Skip to main content
Top
Published in: Supportive Care in Cancer 12/2021

01-12-2021 | Breast Cancer | Original Article

Addressing sexual concerns of female breast cancer survivors and partners: a qualitative study of survivors, partners, and oncology providers about Internet intervention preferences

Authors: Kelly M. Shaffer, Erin Kennedy, Jillian V. Glazer, Anita H. Clayton, Wendy Cohn, Trish A. Millard, Lee M. Ritterband, Shayna Showalter

Published in: Supportive Care in Cancer | Issue 12/2021

Login to get access

Abstract

Purpose

Sexual side effects after breast cancer treatment are common and distressing to both survivors and their intimate partners, yet few receive interventions to address cancer-related sexual concerns. To direct intervention development, this qualitative study assessed the perceptions of female breast cancer survivors, intimate partners of breast cancer survivors, and breast cancer oncology providers about how an Internet intervention for couples may address breast cancer-related sexual concerns.

Methods

Survivors (N = 20) responded to online open-ended surveys. Partners (N = 12) and providers (N = 8) completed individual semi-structured interviews. Data were inductively coded using thematic content analysis.

Results

Three primary intervention content areas were identified by the key stakeholder groups: (1) information about and strategies to manage physical and psychological effects of cancer treatment on sexual health, (2) relationship and communication support, and (3) addressing bodily changes and self-image after treatment. Survivors and partners tended to express interest in some individualized intervention private from their partner, although they also emphasized the importance of opening communication about sexual concerns within the couple. Survivors and partners expressed interest in an intervention that addresses changing needs across the cancer trajectory, available from the time of diagnosis and through survivorship.

Conclusion

Internet intervention for couples to address cancer-related sexual concerns, particularly one that provides basic education about treatment side effects and that evolves with couples’ changing needs across the cancer trajectory, was perceived as a valuable addition to breast cancer care by survivors, partners, and providers.
Appendix
Available only for authorised users
Literature
1.
go back to reference Seav SM, Dominick SA, Stepanyuk B et al (2015) Management of sexual dysfunction in breast cancer survivors: a systematic review. Women’s Midlife Health 1:9CrossRef Seav SM, Dominick SA, Stepanyuk B et al (2015) Management of sexual dysfunction in breast cancer survivors: a systematic review. Women’s Midlife Health 1:9CrossRef
2.
go back to reference Cella D, Fallowfield LJ (2008) Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy. Breast Cancer Res Treat 107:167–180CrossRef Cella D, Fallowfield LJ (2008) Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy. Breast Cancer Res Treat 107:167–180CrossRef
3.
go back to reference Schover LR (1991) The impact of breast cancer on sexuality, body image, and intimate relationships. CA Cancer J Clinicians 41:112–120CrossRef Schover LR (1991) The impact of breast cancer on sexuality, body image, and intimate relationships. CA Cancer J Clinicians 41:112–120CrossRef
4.
go back to reference Oberguggenberger A, Martini C, Huber N et al (2017) Self-reported sexual health: Breast cancer survivors compared to women from the general population–an observational study. BMC Cancer 17:599CrossRef Oberguggenberger A, Martini C, Huber N et al (2017) Self-reported sexual health: Breast cancer survivors compared to women from the general population–an observational study. BMC Cancer 17:599CrossRef
5.
go back to reference Panjari M, Bell RJ, Davis SR (2011) Sexual function after breast cancer. J Sex Med 8:294–302CrossRef Panjari M, Bell RJ, Davis SR (2011) Sexual function after breast cancer. J Sex Med 8:294–302CrossRef
6.
go back to reference Raggio GA, Butryn ML, Arigo D, Mikorski R, Palmer SC (2014) Prevalence and correlates of sexual morbidity in long-term breast cancer survivors. Psychol Health 29:632–650CrossRef Raggio GA, Butryn ML, Arigo D, Mikorski R, Palmer SC (2014) Prevalence and correlates of sexual morbidity in long-term breast cancer survivors. Psychol Health 29:632–650CrossRef
7.
go back to reference Fergus KD, Gray RE (2009) Relationship vulnerabilities during breast cancer: patient and partner perspectives. Psychooncology 18:1311–1322CrossRef Fergus KD, Gray RE (2009) Relationship vulnerabilities during breast cancer: patient and partner perspectives. Psychooncology 18:1311–1322CrossRef
8.
go back to reference Ochsenkühn R, Hermelink K, Clayton AH et al (2011) Menopausal status in breast cancer patients with past chemotherapy determines long-term hypoactive sexual desire disorder. J Sex Med 8:1486–1494CrossRef Ochsenkühn R, Hermelink K, Clayton AH et al (2011) Menopausal status in breast cancer patients with past chemotherapy determines long-term hypoactive sexual desire disorder. J Sex Med 8:1486–1494CrossRef
9.
go back to reference Reese JB, Porter LS, Casale KE et al (2016) Adapting a couple-based intimacy enhancement intervention to breast cancer: a developmental study. Health Psychol 35:1085CrossRef Reese JB, Porter LS, Casale KE et al (2016) Adapting a couple-based intimacy enhancement intervention to breast cancer: a developmental study. Health Psychol 35:1085CrossRef
10.
go back to reference Flynn KE, Reese JB, Jeffery DD et al (2012) Patient experiences with communication about sex during and after treatment for cancer. Psychooncology 21:594–601CrossRef Flynn KE, Reese JB, Jeffery DD et al (2012) Patient experiences with communication about sex during and after treatment for cancer. Psychooncology 21:594–601CrossRef
11.
go back to reference Nasiri A, Taleghani F, Irajpour A (2012) Men’s sexual issues after breast cancer in their wives: a qualitative study. Cancer Nurs 35:236–244CrossRef Nasiri A, Taleghani F, Irajpour A (2012) Men’s sexual issues after breast cancer in their wives: a qualitative study. Cancer Nurs 35:236–244CrossRef
12.
go back to reference Zahlis EH, Lewis FM (2010) Coming to grips with breast cancer: the spouse’s experience with his wife’s first six months. J Psychosoc Oncol 28:79–97CrossRef Zahlis EH, Lewis FM (2010) Coming to grips with breast cancer: the spouse’s experience with his wife’s first six months. J Psychosoc Oncol 28:79–97CrossRef
13.
go back to reference Leon-Carlyle M, Schmocker S, Victor JC et al (2015) Prevalence of physiologic sexual dysfunction is high following treatment for rectal cancer: but is it the only thing that matters? Dis Colon Rectum 58:736–742CrossRef Leon-Carlyle M, Schmocker S, Victor JC et al (2015) Prevalence of physiologic sexual dysfunction is high following treatment for rectal cancer: but is it the only thing that matters? Dis Colon Rectum 58:736–742CrossRef
14.
go back to reference Yi JC, Syrjala KL (2009) Sexuality after hematopoietic stem cell transplantation. Cancer J 15:57–64CrossRef Yi JC, Syrjala KL (2009) Sexuality after hematopoietic stem cell transplantation. Cancer J 15:57–64CrossRef
15.
go back to reference Shanis D, Merideth M, Pulanic TK, Savani BN, Battiwalla M, Stratton P (2012) Female long-term survivors after allogeneic hematopoietic stem cell transplantation: evaluation and management. Semin Hematol 49:83–93CrossRef Shanis D, Merideth M, Pulanic TK, Savani BN, Battiwalla M, Stratton P (2012) Female long-term survivors after allogeneic hematopoietic stem cell transplantation: evaluation and management. Semin Hematol 49:83–93CrossRef
16.
17.
go back to reference Ussher JM, Perz J, Gilbert E et al (2013) Talking about sex after cancer: a discourse analytic study of health care professional accounts of sexual communication with patients. Psychol Health 28:1370–1390CrossRef Ussher JM, Perz J, Gilbert E et al (2013) Talking about sex after cancer: a discourse analytic study of health care professional accounts of sexual communication with patients. Psychol Health 28:1370–1390CrossRef
18.
go back to reference Coleman E, Elders J, Satcher D et al (2013) Summit on medical school education in sexual health: report of an expert consultation. J Sex Med 10:924–938CrossRef Coleman E, Elders J, Satcher D et al (2013) Summit on medical school education in sexual health: report of an expert consultation. J Sex Med 10:924–938CrossRef
19.
go back to reference Ritterband LM, Thorndike FP, Cox DJ, Kovatchev BP, Gonder-Frederick LA (2009) A behavior change model for Internet interventions. Ann Behav Med 38:18–27CrossRef Ritterband LM, Thorndike FP, Cox DJ, Kovatchev BP, Gonder-Frederick LA (2009) A behavior change model for Internet interventions. Ann Behav Med 38:18–27CrossRef
20.
go back to reference Shaffer KM, Tigershtrom A, Badr H, Benvengo S, Hernandez M, Ritterband LM (2020) Dyadic psychosocial eHealth interventions: systematic scoping review. J Med Internet Res 22:e15509CrossRef Shaffer KM, Tigershtrom A, Badr H, Benvengo S, Hernandez M, Ritterband LM (2020) Dyadic psychosocial eHealth interventions: systematic scoping review. J Med Internet Res 22:e15509CrossRef
21.
go back to reference Reese JB, Sorice KA, Oppenheimer NM et al (2020) Why do breast cancer survivors decline a couple-based intimacy enhancement intervention trial? Transl Behav Med 10:435–440CrossRef Reese JB, Sorice KA, Oppenheimer NM et al (2020) Why do breast cancer survivors decline a couple-based intimacy enhancement intervention trial? Transl Behav Med 10:435–440CrossRef
22.
go back to reference Wootten A, Pillay B, Abbott J-A (2016) Can sexual outcomes be enhanced after cancer using online technology? Curr Opin Support Palliat Care 10:81–86CrossRef Wootten A, Pillay B, Abbott J-A (2016) Can sexual outcomes be enhanced after cancer using online technology? Curr Opin Support Palliat Care 10:81–86CrossRef
23.
go back to reference Barbera L, Fitch M, Adams L, Doyle C, DasGupta T, Blake J (2011) Improving care for women after gynecological cancer: the development of a sexuality clinic. Menopause 18:1327–1333CrossRef Barbera L, Fitch M, Adams L, Doyle C, DasGupta T, Blake J (2011) Improving care for women after gynecological cancer: the development of a sexuality clinic. Menopause 18:1327–1333CrossRef
24.
go back to reference Schover LR, Evans RB, von Eschenbach AC (1987) Sexual rehabilitation in a cancer center: diagnosis and outcome in 384 consultations. Arch Sex Behav 16:445–461CrossRef Schover LR, Evans RB, von Eschenbach AC (1987) Sexual rehabilitation in a cancer center: diagnosis and outcome in 384 consultations. Arch Sex Behav 16:445–461CrossRef
25.
go back to reference 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 Res Treat 130:711–724CrossRef 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 Res Treat 130:711–724CrossRef
26.
go back to reference Andersen BL, Woods XA, Copeland LJ (1997) Sexual Self-Schema and Sexual Morbidity Among Gynecologic Cancer Survivors. J Consult Clin Psychol 65:221–229CrossRef Andersen BL, Woods XA, Copeland LJ (1997) Sexual Self-Schema and Sexual Morbidity Among Gynecologic Cancer Survivors. J Consult Clin Psychol 65:221–229CrossRef
27.
go back to reference Emilee G, Ussher JM, Perz J (2010) Sexuality after breast cancer: a review. Maturitas 66:397–407CrossRef Emilee G, Ussher JM, Perz J (2010) Sexuality after breast cancer: a review. Maturitas 66:397–407CrossRef
28.
go back to reference Rowland E, Metcalfe A (2014) A systematic review of men’s experiences of their partner’s mastectomy: coping with altered bodies. Psychooncology 23:963–974CrossRef Rowland E, Metcalfe A (2014) A systematic review of men’s experiences of their partner’s mastectomy: coping with altered bodies. Psychooncology 23:963–974CrossRef
29.
go back to reference Annon JS (1976) The PLISSIT model: A proposed conceptual scheme for the behavioral treatment of sexual problems. Journal of Sex Education and Therapy 2:1–15CrossRef Annon JS (1976) The PLISSIT model: A proposed conceptual scheme for the behavioral treatment of sexual problems. Journal of Sex Education and Therapy 2:1–15CrossRef
30.
go back to reference Robinson JW, Lounsberry JJ (2010) Communicating about sexuality in cancer care. In: Kissane D, Bultz B, Butow P, Finlay I (eds) Handbook of communication in oncology and palliative care. Oxford University Press, Oxford, pp 409–422CrossRef Robinson JW, Lounsberry JJ (2010) Communicating about sexuality in cancer care. In: Kissane D, Bultz B, Butow P, Finlay I (eds) Handbook of communication in oncology and palliative care. Oxford University Press, Oxford, pp 409–422CrossRef
31.
go back to reference Park ER, Norris RL, Bober SL (2009) Sexual health communication during cancer care: barriers and recommendations. The Cancer Journal 15:74–77CrossRef Park ER, Norris RL, Bober SL (2009) Sexual health communication during cancer care: barriers and recommendations. The Cancer Journal 15:74–77CrossRef
32.
go back to reference Bober SL, Reese JB, Barbera L et al (2016) How to ask and what to do: a guide for clinical inquiry and intervention regarding female sexual health after cancer. Curr Opin Support Palliat Care 10:44–54CrossRef Bober SL, Reese JB, Barbera L et al (2016) How to ask and what to do: a guide for clinical inquiry and intervention regarding female sexual health after cancer. Curr Opin Support Palliat Care 10:44–54CrossRef
33.
go back to reference Lisy K, Peters MD, Schofield P, Jefford M (2018) Experiences and unmet needs of lesbian, gay, and bisexual people with cancer care: a systematic review and meta-synthesis. Psychooncology 27:1480–1489CrossRef Lisy K, Peters MD, Schofield P, Jefford M (2018) Experiences and unmet needs of lesbian, gay, and bisexual people with cancer care: a systematic review and meta-synthesis. Psychooncology 27:1480–1489CrossRef
34.
go back to reference Yedjou CG, Tchounwou PB, Payton M et al (2017) Assessing the racial and ethnic disparities in breast cancer mortality in the United States. Int J Environ Res Public Health 14:486CrossRef Yedjou CG, Tchounwou PB, Payton M et al (2017) Assessing the racial and ethnic disparities in breast cancer mortality in the United States. Int J Environ Res Public Health 14:486CrossRef
35.
go back to reference Weinfurt KP, Lin L, Bruner DW et al (2015) Development and initial validation of the PROMIS® sexual function and satisfaction measures version 2.0. J Sex Med 12:1961–1974CrossRef Weinfurt KP, Lin L, Bruner DW et al (2015) Development and initial validation of the PROMIS® sexual function and satisfaction measures version 2.0. J Sex Med 12:1961–1974CrossRef
36.
go back to reference Rosen R, Brown C, Heiman J et al (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208CrossRef Rosen R, Brown C, Heiman J et al (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208CrossRef
37.
go back to reference Wiegel M, Meston C, Rosen R (2005) The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther 31:1–20CrossRef Wiegel M, Meston C, Rosen R (2005) The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther 31:1–20CrossRef
38.
go back to reference Clayton AH, McGarvey EL, Clavet GJ (1997) The Changes in Sexual Functioning Questionnaire (CSFQ): development, reliability, and validity. Psychopharmacol Bull 33:731PubMed Clayton AH, McGarvey EL, Clavet GJ (1997) The Changes in Sexual Functioning Questionnaire (CSFQ): development, reliability, and validity. Psychopharmacol Bull 33:731PubMed
39.
go back to reference Hendrick SS, Dicke A, Hendrick C (1998) The relationship assessment scale. J Soc Pers Relat 15:137–142CrossRef Hendrick SS, Dicke A, Hendrick C (1998) The relationship assessment scale. J Soc Pers Relat 15:137–142CrossRef
Metadata
Title
Addressing sexual concerns of female breast cancer survivors and partners: a qualitative study of survivors, partners, and oncology providers about Internet intervention preferences
Authors
Kelly M. Shaffer
Erin Kennedy
Jillian V. Glazer
Anita H. Clayton
Wendy Cohn
Trish A. Millard
Lee M. Ritterband
Shayna Showalter
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 12/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-021-06302-w

Other articles of this Issue 12/2021

Supportive Care in Cancer 12/2021 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine