PSYCHOSEXUAL FUNCTIONING AFTER TREATMENT FOR GYNECOLOGIC MALIGNANCY (NEOPLASMS, SEXUAL DISORDERS, PSYCHOSOMATIC DISORDERS)

Abstract

A descriptive study of sexual functioning after radiation therapy for cervical cancer is presented. A literature review from 1951-1984 about sexual function following treatment for gynecologic malignancy showed a 0-79% incidence of sexual disability among irradiated subjects. To further explore the effects of radiation therapy, a retrospective design was constructed and applied to a French population irradiated for cervical carcinoma, stage Ia-IIb. Twenty-six subjects, average age 52, were selected using a quota sampling technique: 14 had received radiation therapy alone, 12 had undergone combined surgery and irradiation. Sixteen women treated for early breast cancer by lumpectomy and radiation were chosen as the control population. At a mean of 46 months posttreatment, the subjects were administered the Sexual Function After Gynecologic Illness Scale-18, the Self-Rated Depression Scale, and the State-Trait Anxiety Inventory. Eighteen sexual partners (nine experimental, nine control) completed the Sexual Function After Gynecologic Illness Scale-Male and the same psychological scales. For the gynecologic subjects, information about their treatment, physical complications, and health provider interventions was also collected. The findings indicated that the posttherapy sexual functioning of the gynecologic patients was correlated with depression, age at menopause, the volume of the irradiated vagina, and, to a lesser extent, hormonal treatment. No significant differences were found between the experimental group and the control groups on the variables of age, sexual functioning, depression, state anxiety, or trait anxiety. Compared to the radiation therapy alone group, the combined treatment group had significantly higher levels of depression and trait anxiety, and somewhat higher levels of state anxiety and lower levels of sexual functioning. Patient age, specific treatment parameters, and posttreatment complications were not correlated with sexual functioning. Physician intervention variables were also not related to sexual functioning though less anxiety was reported by subjects who had received sexual information. The major finding of this research is that radiation therapy is not synonymous with a high incidence of sexual disability; instead, particular combinations of surgery and radiation may adversely influence posttherapy levels of sexual functioning in conjunction with the psychological and menopausal status of the woman.