Assessment of an onco-sexology support and follow-up program in cervical or vaginal cancer patients undergoing brachytherapy.

PURPOSE: Women's sexual health and wellbeing with cervical or vaginal cancer may be largely affected by complications from external beam radiotherapy (EBRT) and utero-vaginal brachytherapy (BT), of which vaginal stenosis is the main complication. The objective of this study was to assess the impact of support by a nurse sexologist on sexuality, vaginal side-effects, and the quality of clinical follow-up in patients treated with brachytherapy for cervical or vaginal cancer. METHODS: We performed a retrospective study of the sexuality of women treated for cervical or vaginal cancer. Data from patients with cervical or vaginal cancer who underwent brachytherapy between 2013 and 2017 were collected at Institut Universitaire de Cancer de Toulouse-Oncopôle (IUCT-Oncopôle). Patients were divided into two groups: group A (intervention group) received support from a nurse sexologist and group B (control group) did not. The chi-square test and a logistic multivariate model were used for data analysis. RESULTS: A total of 156 patients were included in this study, including 57.7% who were followed by a nurse sexologist. We observed low compliance in using vaginal dilators after brachytherapy and/or radiotherapy over time regardless of the group, and patients' sexual activity was inadequately addressed. Information regarding the resumption of sexuality 2 months after treatment was missing in 1.1% of patients in group A and in 36.4% of patients in group B. Multivariate analysis showed that patients in group A had a lower risk of developing vaginal stenosis with OR crude = 0.5 (95% CI = 0.25-0.92) and OR adj. = 0.5 (95% CI = 0.26-1.09) compared with those in group B. CONCLUSION: This retrospective study highlights the lack of information collected by physicians during follow-up concerning the sexuality of patients with cervical or vaginal cancer treated by EBRT and BT. The support offered by nurse sexologists in improving patients' sexual activity and reducing their physical side-effects such as vaginal stenosis is likely to be beneficial. A prospective study is currently being conducted to validate the present findings.

International cooperation in public health in Martinique: geostrategic utility for cancer surveillance in the Caribbean.

BACKGROUND: Cooperation in public health and in oncology in particular, is currently a major issue for the island of Martinique, given its geopolitical position in the Caribbean region. The region of Martinique shares certain public health problems with other countries of the Caribbean, notably in terms of diagnostic and therapeutic management of patients with cancer. We present here a roadmap of cooperation priorities and activities in cancer surveillance and oncology in Martinique. MAIN BODY: The fight against cancer is a key public health priority that features high on the regional health policy for Martinique. In the face of these specific epidemiological conditions, Martinique needs to engage in medical cooperation in the field of oncology within the Caribbean, to improve skills and knowledge in this field, and to promote the creation of bilateral relations that will help to improve cancer management in an international healthcare environment. CONCLUSIONS: These collaborative exchanges will continue throughout 2020 and will lead to the implementation of mutual research projects across a larger population basin, integrating e-health approaches and epidemiological e-cohorts.

Sexual health and needs for sexology care in digestive cancer patients undergoing chemotherapy: a 4-month cross-sectional study in a French University Hospital.

PURPOSE: To assess sexual health and needs for sexology care of cancer patients during chemotherapy. METHODS: We performed a 4-month cross-sectional study in cancer patients treated by chemotherapy in the digestive cancer department of a regional university hospital. Patients were asked to fill out a self-administered questionnaire about their sexual health, Sexual Quality of Life Questionnaire for Male (SQoL-M) or Female (SQoL-F), and their needs for sexology care. RESULTS: The study sample was composed of 47 men and 31 women. Tumor locations were 36 colorectal (46%), 23 pancreatic (30%), and 19 other digestive cancers (24%). SQoL scores were lower in women (p < .001), in pancreatic and colorectal tumors (p = .041 and p = .033, respectively) compared to other digestive cancers, and in less-educated patients (p = .023). During chemotherapy, 40% of sexually active patients had less frequent sexual intercourse than before diagnosis, and 33% had completely stopped sexual activity. Sexuality care was desired by 44% of respondents. Among them, 83% favored a consultation with a medical sexologist and 63% with a psycho-sexologist, 54% wanted couple therapy, and 31% considered support groups. Patients with colorectal cancer had more frequent sexual intercourse without penetration at the time of survey (p = .036) and more often wanted couple therapy than patients with pancreatic cancer (p = .048). CONCLUSIONS: This study is the first determination of sexual health and sexual quality of life in digestive cancers. Targets for interventions during chemotherapy for digestive cancers include populations with lower sexual quality of life: women, pancreatic sites, patients with sexual troubles during chemotherapy, and less-educated patients.

Phase 1-3 of the cross-cultural development of an EORTC questionnaire for the assessment of sexual health in cancer patients: the EORTC SHQ-22.

To develop and pretest an European Organization for the Research and Treatment of Cancer Sexual Health Questionnaire (EORTC SHQ-22) for the assessment of physical, psychological, and social aspects of sexual health (SH) in male and female cancer patients and survivors. Questionnaire construction started with creating a list of relevant SH issues based on a comprehensive literature review. Issues were subsequently evaluated for relevance and prioritization by 78 healthcare professionals (HCP) and 107 patients from 12 countries during in-depth interviews (phase 1). Extracted issues were operationalized into items (phase 2). Phase 3 focused on pretesting the preliminary questionnaire in a cross-cultural patient sample (n = 171) using debriefing interviews. Psychometric properties were preliminary determined using a principal component analysis and Cronbach's alpha. We derived 53 relevant SH issues from the literature. Based on HCP and patient interviews, 22 of these 53 issues were selected and operationalized into items. Testing the preliminary 22-item short questionnaire resulted in a change of wording in five items and two communication-related items; no items were removed. Preliminary psychometric analysis revealed a two-factor solution and 11 single items; both scales showed good reliability indicated by a Cronbach's alpha of 0.87 (sexual satisfaction) and 0.82 (sexual pain). Cross-cultural pretesting of the preliminary EORTC SH questionnaire has indicated excellent applicability, patient acceptance, and comprehensiveness as well as good psychometric properties. The final development phase, that is psychometric validation (phase four) including large-scale, cross-cultural field testing of the EORTC SHQ-22, has commenced.

Risk factors for IUD failure: results of a large multicentre case-control study.

BACKGROUND: This study was conducted to identify the risk factors for intrauterine device (IUD) failure. METHODS: A retrospective case-control study was carried out between 1999 and 2002. Cases (women with an IUD and a confirmed pregnancy) and controls (women with an IUD and who were not pregnant) were recruited by gynaecologists. An anonymous questionnaire was filled in during the consultation, with specific items regarding any type of drugs used before the predicted fertile period for cases and within the cycle that ended in menses for controls. RESULTS: Two hundred and sixteen cases were compared with 657 controls. Age was associated with IUD failure, with a significantly lower failure risk in women>35 years. A significant relationship was observed between a history of IUD expulsion and IUD failure risk (age-adjusted odds ratio 3.31, 95% CI 1.40-7.81). No relationship was observed between the risk of IUD failure and gynaecological background (fibroma, polyps and miscarriage), nor with any type of medicine taken by the woman. CONCLUSION: This study is clearly reassuring, as we found that anti-inflammatory drugs and any other medicines taken by the woman were not implicated in IUD failure. Only a history of previous IUD expulsion was found to be a risk factor for failure, indicating that these women should have regular medical and echographical follow-up. Comparing the efficacy rate of various types of IUDs, we found a clear advantage for levonorgestrel-releasing devices.