Introduction
Gynecologic cancer treatment can have a profound impact on women. In particular, cancer treatment can impact sexual function and sexuality and include issues such as pain, bodily changes, alternation in body image, shifts in relationships, and emotional distress. We created an innovative specialized clinic to address the concerns about sexual health, rehabilitation, and quality of life following cancer treatment for women with gynecologic cancer.
Methods
The initial clinic visit involves an in-depth assessment by the nurse using a customized tool, based on the Supportive Care Framework, with other standardized measures. The assessment helps to tailor intervention related to physical, psychosocial, informational and practical patient concerns. Brief counseling and education are provided by the nurse and individualized resource packages are provided. Subsequently the patient returns for a second appointment with the physician and nurse together. Referral is made to social work or psychology as required.
Results
Of the 168 women who attended the clinic, 95% had surgery, chemotherapy, and radiation. The most frequently identified problems were fatigue (75.6%), depression (58.3%), anxiety (62.5%), fear (45.8%), pain (45.8%), appearance (44.6%) and weight change (44.0%). Feedback about the clinic is very positive with ratings being primarily “very satisfied”. In particular, women reported their information needs were met through the interaction with the staff. Learning how to better manage the effects they were experiencing and learning more about community-based resources were cited as helpful and contributed to reducing their anxiety.
Conclusion
This presentation will describe the design of our sexual health clinic for women following gynecologic cancer. The nature of the practice will be described in terms of the issues women bring forward, the interventions offered, and the resulting impact on patient outcomes. Given the emerging survivor issues regarding sexuality, this clinic offers an effective model for providing care to this population.