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The Sexual Adjustment Process of Cancer Patients and Their Partners: A Qualitative Evidence Synthesis

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Abstract

When confronted with cancer, a prominent challenge for patients and their partners is their changed sexual relationship. An empirically based theoretical model of the sexual adaptation process during cancer might be helpful in guiding the development of adequate interventions for couples who struggle with their sexual relationship. Therefore, the purpose of this study was to synthesize evidence from primary qualitative research studies and to arrive at a detailed description of the process of sexual adjustment during cancer. We conducted a qualitative evidence synthesis of a purposeful sample of 16 qualitative papers, using the meta-ethnography approach to synthesis. We found that the subsequent studies used different theoretical approaches to describe the sexual adaptation process. This led to three divergent sexual adaptation processes: (1) the pathway of grief and mourning, depicting sexual changes as a loss; (2) the pathway of restructuring, depicting the adjustment process toward sexual changes as a cognitive process with a strong focus on the social and cultural forces that shape the values and experiences of sexuality; and (3) the pathway of sexual rehabilitation, depicting sexual changes as a bodily dysfunction that needs treatment and specific behavioral strategies. All three pathways have their own opportunities and challenges. A greater awareness of these different pathways could help healthcare providers to better understand the ways a particular couple might cope with changed sexuality, offering them opportunities to discover alternative pathways for sexual adjustment.

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Acknowledgments

The study was financially supported by a grant from the Research Foundation Flanders.

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Authors and Affiliations

  1. Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium

    Charlotte Benoot, Marlies Saelaert & Johan Bilsen

  2. Centre for Sociological Research, Catholic University of Leuven, Parkstraat 45, 3000, Louvain, Belgium

    Karin Hannes

Authors
  1. Charlotte Benoot
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  2. Marlies Saelaert
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  3. Karin Hannes
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  4. Johan Bilsen
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Correspondence to Charlotte Benoot.

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The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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As we did a secondary analysis of published articles, this article does not contain any studies with human participants performed by any of the authors.

Appendix

Appendix

List of articles that were included in the study but not used in the meta-synthesis.

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  • Wang, F., Chen, F., Huo, X., Xu, R., Wu, L., Wang, J., & Lu, C. (2013). A neglected issue on sexual well-being following breast cancer diagnosis and treatment among Chinese women. PloS ONE, 8(9), e74473.

  • Warkentin, K. M., Gray, R. E., & Wassersug, R. J. (2006). Restoration of satisfying sex for a castrated cancer patient with complete impotence: A case study. Journal of Sex & Marital Therapy, 32(5), 389–399.

  • White, I. D., Faithfull, S., & Allan, H. (2013). The re-construction of women’s sexual lives after pelvic radiotherapy: A critique of social constructionist and biomedical perspectives on the study of female sexuality after cancer treatment. Social Science & Medicine, 76, 188–196.

  • Wilmoth, M. C., Hatmaker-Flanigan, E., LaLoggia, V., & Nixon, T. (2011, November). Ovarian cancer survivors: Qualitative analysis of the symptom of sexuality. Oncology Nursing Forum, 38(6), 699—708.

  • Wittmann, D., Northouse, L., Crossley, H., Miller, D., Dunn, R., Nidetz, J., … Montie, J. E. (2015). A pilot study of potential pre-operative barriers to couples’ sexual recovery after radical prostatectomy for prostate cancer. Journal of Sex & Marital Therapy, 41(2), 155–168.

See Table 5.

Table 5 Data extraction sheet of each of the included studies
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Benoot, C., Saelaert, M., Hannes, K. et al. The Sexual Adjustment Process of Cancer Patients and Their Partners: A Qualitative Evidence Synthesis. Arch Sex Behav 46, 2059–2083 (2017). https://doi.org/10.1007/s10508-016-0868-2

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