SAN ANTONIO — Researchers in the United States have shown a large gender gap between women and men undergoing brachytherapy in whether they are asked about their sexual function.
Brachytherapy, in which radioactive beads are implanted, is an “important treatment for genitourinary cancers,” but carries long-term risks of sexual dysfunction, says first author, Radiation Oncology, University of Michigan Rogel. resident Jamie Takayes, M.D., noted. Cancer Center in Ann Arbor, Michigan.
Up to 90% of women and 50% of men with gynecologic malignancies prostate cancer Report sexual problems after such treatment.
But when her team examined records of more than 200 patients who underwent brachytherapy for cervical or prostate cancer at a facility, women were rarely asked about their sexual health. understood.
Most men (89%) were asked about their sexual health before treatment, whereas only 13% of women were asked (P. < .001).
again, cervical cancer Sexual functioning was assessed using patient-reported outcomes (PROs) compared with 81% of men with prostate cancer.
“And this was despite the fact that women were on average nearly 20 years younger than men,” Takayes said. (The average age of women with cervical cancer was 51 for her, and for men with prostate cancer she was 69.)
The team also accessed the National Institutes of Health’s clinical trial database and found that 17% of prostate cancer clinical trials had 12% as a primary or secondary endpoint, compared with only 6% of cervical cancer clinical trials. found to contain sexual function (P. = .040).
The study was presented at the American Society for Radiation Oncology (ASTRO) 2022 Annual Meeting on October 23.
“This is an eye-opening study for radiation oncologists,” commented David Byun, MD, a radiation oncologist at NYU Langone’s Perlmutter Cancer Center in New York City, who was not involved in the study.
“Although this is a small, retrospective study, the marked disparity in sexual health ratings between men and women is truly intriguing,” he said.
“Potential long-term quality-of-life side effects, including sexual health implications, should be fully discussed during the consultation so that the patient is well informed,” Byun said. added.
“This finding should be shocking, except sadly it’s not,” commented Fumiko Chino, MD, a radiation oncologist at Memorial Sloan Kettering Cancer Center in New York City.
But highlighting known issues “brings them to the forefront and makes you realize that you need to start addressing them,” she said. Medscape Medical News.
Sexual health is “the ability to have meaningful relationships with others, and these can be severely damaged by radiation,” Chino said. It’s a powerful tool, but it needs to be used smarter to do less long-term and lasting damage.”
This is a ‘important survivorship issue’ but ‘simply ignored’, especially for women. It made us realize that it was important, but that realization didn’t really happen to women.”
This may be due to the “increasing complexity” of women’s sexual health, or it may be due to the “simplification of men’s sexual health.” For real. “
She said there are “good treatments” for female sexual dysfunction, but these aren’t prescribed because women aren’t asked about their sexual function.
Survey details
At a press conference held during the conference, Takaesu said:
“Of course, there are many confounding factors,” she adds, adding that men with prostate cancer generally tend to live longer than women with cervical cancer.
And as prostate cancer patients “have more types of treatments available, sexual function becomes a way to stratify which treatment is best for them.”
“But I think many steps are still needed to improve sexual health and how we approach women,” she said, including implementing standardized PROs and providing guidance to colleagues. rice field.
“I also consult with other professionals and other colleagues in occupational therapy, physical therapy and sexual health clinics to try to manage the sexual turmoil these women are experiencing.
Only once it has been implemented and some of the “implicit biases and social constructs” about sexual health have been addressed will it be possible to “realize” how radiotherapy “can be modified” to “reduce sexual toxicity”. can be considered,” she said. Treatments should be evaluated as “addressing female sexual dysfunction”.
Commenting in a press briefing, Iris C. Gibs, MD, professor of radiation oncology at Stanford Cancer Center in Stanford, Calif., said the study “provides a lens for approaching better overall outcomes… It’s back to us as providers.”
These findings oblige clinicians to “become more inclusive and recognize the potential for this type of sexual morbidity with treatment of all genders.”
No funding for the research was mentioned. The authors have not disclosed any relevant financial relationships.
American Society for Radiation Oncology (ASTRO) Annual Meeting 2022: Abstract 2306. Presented October 23, 2022.
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