Sexual health in Belgian cervical cancer survivors: an exploratory qualitative study.

PURPOSE: To assess experiences of sexuality and of receiving sexual healthcare in cervical cancer (CC) survivors. METHODS: A qualitative phenomenological study using semistructured one-on-one interviews was conducted with 15 Belgian CC survivors recruited in 5 hospitals from August 2021 to February 2022. The interviews were audiotaped and transcribed verbatim. Data were analyzed using inductive thematic analysis. COREQ and SRQR reporting guidelines were applied. RESULTS: Most participants experienced an altered sexuality after CC treatment with often long-term loss/lack of sex drive, little/no spontaneity, limitation of positions to avoid dyspareunia, less intense orgasms, or no sexual activity at all. In some cases, emotional intimacy became more prominent. Physical (vaginal bleeding, vaginal dryness, dyspareunia, menopausal symptoms) and psychological consequences (guilt, changed self-image) were at the root of the altered sexuality. Treatment-induced menopause reduced sex drive. In premenopausal patients, treatment and/or treatment-induced menopause resulted in the sudden elimination of family planning. Most participants highlighted the need to discuss their altered sexual experience with their partner to grow together toward a new interpretation of sexuality. To facilitate this discussion, most of the participants emphasized the need for greater partner involvement by healthcare providers (HPs). The oncology nurse or sexologist was the preferred HP with whom to discuss sexual health. The preferred timing for information about the sexual consequences of treatment was at treatment completion or during early follow-up. CONCLUSION: Both treatment-induced physical and psychological experiences were prominent and altered sexuality. Overall, there was a need for HPs to adopt proactive patient-tailored approaches to discuss sexual health.

Skin metastases from vulvar cancer: a fatal event.

BACKGROUND: Cutaneous metastases from a vulval cancer are exceptional with only 4 reported cases in the literature. CASE: The present case is a patient who had a radical vulvectomy with bilateral groin node dissection for a vulvar cancer stage Ib. After 9 months she a local recurrence, which was treated with radiotherapy. An anterior exenteration was performed 8 months later for a second local recurrence. Three months thereafter she had skin metastases at her thighs and calves. Chemotherapy was started; yet the lesions slowly increased. The treatment was discontinued and she died 4 months later. CONCLUSIONS: Skin metastases must be considered a preterminal event with no well-established treatment. They could be caused by retrograde permeation of tumor cells after the destruction of the local draining system.