Skip to main content

Advertisement

SpringerLink
Log in

Clinician and Patient Communication on Body Image, Sexuality, and Sexual Function in Gynecologic Cancer: An Integrative Review

  • Original Paper
  • Published:
Sexuality and Disability Aims and scope Submit manuscript

Abstract

Body image, sexuality, and sexual function commonly affect women with gynecologic cancer. While these issues are common and cause distress, patients report little communication regarding these topics with clinicians. The purpose of this review was to present the literature surrounding these topics, describe and appraise the quality of the literature, identify significant gaps in the literature, and provide implications for practice and/or future research. A systematic search of the literature was conducted using three databases. Keywords and MESH headings were used to obtain appropriate articles. Data was evaluated using PRISMA guidelines. Nine articles were retrieved. Most (5) focused on patients’ perspectives of communication, while 3 focused on clinician perspectives. Only one included the perspectives of both. Further research is needed to better understand the issues surrounding patient-clinician communication on these topics. Clinicians need to routinely assess patients for issues related to body image and sexual health, feel comfortable discussing these topics, and be prepared to provide information or resources for patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Siegel, R.L., Miller, K.D., Jemal, A.: Cancer statistics, 2019. CA. Cancer J. Clin. 69(1), 7–34 (2019)

    Article  PubMed  Google Scholar 

  2. Ashing-Giwa, K.T., et al.: The impact of cervical cancer and dysplasia: a qualitative, multiethnic study. Psychooncology. 13(10), 709–728 (2004)

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bakker, R.M., et al.: Sexual distress and associated factors among cervical cancer survivors: a cross-sectional multicenter observational study. Psychooncology 26(10), 1470–1477 (2017)

    Article  PubMed  Google Scholar 

  4. Carter, J., Huang, H., Chase, D.M., Walker, J.L., Cella, D., Wenzel, L.: Sexual function of patients with endometrial cancer enrolled in the Gynecologic Oncology Group LAP2 Study. Int. J. Gynecol. Cancer 22(9), 1624–1633 (2012)

    Article  PubMed  PubMed Central  Google Scholar 

  5. Donovan, K.A., Taliaferro, L.A., Alvarez, E.M., Jacobsen, P.B., Roetzheim, R.G., Wenham, R.M.: Sexual health in women treated for cervical cancer: characteristics and correlates. Gynecol. Oncol. 104(2), 428–434 (2007)

    Article  PubMed  Google Scholar 

  6. Cleary, V., Hegarty, J., McCarthy, G.: Sexuality in Irish women with gynecologic cancer. Oncol. Nurs. Forum 38(2), E87-96 (2011)

    Article  PubMed  Google Scholar 

  7. Hawighorst-Knapstein, S., et al.: The impact of treatment for genital cancer on quality of life and body image–results of a prospective longitudinal 10-year study. Gynecol. Oncol. 94(2), 398–403 (2004)

    Article  PubMed  Google Scholar 

  8. Hazewinkel, M.H., Sprangers, M.A., Velden, J., Burger, M.P., Roovers, J.P.: Severe pelvic floor symptoms after cervical cancer treatment are predominantly associated with mental and physical well-being and body image: a cross-sectional study. Int. J. Gynecol. Cancer 22(1), 154–160 (2012)

    Article  PubMed  Google Scholar 

  9. Lamb, M.A., Sheldon, T.A.: The sexual adaptation of women treated for endometrial cancer. Cancer Pract. 2(2), 103–113 (1994)

    PubMed  Google Scholar 

  10. Mikkelsen, T.B., Sørensen, B., Dieperink, K.B.: Prediction of rehabilitation needs after treatment of cervical cancer: What do late adverse effects tell us? Support. Care Cancer 25(3), 823–831 (2017)

    Article  PubMed  Google Scholar 

  11. Zeng, Y.C., Li, D., Loke, A.Y.: Life after cervical cancer: quality of life among Chinese women. Nurs. Health Sci. 13(3), 296–302 (2011)

    PubMed  Google Scholar 

  12. Wilmoth, M.C., Spinelli, A.: Sexual implications of gynecologic cancer treatments. JOGNN J. Obstet. Gynecol. Neonatal Nurs. 29(4), 413–421 (2000)

    Article  PubMed  Google Scholar 

  13. Bilodeau, K., Bouchard, L.: The sexuality of Quebec women with cervical cancer: looking for love despite radiotherapy’s trauma to their sexual body. Can. Oncol. Nurs. J. 21(4), 233–237 (2011)

    Article  PubMed  Google Scholar 

  14. Wenzel, L., et al.: Quality of life in long-term cervical cancer survivors. Gynecol. Oncol. 97(2), 310–317 (2005)

    Article  PubMed  Google Scholar 

  15. Aerts, L., Enzlin, P., Verhaeghe, J., Poppe, W., Vergote, I., Amant, F.: Long-term sexual functioning in women after surgical treatment of cervical cancer stages IA to IB: a prospective controlled study. Int. J. Gynecol. Cancer 24(8), 1527–1534 (2014)

    Article  PubMed  Google Scholar 

  16. Aerts, L., Enzlin, P., Verhaeghe, J., Poppe, W., Vergote, I., Amant, F.: Sexual functioning in women after surgical treatment for endometrial cancer: a prospective controlled study. J. Sex. Med. 12(1), 198–209 (2015)

    Article  PubMed  Google Scholar 

  17. Bae, H., Park, H.: Sexual function, depression, and quality of life in patients with cervical cancer. Support. Care Cancer 24(3), 1277–1283 (2016)

    Article  PubMed  Google Scholar 

  18. Saewong, S., Choobun, T.: Effects of radiotherapy on sexual activity in women with cervical cancer. J. Med. Assoc. Thai. 88(Suppl 2), 11–5 (2005)

    Google Scholar 

  19. Sung Uk, L., et al.: General health status of long-term cervical cancer survivors after radiotherapy. Strahlentherapie und Onkol. 193(7), 543–551 (2017)

    Article  Google Scholar 

  20. Segal, S., et al.: Urinary incontinence and other pelvic floor disorders after radiation therapy in endometrial cancer survivors. Maturitas 105, 83–88 (2017)

    Article  PubMed  Google Scholar 

  21. Hordern, A.J., Street, A.F.: Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs. Med. J. Aust. 186(5), 224–227 (2007)

    Article  PubMed  Google Scholar 

  22. Hunter, J.: The impact of cervical cancer treatment of sexual function and intimate relationships: a crying shame. J. Gynecol. Oncol. Nurs. 21(2), 22–32 (2011)

    Google Scholar 

  23. Kylstra, W.A., et al.: Sexual outcomes following treatment for early stage gynecological cancer: a prospective multicenter study. Int. J. Gynecol. Cancer 9(5), 387–395 (1999)

    Article  PubMed  Google Scholar 

  24. Lindau, S.T., Gavrilova, N., Anderson, D.: Sexual morbidity in very long term survivors of vaginal and cervical cancer: a comparison to national norms. Gynecol. Oncol. 106(2), 413–418 (2007)

    Article  PubMed  PubMed Central  Google Scholar 

  25. Vermeer, W.M., Bakker, R.M., Kenter, G.G., de Kroon, C.D., Stiggelbout, A.M., ter Kuile, M.M.: Sexual issues among cervical cancer survivors: How can we help women seek help? Psychooncology. 24(4), 458–464 (2015)

    Article  PubMed  Google Scholar 

  26. Wilson, C.M., McGuire, D.B., Rodgers, B.L., Elswick, R.K., Jr., Temkin, S.M.: Body image, sexuality, and sexual functioning in women with gynecologic cancer. Cancer Nurs 44, E252–E286 (2020)

    Google Scholar 

  27. Ye, S., Yang, J., Cao, D., Lang, J., Shen, K.: A systematic review of quality of life and sexual function of patients with cervical cancer after treatment. Int. J. Gynecol. Cancer 24(7), 1146–1157 (2014)

    Article  PubMed  Google Scholar 

  28. Rosen, R., et al.: The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J. Sex Marital Ther. 26, 191–208 (2000)

    Article  PubMed  Google Scholar 

  29. Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., Grupan, T.P.: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6(7), e1000097 (2009)

    Article  PubMed  PubMed Central  Google Scholar 

  30. Williams, N.F., Hauck, Y.L., Bosco, A.M.: Nurses’ perceptions of providing psychosexual care for women experiencing gynaecological cancer. Eur. J. Oncol. Nurs. 30, 35–42 (2017)

    Article  PubMed  Google Scholar 

  31. Zeng, Y.C., Liu, X., Loke, A.Y.: Addressing sexuality issues of women with gynaecological cancer: Chinese nurses’ attitudes and practice. J. Adv. Nurs. 68(2), 280–292 (2012)

    Article  PubMed  Google Scholar 

  32. Wang, J., et al.: Attitudes and behavior of radiation oncologists toward sexual issues of cervical cancer patients who receive radiation therapy. Int. J. Gynecol. Cancer 23(2), 393–398 (2013)

    Article  PubMed  Google Scholar 

  33. Stead, M.L., Brown, J.M., Fallowfield, L., Selby, P.: Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. Br. J. Cancer 88(5), 666–671 (2003)

    Article  PubMed  PubMed Central  Google Scholar 

  34. Ekwall, E., Ternestedt, B.-M., Sorbe, B.: Important Aspects of Health Care for Women With Gynecologic Cancer. Oncol. Nurs. Forum 30(2), 313–319 (2003)

    Article  PubMed  Google Scholar 

  35. Iavazzo, C., Johnson, K., Savage, H., Gallagher, S., Datta, M., Winter-Roach, B.A.: Sexuality issues in gynaecological oncology patients: post treatment symptoms and therapeutic options. Arch. Gynecol. Obstet. 291(3), 653–656 (2015)

    Article  PubMed  Google Scholar 

  36. Sekse, R.J.T., Råheim, M., Gjengedal, E.: Shyness and openness—common ground for dialogue between health personnel and women about sexual and intimate issues after gynecological cancer. Health Care Women Int. 36(11), 1255–1269 (2015)

    Article  PubMed  Google Scholar 

  37. Juraskova, I., Butow, P., Robertson, R., Sharpe, L., McLeod, C., Hacker, N.: Post-treatment sexual adjustment following cervical and endometrial cancer: a qualitative insight. Psychooncology. 12(3), 267–279 (2003)

    Article  PubMed  Google Scholar 

  38. Chapman, C.H., et al.: Gynecologic radiation oncology patients report unmet needs regarding sexual health communication with providers. J. Cancer Res. Clin. Oncol. 145(2), 495–502 (2019)

    Article  PubMed  Google Scholar 

  39. Oliver D.P., et al.: Palliative and Supportive Care Behind the doors of home hospice patients: a secondary qualitative analysis of hospice nurse communication with patients and families (2019)

  40. Schoenthaler, A., Knafl, G.J., Fiscella, K., Ogedegbe, G.: Addressing the social needs of hypertensive patients the role of patient-provider communication as a predictor of medication adherence. Circ. Cardiovasc. Qual. Outcomes 10(9), e003659 (2017)

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number T32NR013456. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health.

Funding

The authors have not disclosed any funding.

Author information

Authors and Affiliations

  1. College of Nursing, University of Utah, 10 South 2000 East84112, Salt Lake City, UT, USA

    Christina M. Wilson, Alexandra Gee & Kathi Mooney

  2. Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    Kathi Mooney

Authors
  1. Christina M. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexandra Gee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathi Mooney
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christina M. Wilson.

Ethics declarations

Conflicts of interest

The authors have nothing to disclose.

Ethical approval

The authors have nothing to disclose. This manuscript, reviewed previously reported research studies, and did not have direct contact with human participants, therefore, not requiring informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wilson, C.M., Gee, A. & Mooney, K. Clinician and Patient Communication on Body Image, Sexuality, and Sexual Function in Gynecologic Cancer: An Integrative Review. Sex Disabil 40, 363–379 (2022). https://doi.org/10.1007/s11195-022-09736-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11195-022-09736-0

Keywords

Search

Navigation