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Sexuality and Reproductive Issues (PDQ®): Supportive care - Health Professional Information [NCI] - Treatment of Sexual Problems in People With Cancer

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The intervention was delivered in person, in groups, at 2-hour sessions over a 6-week period. The primary outcome was the Mental Health Index, providing a measure of anxiety, depression, loneliness, distress, well-being, and positive affect. Other outcomes included sexual satisfaction, self-image, and functioning, such as dyspareunia. Women were identified through a mailed survey and randomly assigned ahead of time either to the intervention or to the control group (written material only). Women randomly assigned to the intervention were then invited to participate. Of 284 women assigned to the intervention, only 83 agreed to participate; of those, only 72 attended any of the sessions. The most common reasons for declining participation were inconvenient time and/or location, being too busy, or feeling that the intervention was not needed. One hundred twenty-seven women were randomly assigned to the control group, and follow-up was reported for 98 of them.[73]

Results from this study are presented for three groups:

  • Control group.
  • Intervention nonparticipants.
  • Intervention participants.

An intent-to-treat analysis showed no significant differences between groups for the Mental Health Index. However, there was an intervention effect for general satisfaction with sex. An as-treated analysis did suggest improvement on the Mental Health Index, with women who reported more distress at baseline experiencing more benefit.[73] This study provides data to support the idea that interventions focusing on psychosocial and cognitive factors may be an important component of interventions to improve emotional and sexual outcomes. However, more research is needed to develop psychoeducational interventions that are less time intensive, can be disseminated easily, and are more readily accepted by cancer survivors.

Sexual counseling can be provided for individuals, couples, or groups. The effectiveness of these different formats has not been compared for people with cancer. It is also not known whether brief counseling can enhance the impact of medical treatments, such as those used to overcome erectile dysfunction or dyspareunia. There is limited research about the impact of support groups on sexual outcomes for men with prostate cancer.[74][Level of evidence: II] It is likely that associations between better outcomes and participation in support groups reflect baseline sociographic and clinical differences between those who participate in support groups and those who do not.

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