Education program helps with side effects of ovary removal for cancer prevention

More women are having ovary-removing surgery as a cancer prevention measure, but many are often unaware of sexual or psychological side effects of the procedure. A new study shows a half-day educational program can help successfully deal with these issues by educating women on how to address them.

The program, developed by researchers at Dana-Farber Cancer Institute in Boston, Massachusetts, taught women how to manage some of the physical and emotional difficulties that can follow ovary-removing surgery. It also helped many participants resume satisfying sexual activity and reduce feelings of anxiety and depression, the investigators found.

The study, published in the Journal of Sexual Medicine (2014; doi:10.1111/jsm.12713), underscores the need to inform women about the aftereffects of this type of surgery and, critically, let them know that such problems can be dealt with successfully.

"For women who inherit genetic mutations that put them at increased risk for ovarian cancer, oophorectomy—surgical removal of the ovaries—can sharply lower that risk. But the procedure can have potentially difficult side effects," said the study's first author, Sharon Bober, PhD, Founder and Director, Sexual Health Program at Dana-Farber. "Patients often experience problems such as vaginal dryness, which can make intercourse difficult or painful, a decrease in libido, a change in body image, and a loss of a sense of vitality or femininity. In this study, we sought to see whether an education and training program could improve sexual functioning and relieve distress in these patients."

The study involved 37 oophorectomy patients who carried mutations in the BRCA1 or BRCA2 genes, which predisposed them to developing breast or ovarian cancer. All attended a half-day educational session designed by Bober that taught them how to manage side effects of the procedure, improve their self-image, and practice relaxation techniques. That was followed by two sessions of telephone counseling.

At the start of the program and two months after its conclusion, participants completed questionnaires about their sexual and emotional well-being. They reported significant improvement in sexual health, an increase in sexual desire and satisfaction, and a decrease in pain associated with intercourse. They also reported feeling less anxiety.

"We found that in addition to acquiring new skills and knowledge, participants found it helpful to be in a setting with others who have gone through a similar experience," Bober remarked. "We hope to study whether this approach can be effective on a larger scale, perhaps by engaging patients in a Web-based program."

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