Multimodal Follow-up Improved Postradiotherapy Sexual Health in Lower GI, Gynecologic Cancers
Study participants underwent a sexual health assessment, completed the PROMIS sexual function survey, and were educated to minimize or prevent vaginal stenosis.
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WASHINGTON, DC — A nurse-run multimodal continuity of care program may provide much needed information and improve sexual health of female patients with gynecologic and lower gastrointestinal cancers who undergo pelvic radiation, according to findings presented at the 2018 Oncological Nursing Society (ONS) Annual Congress.
Sexual dysfunction is one of the most common but challenging adverse effects experienced by this patient population after radiation therapy.
“Looking at the literature, there's not a lot of surprises here,” said Lorraine Drapek, DNP, FNP-BC, AOCNP. “There is long term sexual dysfunction from radiation therapy and very low vaginal dilator adherence. [The use of vaginal dilators following pelvic radiation] is widely understood and widely recommended.” Vaginal dilators may improve symptoms but compliance 2 years after treatment is reported to only be 50%; an effective follow-up program may improve the quality of life for this patient population.
For this study, researchers enrolled 16 patients into the multimodal continuity of care program, which consisted of 3 clinic visits over 5 months: prior to radiation therapy, at the end of treatment, and 6 to 8 weeks after treatment. Patients underwent a sexual health assessment, completed the Patient Reported Outcomes and Measures Information Systems (PROMIS) sexual function survey, and received education and materials to minimize or prevent vaginal stenosis.
All 16 (100%) patients attended the first visit, 13 (83%) attended the second, and 12 (75%) attended the last visit.
Results showed that 50% of patients did not experience dyspareunia — pain during sexual intercourse — and 85% reported using vaginal dilators at the third clinic visit.
“This was an important project in assisting female patients who have received pelvic radiation by addressing sexual health,” said Drapek. “This project is sustainable as it was not challenging to implement once the infrastructure is in place, and can be implemented for any women who receive pelvic radiation.”'
Drapek L, Cooley M, Sheldon L, Wo J. A multimodal continuity of care program to prevent or minimize vaginal effects of pelvic radiation therapy for women with lower gastrointestinal and gynecologic cancers. Oral presentation at: ONS 43rd Annual Congress; May 17-20, 2018; Washington, DC.