Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

Psychosexual effects of gynaecological cancer survivors in India (#404)

Indrani BasuMallik 1
  1. Cancer Centre Welfare Home &Research Institute, Kolkata, W.B , India

Background:Scientific observations led to the fact that gynecological cancer patients suffer from intense stress featuring anxiety, depression, fear of treatment procedures, and fear of recurrence not only during the diseased state, but also at a disease free state after treatment. Stress resulting from the disease and treatment procedures affect the psychosexuality of the patients. The survivors reported sexual dysfunction and changed relationship with their partners.
Objective:Psychological stress and sexual dysfunction caused due to gynecological cancer and various oncological treatments , need to be identified and quantified for support and rehabilitation. Attempt was taken to quantify the stress levels at various stages of the disease and also at a disease free state. The sexual relationship before and after the disease and treatment were also studied.
Method:200 women cancer survivors in the age group of 35 to 45, who had undergone various oncological treatments were studied.
(a) The psychological stress factors were quantified by standard psychological tools and questionnaire.
(b) The site of cancer and the treatment modalities were obtained from the hospital records of the patients,
(c) The sexual factors were quantified by the average frequency of intimacy with partners after treatment and this frequency was compared with their self reported average frequency of intimacy at their pre-diagnosed state (considered as the control group).
Results:1. Stress level was acute for 92% of the patients at diagnosis,85% showed sub acute anxiety during treatment and 68% showed moderate to mild anxiety in 3-8 years of disease free state.
2. Fear of recurrence came down in the passage of time or increased duration of disease free state.
3. Analysis of the occurrence of cancer sites showed 65% cancer cervix, 28% cancer ovary, 4% Gestational Trophoblastic Tumor and 3% endometrical cancer.

4. Analysis of treatment modality.
treatment                                        cervix               ovary            GTT                  endometrium

Surgery                                             17%                 10%               -                              2%
Radiation therapy(RT)                      32%                   -                   -                              -
Chemotherapy(CT)                            -                      10%              3%                           -
Surgery +RT                                     10%                   -                   -                              1%
Surgery +CT                                       -                       8%               1%                           -
Surgery +CT+RT                               6%                    -                   -                               -

5. Change in relationship with partner after diagnosis and treatment were indicated in the results:

Treatment Modality                                                   Results of statistical hypothesis tests
1. Surgery                                                                           Not significantly different
2. RT                                                                                   Significantly different
3. CT                                                                                   Not significantly different
4. Surgery & CT                                                                 Significantly different
5. Surgery & RT                                                                 Significantly different
6. surgery, CT & RT                                                          Significantly different

Primary curative surgery caused minimum psychosexual problem, GTT patients with chemotherapy treatment also showed less problem, radiated patients were significantly affected. The worst affected were those who had undergone surgery, radiation and chemotherapy combined. 14% of the patients suffered from sexual morbidity.

Conclusion:Anxiety and fear of recurrence diminished with duration of disease free state.Treatment modality seemed to have influence on psychosexuality. Research with a larger sample group is suggested. The cancer survivors with sexual dysfunctions needed medical and psychological intervention and support to regain normal relationship with partners.

  1. Schover L R: Sexuality and cancer: For the Women Who Has cancer, and Her Partner(order#4657). New York, American Cancer Society, 1995.