive phenomenological study. Quality of life in long-term cervical cancer survivors: a population-based study. Reproductive concerns of women treated with radical trachelectomy for cervical cancer. A 2-year prospective study assessing the emotional, sexual, and quality of life concerns of women undergoing radical trachelectomy versus radical hysterectomy for treatment of early-stage cervical cancer. Radical trachelectomy for cervical cancer: postoperative physical and emotional adjustment concerns. The blame game: Cervical cancer, knowledge of its link to human papillomavirus and stigma
OBJECTIVE A large proportion of women with a history of cervical cancer experience sexual problems as a result of treatment . The present study examined whether differences in sexual health between cervical cancer survivors and women with no history of cervical cancer could be explained by selected demographic , clinical , and psychosocial and physical factors . METHODS Women treated between 1 and 5 years previously for stage 0 to II cervical cancer and age- and education-matched women with no history of cancer undergoing routine cervical cancer screening were recruited to participate . All participants had a partner with whom they had ever been sexually active . Women completed measures of sexual health , vaginal changes , partner relationship quality , perceived physical appearance , and sexual self-concept . RESULTS Cervical cancer survivors reported significantly ( p<.05 ) less sexual interest , more sexual dysfunction , and lower sexual satisfaction . The most consistent predictors of sexual health after treatment among survivors were time since diagnosis , receipt of radiotherapy , partner relations , and perceived physical appearance , as well as vaginal changes . These variables accounted for about 50 % of the variance in sexual health outcomes . CONCLUSION The findings suggest that efforts to improve sexual health in women with a history of cervical cancer must move beyond the direct effects of cancer treatment on vaginal anatomy and physiology . Sexual rehabilitation interventions should consider partner relationships , perceived physical appearance , and women 's attitudes toward themselves as sexual beings , in addition to vaginal changes . Future research should use prospect i ve longitudinal research design s incorporating appropriate comparison groups to further explore this issue Ovarian cancer is a life-threatening diagnosis which poses multiple challenges . The purpose of this study is to describe the quality of life ( QOL ) concerns and survivorship sequelae of long-term ( > 5 yr ) early-stage ovarian cancer survivors accrued through the clinical cooperative Gynecologic Oncology Group . Forty-nine ovarian cancer survivors with a mean age at diagnosis of 55.9 yr ( range 30 - 76 ) completed a telephone interview assessing QOL , psychosocial status , sexual functioning and late-effects of treatment .  Results indicate that this disease-free early-stage sample enjoys a good QOL , with physical , emotional , and social well-being comparable to other survivors and same-aged noncancer cohorts . However , 20 % of survivors indicated the presence of long-term treatment side effects , with a subset reporting problems related to abdominal and gynecologic symptoms , and neurotoxicity . Spiritual well-being was significantly positively associated with personal growth and mental health , and negatively associated with a declining health status . Lingering psychological survivorship sequelae included fear of follow-up diagnostic tests and fear of recurrence . Forty-three percent of respondents expressed that they would likely participate in a counseling program today to discuss psychosocial issues raised by having had ovarian cancer , and 56 % stated that they would have attended a support program during the initial treatment if it had been offered . This information provides some insight into the complex survivorship relationships between quality of life , long-term physical and sexual sequelae , and factors of resilience and growth which appear to promote a sense of well-being as a result of the cancer experience PURPOSE This paper reports on a phenomenological study of women 's experiences 1 - 10 years following a radical vaginal trachelectomy  and describes the impact on health , sexuality , fertility and perceived supportive care needs . METHOD AND SAMPLE Qualitative telephone interviews employing a descriptive phenomenological approach were conducted using a purposive sample of 12 women . KEY RESULTS Several felt their cancer experience was positive ; bringing them closer to family and changed their outlook on life . A few experienced delayed psychological reactions and /or fears of recurrence . Many experienced isolation and the desire to contact others with similar experiences . Women recovered well but a few experienced fears/concerns about lymphoedema and intermenstrual bleeding . Sexual function was not a long-term issue for most . Some that could feel the cerclage ( stitch ) during intercourse , developed techniques to reduce this . Single women felt vulnerable in new relationships . Pregnancy was an anxious time , especially for those that experienced a miscarriage or pre-term birth . Sources of support included the clinical nurse specialist , family/friends , surgical consultant , online patient forums and a support group . Women needed more information on trachelectomy statistics , pregnancy care recommendations as well as access to counselling , peer support , being seen by the same person and increased public awareness . CONCLUSIONS This study has provided an interesting and detailed insight into women 's experiences in the years following a trachelectomy , with results that have important considerations for practice such as provision of statistical information ; counselling ; peer support ; consistent pregnancy recommendations ; increased public awareness and increased identification and management or prevention of long-term physical effects OBJECTIVES To assess long-term quality of life ( QOL ) in cervical cancer survivors ( CCSs ) , 5 , 10 , and 15 years after diagnosis . METHODS In a cross-sectional population -based study , CCSs diagnosed in 1990 , 1995 , or 2000 were r and omly selected from 3 tumor registries in France . Healthy controls were r and omly selected from electoral rolls , stratifying on age group and residence area . Five  QOL question  naires ( SF-36 , EORTC QLQ-C30 , the cervical cancer-specific module ( EORTC QLQ-CX24 ) , the MFI fatigue question naire , the STAI for anxiety ) and a  life condition question naire were used . Analysis of variance was used to compare QOL scores of survivors by period of diagnosis ( 5 , 10 , and 15 years ) with those of controls and according to treatment modality , adjusted for socio-demographic data . RESULTS A total of 173 localized CCSs ( 42 % treated with surgery alone and 58 % with a combination of treatments ) and 594 controls participated in the study . Compared with controls , CCSs expressed globally similar good QOL , except for impaired psychoemotional domains in 15-year survivors ( p<0.01 ) . Worsening of some symptoms was observed over time , 15-year survivors in particular reported significantly more lymphedema than 5-year ( p=0.0009 ) and 10-year CCSs ( p=0.002 ) . Compared with CCSs treated by surgery alone , QOL of CCSs who received radiotherapy was significantly more affected in terms of cervical cancer specific problems , such as sexual dysfunction ( p=0.002 ) , voiding and abdominal symptoms ( p=0.01 ) , and lymphedema ( p=0.01 ) . CONCLUSIONS Even after 15 years , QOL of CCSs is impacted in psychological domains , compared with healthy controls . Among CCSs , women treated by adjuvant radiotherapy expressed more physical sequelae OBJECTIVE To report the reproductive concerns of women treated for stage I cervical cancer with fertility-preserving surgery .  MATERIAL S AND METHODS Newly diagnosed cervical cancer patients undergoing radical trachelectomy  were enrolled in this study preoperatively and assessed over time . Preliminary data from the preoperative analysis and 3-month and 6-month assessment points addressing reproductive concerns are presented . RESULTS Between February 2004 and June 2006 , 29 patients were enrolled in the study . Three patients were excluded because they did not undergo the planned surgery and 6 patients were excluded because they required adjuvant therapy .  Future childbearing was the main reason most women chose to undergo the procedure ; however , treatment choice was also guided by conversations with their doctors ( 41 % , n=12 ) . Twenty-six ( 90 % ) initially expressed concern over future conception and childbearing , but this increased to all patients by 6 months . At enrollment , the majority of the patients had high expectations for future conception and childbearing but this declined over time . Despite this , patients ' distress gradually decreased over time . CONCLUSIONS Our results show that many women who have undergone a radical trachelectomy  present with distress and reproductive concerns that persist for up to 6 months postoperatively . Concerns about conception appear to decrease following surgery ; however , concerns about pregnancy appear to increase post trachelectomy itself . This pilot study reflects the first preliminary data from an active ongoing study prospect ively collecting information over 2 years from newly diagnosed stage I cervical cancer patients undergoing radical trachelectomy OBJECTIVE To prospect ively assess and describe the emotional , sexual , and QOL concerns of women with early-stage cervical cancer undergoing radical surgery .  METHODS Seventy-one women who were consented for radical trachelectomy ( RT ) or radical hysterectomy ( RH )  were enrolled preoperatively in this 2-year study ; 52 women ( 33 RT ; 19 RH ) were actively followed . Patients completed self-report surveys composed of 4 empirical measures in addition to exploratory items . Data analyses for the 2 years of prospect i ve data are presented . RESULTS At preoperative assessment , women choosing RH reported greater concern about cancer recurrence ( x=7.27 [ scale from 0 to 10 ] ) than women choosing RT ( x=5.66 ) ( P=0.008 ) . Forty-eight percent undergoing RH compared to 8.6 % undergoing RT reported having adequate " time to complete childbearing " ( P<0.001 ) . Both groups demonstrated scores suggestive of depression ( based on the CES-D scale ) and distress ( based on the IES scale ) preoperatively ; over time , however , CES-D and IES scores generally improved . Scores on the Female Sexual Functioning Inventory ( FSFI ) for the total sample were below the mean cut-off ( 26.55 ) , suggestive of sexual dysfunction ; however , the means increased from 16.79 preoperatively to 23.78 by 12 months and 22.20 at 24 months . CONCLUSION Measurements of mood , distress , sexual function , and QOL did not differ significantly by surgical type , and instead reflect the challenges faced by young cervical cancer patients treated by RT or RH without adjuvant treatment . Points of vulnerability were identified in which patients may benefit from preoperative consultation or immediate postoperative support . Overall , patients improved during the first year , reaching a plateau between Year-1 and Year-2 , which may reflect a new level of functioning in survivorship OBJECTIVE To investigate the incidence of cervical stenosis and related emotional and sexual adjustment concerns in women treated with radical trachelectomy . METHODS Prospect i ve data of 30 stage I cervical cancer patients enrolled in an ongoing study were evaluated in combination with a medical chart review . RESULTS Eight patients ( 27 % ) did not have any stenosis of the neo-cervix postoperatively ; 10 ( 33 % ) had clinical ly notable stenosis not requiring neo-cervical dilation to allow adequate sampling ; moreover , 12 ( 40 % ) had sufficient stenosis requiring a neo-cervical dilation procedure , which proved to be safe and useful . The majority of the dilation procedures ( n=8 ) were conducted under local anesthesia in the office . At preoperative baseline survey , women reported a high rate of sexual inactivity . Fear of intercourse and dyspareunia were reported prior to surgery ; however , trends of adjustment and improvement were noted over time postoperatively . Overall , fear of sexual activity tended to lessen if the degree of dyspareunia decreased over time . Postoperative dyspareunia decreased over time , which could have been associated with the mechanical stretching due to vaginal dilator use or dilating benefit of intercourse . CONCLUSION Postoperative concerns associated with radical trachelectomy may be greater than what has been reported in the literature ; however , several adjustment trends were noted with intermediate/long-term follow-up . Office cervical dilation is a simple procedure , which is helpful in the management of neo-cervical stenosis . We are currently investigating the value of a physician checklist as a clinical care model to remind medical professionals to monitor and address important survivorship issues This two- study paper examined stigma toward women with cervical cancer . Cervical cancer is caused by human papillomavirus ( HPV ) , a sexually transmitted infection ( STI ) . For Study 1 , participants ( N = 352 ) were r and omly assigned to one of four conditions in which they read a brief description of a patient with either cervical or ovarian cancer in which the cause of the patient ’s cancer was either specified ( cervical : HPV , a STI vs. ovarian : family history ) or unspecified . Participants in the cervical cancer/cause-specified condition rated the patient as more dirty , dishonest and unwise , and reported feeling more moral disgust and ‘ grossed out ’ than participants in the cervical cancer/cause-unspecified condition . For Study 2 , participants ( N = 126 ) were r and omly assigned to read a vignette about a patient with cervical cancer  in which the cause of cancer was either specified or unspecified . Consistent with Study 1 , participants in the cause-specified condition rated the patient as more unwise , and reported feeling more moral disgust and ‘ grossed out ’ than participants in the cause-unspecified condition . These effects were mediated by attributions of blame toward the patient . Findings suggest that women with cervical cancer may be stigmatised and blame may play a role in this process
BACKGROUND Women with cervical cancer constitute a patient population in need for ongoing , person-centred supportive care .
Our aim was to synthesis e current available evidence with regard to the supportive care needs of women living with and beyond cervical cancer .