Cancer in women and sexuality. An integrated approach between sexual function, treatment and body representation

Author/s Mariapia Di Nicola, Elisabetta Todaro
Publishing Year 2018 Issue 2018/2 Language Italian
Pages 19 P. 30-48 File size 202 KB
DOI 10.3280/RSC2018-002002
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

In Italy it is estimated that 365.000 new cases of cancer are diagnosed each year; 48% of these cases concerns female population. Diagnostic and therapeutic improvements have increased survival rates and attention to sexual and reproduc-tive function, as well as body image and impact on relationships. Although the sexual dysfunction related to uterus, cervix, endometrium and breast cancers are known in the literature, there is a disparity in studies on the sexual health of wom-en with breast cancer compared to those with neoplasia of the internal genitalia. The aim of work is to present a review of the recent literature on the sexuality of women treated for breast cancer with those of internal genitalia, in order to analyze the intervention in different kind of female cancer. Further contributions are expected to expand scientific knowledge and to implement interventions that take into account the mind-body unit and the impact on representations and sexual identity of patients affected by all types of cancer.

Keywords: Female cancer, promotion, sexual health, integrated approach, body-mind unit, biopsychosocial.

  1. Siegel R.L., Miller K.D., Jemal A. (2015). Cancer statistics. A Cancer Journal for Clinicians, 65: 5-29.
  2. Aerts L., Christiansens M.R., Enzlin P., Neven P., Amant F. (2014). Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study. The Breast, 23(5): 629-36.
  3. Aerts L., Enzlin P., Verhaeghe J., Poppe W., Vergote I., Amant F. (2014). Long-term sexual functioning in women after surgical treatment of cervical cancer stages IA to IB: a prospective controlled study. International Journal of Gynecological Cancer, 24(8): 1527-34.
  4. Aerts L., Enzlin P., Verhaeghe J., Poppe W., Vergote I., Amant F. (2015). Sexual functioning in women after surgical treatment for endometrial cancer: a prospective controlled study. Journal of Sexual Medicine, 12(1): 198-209.
  5. Ben Charif A., Bouhnik A.D., Rey D., Provansal M., Courbiere B., Spire B., Mancini J. (2015). Satisfaction with fertility- and sexuality-related information in young women with breast cancer--ELIPPSE40 cohort. BMC Cancer, Aug 5; 15: 572.
  6. Bohemer U., Glickman M., Winter M., Clark M.A. (2013). Lesbian and bisexual women’s adjustment after a breast cancer diagnosis. American Psychiatric Nurses Association, 19(5): 280-92. DOI: 10.1177/107839031350458
  7. Cairo Notari S., Favez N., Notari L., Panes-Ruedin B., Antonini T., Delaloye J.F. (2018). Women’s experiences of sexual functioning in the early weeks of breast cancer treatment. European Journal of Cancer Care, 27(1).
  8. Candy B., Jones L., Vickerstaff V., Tookman A., King M. (2016). Interventions for sexual dysfunction following treatments for cancer in women. Cochrane Database Systematic Review, 2; 2.
  9. Carta G., D’ Alfonso A., Di Nicola M., Di Nicola L., Mastrocola N., Carta A., Necozione S., Di Cesare E., Patacchiola F. (2014). Impact of surgery and radiotherapy in women with uterine malignancies. European Journal of Gynaecological Oncology, 35(6): 662-5.
  10. Carter J., Stabile C., Seidel B., Baser R.E., Gunn A.R., Chi S., Steed R.F., Goldfarb S., Goldfrank D.J. (2015). Baseline characteristics and concerns of female cancer patients/survivors seeking treatment at a Female Sexual Medicine Program. Support Care Cancer, 23(8): 2255-65.
  11. Cortes-Flores A., Vargas-Meza A., Morgan-Villeda G. (2017). Sexuality among woman treated for breast cancer: a survey of three surgical procedures. Aesthetic Plastic Surgery, 41(6): 1275-1279.
  12. Dorros S.M., Segrin C., Badger T.A. (2017). Cancer survivors’ and partners’ key concerns and quality of life. Psychology and Health, Nov; 32(11): 1407-1427.
  13. Gilbert E., Ussher J.M., Perz J. (2011). Sexuality after gynecological cancer: a review of the material, intrapsychic, and discursive aspects of treatment on women’s sexual-wellbeing. Maturitas, 70(1): 42-57.
  14. Gopie J.P., Kuile M.M., Timman R., Mureau M.A., Tibben A. (2014). Impact of delayed implant and DIEP flap breast reconstruction on body image and sexual satisfaction: a prospective follow-up study. Psychooncology, 23(1): 100-7.
  15. Hill E.K., Sandbo S., Abramsohn E., Makelarski J., Wroblewski K., Wenrich E.R. (2010). Assessing gynecologic and breast cancer survivors’ sexual health care needs. Cancer, 117(12): 2643-51.
  16. Hopwood P., Fletcher I., Lee A., Al Ghazal S. (2001). A body image scale for use with cancer patients. European Journal of Cancer, 37(2): 189-97.
  17. Howlader N., Noone A.M., Krapcho M., Miller D., Bishop K., Kosary C.L., Yu M., Ruhl J., Tatalovich Z., Mariotto A., Lewis D.R., Chen H.S., Feuer E.J., Cronin K.A. (2014). SEER Cancer Statistics Review, 1975-2014. National Cancer Institute. Bethesda, MD. -- Testo disponibile al sito: 2014/. Consultato in data: 8 Agosto 2018.
  18. Hummel S.B., Van Lankveld J.J., Oldenburg H.S., Hahn D.E., Broomans E., Aaronson N.K. (2015). Internet-based cognitive behavioral therapy for sexual dysfunctions in women treated for breast cancer: design of a multicenter, randomized controlled trial. BMC Cancer, 15: 321.
  19. Hungr C., Sanchez-Varela V., Bober S.L. (2017). Self-Image and Sexuality Issues among Young Women with Breast Cancer: Practical Recommendations. Revista de Investigation Clinica, 69(2): 114-22.
  20. Juraskova I., Butow P., Bonner C., Robertson R., Sharpe L. (2013). Sexual adjustment following early stage cervical and endometrial cancer: prospective controlled multi-centre study. Psycho-Oncology, 22(1): 153-9.
  21. Lee M., Kim Y.H., Jeon M.J. (2015). Risk factors for negative impacts on sexual activity and function in younger breast cancer survivors. Psycho-Oncology, 24(9): 1097-103.
  22. Loaring J.M., Larkin M., Shaw R., Flowers P. (2015). Renegotiating sexual intimacy in the context of altered embodiment: the experiences of women with breast cancer and their male partners following mastectomy and reconstruction. Health Psychology, 34(4): 426-36.
  23. Lonnee-Hoffmann R., Pinas I. (2014). Effects of Hysterectomy on Sexual Function. Current Sexual Health Reproduction, 6(4): 244-251.
  24. Male D.A, Fergus K.D., Cullen K. (2016). Sexual identity after breast cancer: sexuality, body image, and relationship repercussions. Current Opinion in Supportive Palliative Care, 10(1): 66-74.
  25. Neto M.S., De Aguilar Menezes M.V., Moreira J.R., Garcia E.B., Abla L.E., Ferreira L.M. (2013). Sexuality after breast reconstruction post mastectomy. Aesthetic Plastic Surgery, 37(3): 643-7.
  26. Oberguggenberger A., Martini C., Huber N., Fallowfield L., Hubalek M., Daniaux M., Sperner-Unterweger B., Holzner B., Sztankay M., Gamper E., Meraner V. (2017). Self-reported sexual health: Breast cancer survivors compared to women from the general population – an observational study. BMC Cancer, 17(1): 599.
  27. Ones L.M., McCabe M.P. (2011). The effectiveness of an Internet-based psychological treatment program for female sexual dysfunction. Journal of Sexual Medicine, 8(10): 2781-92.
  28. Panjari M., Bell R.J., Davis S.R. (2011). Sexual function after breast cancer. Journal of Sexual Medicine, 8(1): 294-302.
  29. Paterson C.L., Lengacher C.A., Donovan K.A., Kip K.E., Tofthager C.S. (2015). Body Image in Younger Breast Cancer Survivors: A Systematic Review. Cancer Nursing, 39(1): E39-58.
  30. Quintard B., Constant A., Lakdja F., Labeyrie-Lagardere H. (2014). Factors predicting sexual functioning in patients 3 months after surgical procedures for breast cancer: the role of the Sense of Coherence. European Journal of Oncology Nursing, 18(1): 41-5.
  31. Raggio G.A., Butryn M.L., Arigo D., Mikorski R., Palmer S.C. (2014). Prevalence and correlates of sexual morbidity in long-term breast cancer survivors. Psychology and Health, 29(6): 632-50. DOI: 10.1080/08870446.2013.87913
  32. Rashidi S., Dashti F. (2015). Sexual Behavior Pattern and Related Factors in Women with Breast Cancer in Iran. Global Journal of Health Science, 8(7): 266-72.
  33. Ratner E.S., Foran K.A., Schwartz P.E., Minkin M.J. (2010). Sexuality and intimacy after gynecological cancer. Maturitas, 66(1): 23-6.
  34. Rojas K., Onstad M., Raker C., Clark M., Stukey A., Gass J. (2017). The impact of mastectomy type on the Female Sexual Function Index (FSFI), satisfaction with appearance, and the reconstructed breast’s role in intimacy. Breast Cancer Research and Treatment, 163(2): 273-9.
  35. Rosenberg S.M., Tamimi R.M., Gelber S., Ruddy K.J., Bober S.L., Kereakoglow S., Borges V.F., Come S.E., Schapira L., Partridge A.H. (2014). Treatment-related amenorrhea and sexual functioning in young breast cancer survivors. Cancer, 120(15): 2264-71.
  36. Schover L.R., Yuan Y., Fellman B.M., Odensky E., Lewis P.E., Martinetti P. (2013). Efficacy trial of an Internet-based intervention for cancer-related female sexual dysfunction. Journal of National Comprehensive Cancer Network, 11(11): 1389-97.
  37. Tat S., Doan T., Yoo Gj., Levine E.G. (2016). Qualitative Exploration of Sexual Health Among Diverse Breast Cancer Survivors. Cancer Education.
  38. Taylor C.B., Luce K.H. (2003). Computer-and Internet-Based Psychotherapy Interventions. Current Directions in Psychological Science, 12(1): 18-22. DOI: 10.1111/1467-8721.0121
  39. Taylor S., Harley C., Ziegler L., Brown J., Velikova G. (2011). Interventions for sexual problems following treatment for breast cancer: a systematic review. Breast Cancer Research and Treatment, 130(3): 711-24.
  40. Tucker P.E., Saunders C., Bulsara M.K., Tan J.J., Salfinger S.G., Green H., Cohen P.A. (2016). Sexuality and quality of life in women with a prior diagnosis of breast cancer after risk-reducing salpingo-oophorectomy. The Breast, 30: 26-31.
  41. Ussher J.M., Perz J., Gilbert E. (2012). Changes to sexual well-being and intimacy after breast cancer. Cancer Nursing, 35(6): 456-65.
  42. Vermeer W.M., Bakker R.M., Kenter G.G., Stiggelbout A.M., Ter Kuile M.M. (2015). Cervical cancer survivors’ and partners’ experiences with sexual dysfunction and psychosexual support. Supportive Care in Cancer, 24(4): 1679-87.
  43. Vieira E.M., Yoshinari Junior G.H., De Souza H.C., Mancini M.P., Perdonà G.S. (2013). Reproductive and sexual history of women treated of breast cancer. Revista Brasileira de Ginecologia e Obstetrícia, 35(2): 78-83. DOI: 10.1590/S0100-7203201300020000
  44. White I.D., Sangha A., Lucas G., Wiseman T. (2016). Assessment of sexual difficulties associated with multi-modal treatment for cervical or endometrial cancer: A systematic review of measurement instruments. Gynecologic Oncology,143(3): 664-673.
  45. Xiao M., Gao H., Bai H., Zhang Z. (2016). Quality of life and sexuality in disease-free survivors of cervical cancer after radical hysterectomy alone: A comparison between total laparoscopy and laparotomy. Medicine, 95(36): 47-87.
  46. Ye S., Yang J., Cao D., Lang J., Shen K. (2014). A systematic review of quality of life and sexual function of patients with cervical cancer after treatment. International Journal of Gynecological Cancer, 24(7): 1146-57.
  47. Ye S., Yang J., Cao D., Zhu L., Lang J., Chuang L.T., Shen K. (2014). Quality of life and sexual function of patients following radical hysterectomy and vaginal extension. Journal of Sexual Medicine, 11(5): 1334-42.
  48. Zhong T., Hu J., Bagher S., Vo A., O’ Neil A.C., Butler K., Novak C.B., Hofer S.O., Metcalfe K.A. (2016). A Comparison of Psychological Response, Body Image, Sexuality, and Quality of Life between Immediate and Delayed Autologous Tissue Breast Reconstruction: A Prospective Long-Term Outcome Study. Plastic and Reconstructive Surgery, 138(4): 772-80.

Mariapia Di Nicola, Elisabetta Todaro, Tumori femminili e sessualità. Un approccio integrato tra funzionalità, trattamento e rappresentazione del corpo in "RIVISTA DI SESSUOLOGIA CLINICA" 2/2018, pp 30-48, DOI: 10.3280/RSC2018-002002