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 Researchers randomly selected 169 breast cancer survivors diagnosed
with sexual dysfunction to receive either online cognitive
behavioral therapy for up to 24 weeks or to join a control group of
people on a waiting list for therapy.
After 10 weeks, women in the therapy group reported bigger
improvements in sexual desire and pleasure and less discomfort
during sex than women on the waitlist, the study found. By the time
treatment ended, women who got online therapy also reported greater
improvements in desire and overall sexual functioning than women on
the waitlist.
"Several studies have demonstrated the efficacy and applicability of
internet-based cognitive behavioral therapy for female sexual
dysfunctions in the general population," said senior study author
Neil Aaronson of the Netherlands Cancer Institute in Amsterdam.
The current study, however, is the first to evaluate and confirm the
effectiveness of this type of treatment for sexual dysfunction in
female breast cancer survivors, Aaronson added by email.
"This is particularly important because the prevalence of sexual
dysfunction in this population is two to three times higher than in
the general population," Aaronson said.
For the study, women in the treatment group could participate in up
to 24 weekly sessions guided by a therapist. Researchers surveyed
all of the participants at the start of the study, after 10 weeks
and after therapy sessions concluded, with a similar schedule for
women on the waiting list and patients in therapy.
Participants were 51 years old on average and most of them had a
romantic partner. Slightly more than half of the women had undergone
breast-conserving treatment, with a majority getting chemotherapy,
radiation or hormones.
The most common type of sexual dysfunction was low desire, which
affected about 83 percent of the women, followed by sexual arousal
disorder, which impacted 40 percent of participants.
Overall, the odds of improved sexual functioning were more than
tripled with therapy, compared with women on the waiting list.
Researchers didn't find any meaningful differences between groups in
orgasmic function, sexual satisfaction, intercourse frequency,
relationship intimacy, psychological distress, marital satisfaction
or health-related quality of life.
One limitation of the study is that it wasn't designed to show
whether web-based treatment might be any better or worse than
in-person therapy sessions, the authors note. Another drawback is
that only 62 percent of women in therapy completed the treatment
cycle.
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In addition, researchers didn't have clinicians examine women at the
end of the study to see how many participants still had a diagnosis
of sexual dysfunction, the researchers note. A goal of treatment
would be to help women improve enough to no longer meet the criteria
for this diagnosis.
While the internet doesn't allow patients to develop the same
personal relationships with therapists that they can establish in
the same room together, online treatment may be a more convenient
and private option that some women may prefer, Aaronson said.
One potential downside to web therapy could be the lack of a
therapist to visit in person when problems arise, said Dr. Christine
Rini, a researcher at Hackensack University Medical Center in New
Jersey who wasn't involved in the study.
"People using the therapy may be less likely to get help for
problems such as distress or relationship conflicts caused by
completing the therapy," Rini said by email. "In an emergency, that
could be a real problem."
But web-based therapy could make treatment available to far more
patients, and be more affordable than in-person visits, Rini said.
"Using the web should allow people to get this therapy even if they
could not or would not attend in-person therapy," Rini added.
"People need to decide whether they prefer in-person versus
web-based therapy."
SOURCE: http://bit.ly/2mflls4 Journal of Clinical Oncology, online
February 27, 2017.
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