Addressing sexual health needs in gynecological cancer survivors: insights from a tertiary cancer center in Jordan

TL;DR

This study explores how gynecological cancer survivors in Jordan feel about discussing sexual health during treatment, finding that most consider it important but rarely have these discussions with their doctors.

Contribution

This is the first study in the MENA region to investigate sexual education needs among gynecological cancer survivors.

Findings

Most patients (66.7%) consider sexual activity important, but few have discussed it with their physicians.

Male physicians and embarrassment are the main barriers to discussing sexual health.

Physicians are more likely to discuss sexual activity with patients who have younger partners.

Abstract

Sexual health is a crucial aspect of quality of life, yet it is rarely addressed by healthcare providers, especially in the context of gynecological cancer. Reports on sexual education (SE) for gynecological cancer patients are particularly scarce in the Middle East and North Africa (MENA) region. This study aims to highlight the experiences, needs, and preferences of gynecological cancer survivors regarding SE during cancer treatment and follow-up.

A cross-sectional survey was conducted among gynecologic cancer survivors at the Radiation Oncology Department of King Hussein Cancer Center. A data collection tool, developed and validated by a multidisciplinary panel of experts, was used to explore patient-provider discussions about sexuality and the factors influencing these discussions. These factors included both patient and healthcare provider-related aspects. Statistical analysis was performed using Chi-square and ANOVA tests.

Sixty married patients participated in our survey, most of whom (n=27; 45%) had cervical cancer. The mean age of patients was 52, and for their sexual partners was 57. Two-thirds (66.7%) reported sexual activity (SA) as a somewhat or very important aspect of their life. While 48% reported that their partners noted a negative impact on SA after treatment, none considered stopping treatment to preserve sexual function. Although 86% felt it was important to discuss SE at clinic, and 41.7% specified that the timing of this discussion should be before treatment, only 35% of patients had had this discussion throughout their treatment and follow up. This discussion was held by the physician in 94% of instances. The most common barrier to discussion was having a male physician (71%), followed by embarrassment (60%). In our analysis, we found that physicians tend to discuss SA with patients who had younger sexual partner’s (p value = 0.024).

This study is the first in the MENA region to address SE in this patient population. SE is a priority for two-thirds of the patients surveyed, yet it appears that physicians are not adequately addressing this need. Further research is needed to evaluate physicians’ knowledge, attitudes, and practices regarding SE to provide comprehensive, high-quality care to gynecological cancer patients.

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