Written by Kara Morris
TUESDAY, Oct. 25, 2022 (HealthDay News) — When a man develops cancer in an area that affects sexual function, his doctor will likely discuss it with him.
But the same doesn’t apply to a woman with cancer in a sexual organ, according to new research. The investigators found that 9 out of 10 men were asked about their sexual health, but only 1 in 10 women received the same care.
“There appears to be a huge discrepancy in the way we approach sexual dysfunction with our patients, with female patients being asked about sexual issues much less often than male patients,” said lead author Dr. Jimmy Takayesu. She is a resident physician in radiation oncology at the University of Michigan’s Rogel Cancer Center.
“It is critical that we see this trend at the national level in clinical trials,” Takayesu said.
The results were presented at the annual meeting of the American Society of Radiation Oncology, in San Antonio.
In the United States, about 13,000 women are diagnosed with cervical cancer each year, while more than 220,000 men have new cases of prostate cancer.
Radiation therapy and other treatments are often used in both cases.
Takayesu said the potential for long-term side effects, including impotence, is an important thing to consider. About 96% of prostate cancer patients and 67% of cervical cancer patients live for at least five years.
In brachytherapy for prostate or cervical cancer, doctors insert radioactive sources directly into the tumor. This can affect the organs in the genital area.
About half of women who receive cervical brachytherapy experience sexual side effects, including uncomfortable and sometimes painful changes in vaginal tissue and dryness, according to the research team.
Somewhere between a quarter and a half of men who receive prostate brachytherapy end up with erectile dysfunction during, or after, treatment.
The lack of openness toward women’s sexual health is not limited to medical offices, Takaiso said.
Culturally, there are differences in how we talk about sexual dysfunction in men versus women. “We see advertisements on TV about erectile dysfunction, for example, but there is no equivalent for that for women,” Takaiso said in a press release for the meeting.
For the study, the researchers combined analyzes of institutional data and national clinical trials.
The authors reviewed counseling notes in the records of 201 patients treated with brachytherapy for prostate or cervical cancer between 2010 and 2021.
Physicians discussed sexual health with about 89% of men versus 13% of women. Physicians did not evaluate any of the women using the patient-reported outcome tool, but they did so with 81% of the men.
In an analysis of the US National Institutes of Health Clinical Trials Database, researchers found that prostate cancer trials, compared to cervical cancer trials, were more likely to include sexual function as a primary or secondary endpoint. They were also more likely to include overall quality of life as an end point.
One radiation oncologist described the new findings as “eye-opening.”
“Although a retrospective study was conducted, the stark disparity in the assessment of sexual health between men and women is already illustrative,” said Dr. David Byon, who is at the Perlmutter Cancer Center in New York City at New York University.
“Potential long-term quality of life side effects, including their impact on sexual health, should be discussed appropriately during the consultation, so that patients are fully informed. [about treatments]Pune said. He’s also a clinical instructor of radiation oncology at New York University’s Grossman School of Medicine.
According to the study authors, some of the reasons for the disparities may be in prostate cancer, as patients have multiple treatment options, some of which affect sexual health. In comparison, cervical cancer does not have the same combination of treatments.
And while men can choose between FDA-approved ED medications, there are little or no ED medications for women.
“The only tools we usually recommend to women are lubricants and extenders, but even those aren’t great options,” Takayesu said.
“It’s easy for us to prescribe different medications to our male patients, but for our female patients, we don’t have that first step. I think that creates a barrier to raising these issues,” she said.
Doctors need to start asking patients about their sexual health frequently. “If we don’t know about the problems, we won’t be able to solve them,” Takayesu said.
Pune agreed. He advised “Educate and communicate – ask your patients what is important to them so that you can serve them best”.
Results presented at medical meetings are considered preliminary until they are published in a peer-reviewed journal.
The US National Cancer Institute provides more about cancer treatment and women’s sexual health.
Source: American Society of Radiation Oncology, press release, October 21, 2022; David Byon, MD, radiation oncologist, NYU Langone Perlmutter Cancer Center, and Clinical Instructor in Radiation Oncology, New York University Grossman School of Medicine, New York City
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