Article

Consequences of Cervical Cancer Treatment on Sexual Health in Chinese Cancer Survivors: A Qualitative Study

Sha Ye¹, Xiangcheng Yang², Guoping He³, Peter A. Maciek³, Wenjuan Zhou³

¹Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine Central, the South University, Changsha, Hunan, China

²Zhuzhou Central Hospital and the Affiliated Zhuzhou Hospital of Xiangya School of Medicine Central South University, Zhuzhou, Hunan, China

³Xiangya School of Nurse, the Central South University, Changsha, Hunan, China

Received July 4, 2018; Accepted October 16, 2018

ABSTRACT

Background: The attitudes and perceptions of cervical cancer survivors (CCS) toward sexual activity subsequent to a diagnosis of cervical cancer and its treatment are unknown. This study describes the experience of CCS in Hunan Chinese in relation to sexuality and sexual function after cervical cancer treatment.

Methods: We used descriptive phenomenology to qualitatively assess these experiences. Purposive sampling was used to recruit 20 CCS. Data were collected through in-depth interviews and analyzed according to Colaizzi’s method to explore the essence of the experience in sexuality among CCS after cancer treatment.

Results: Uncertainty, fear, and worry dominated the attitudes and behaviors of CCS-related to sexual activity after treatment. Four themes explain these complex emotional responses: 1) needing information; 2) dealing with sexual changes physically and emotionally; 3) communicating with a partner; 4) attribution of fault to her one-lifetime sexual partner.

Conclusion: Sexual life was influenced by the physical changes associated with cervical cancer treatment. These changes in combination with inadequate information and limited communication led to uncertainty, fear and worry about engaging in sexual activity and relationship distress. Chinese CCS need targeted and patient-centered information on the change in sexual life caused by treatment, anticipatory guidance, and support in communication with providers and partners, and strategies to cope with the physical and psycho-sexual sequelae of treatment, all of which must be congruent with their cultural norms.

KEYWORDS

Cervical cancer survivors; sexuality; sexual health; phenomenology; quality of life.

Copyright © 2019 by Global Clinical and Translational Research.

How to cite this article:

Ye S, Yang X, He G, Maciek PA, Zhou W. Consequences of cervical cancer treatment on sexual health in Chinese cancer survivors: a qualitative study. Glob Clin Transl Res. 2019; 1(1):31-36. DOI:10.36316/gcatr.01.0004.

References

1.     Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015; 65(2):87-108.

2.     Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016; 66(2):115-132.

3.     Xinhua News Agency. ACWF vigorously promote the health of women and children have made remarkable achievements [Internet]. 2012 Mar 1. Available from: http:// www.gov.cn/jrzg/2012-03/01/content_2079800.html.

4.     Carter J, Stabile C, Gunn A, Sonoda Y. The physical consequences of gynecologic cancer surgery and their impact on sexual, emotional and quality of life issues. J Sex Med. 2013; 10 Suppl 1:21-34.

5.     Bober SL, Varela VS. Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol. 2012; 30(30): 3712-3719.

6.     Tierney DK. Sexuality: a quality-of-life issue for cancer survivors. Semin Oncol Nurs. 2008; 24(2): 71-79.

7.     Ratner ES, Foran KA, Schwartz PE, Minkin MJ. Sexuality and intimacy after gynecological cancer. Maturitas. 2010; 66: 23-26.

8.     Krychman M, Millhesier LS. Sexual health issues in women with cancer. J Sex Med. 2013; 10(Suppl 1):5-15.

9.     Lammerink EA, de Bock GH. Pras E, Reyners AK, Mourits MJ. Sexual functioning of cervical cancer survivors: A review with a female perspective. Maturitas. 2012; 72(4):296-304.

10.   Hughes MK. Alterations of sexual function in women with cancer. Semin Oncol Nurs 2008; 24:91-101.

11.   Zhang X, Gao Y, Yao Y, Yu H, Lu H. Effect of Different Operation Modes on Sex Life in Women Received Hysterectomy. Chin Ment Health J. 2002; 16(11): 749-757.

12.   Chen L, Zhang S, Zhang P. To investigate the clinical value of laparoscopic nerve-sparing radical hysterectomy for early cervical cancer. Chin J Pract Gynecol Obstet. 2013; 29(8): 645-648.

13.   Higgins L, Zheng M, Liu Y, Sun C. Attitudes to marriage and sexual Behaviors: a survey of gender and culture differences in China and United Kingdom. Sex Roles. 2002; 46(3-4):75-89.

14.   So HW, Cheung FM. Review of Chinese sex attitudes and applicability of sex therapy for Chinese couples with sexual dysfunction. J Sex Res. 2005; 42(2):93-101.

15.   Chang J. The Tao of love and sex: the ancient Chinese way to ecstasy. New York: Penguin; 1997. p. 34-45.

16.   Colaizzi PF. Psychological research as the phenomenologist views it. Valle IS, King M, editors. Existential phenomenological alternatives for psychology. New York: Plenum; 1978. p. 48-71.

17.   Linhares CH, The lived experiences of midwives with spirituality in childbirth: mana from heaven. J Midwifery Women Health. 2012; 57(2):165-171.

18.   Barbera L, Fitch M, Adams L, Doyle C, DasGupa T, Blake J. Improving care for women after gynecological cancer: the development of a sexuality clinic. Menopause. 2011;18 (12):1327-1333.

19.   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. 2003; 12(3): 267-279.

20.   Molassiotis A, Chan CW, Yam BM, Chan ES, Lam CS. Life after cancer: adaptation issues faced by Chinese gynecological cancer survivors in Hong Kong. Psychooncology. 2002; 11(2):114-123.

21.   Brotto LA, Yule M, Brecon E. Psychological interventions for the sexual sequelae of cancer: a review of the literature. J Cancer Surviv. 2010; 4:346-360.

22.   Agarwal SS, Sehgal A, Sardana S, Kumar A, Luthra UK. Role of male behavior in cervical carcinogenesis among women with one-lifetime sexual partner. Health Educ Behav. Cancer. 1993; 72(5):1666-1669.

23.   Wingood GM, Scd, DiClemente RJ. Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Educ Behav. 2000; 27(5):539-565.