Naslov
Seksualni problemi u onkoloških bolesnika: jesu li posljedica bolesti ili lijeka
(Sexual problems in patients with oncological problems: are they consequences of a disease or of a treatment?)

Autori
Arbanas, Goran

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, neobjavljeni rad, stručni

Skup
Hrvatski virtualni kongres onkološke farmacije s međunarodnim sudjelovanjem Farmaceutska skrb onkoloških bolesnika u vremenu digitalnog razvoja - novi načini liječenja, nove odgovornosti, 7. - 10. 10. 2021.

Mjesto i datum
Online;, 07.10.2021. - 10.10.2021

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Nije recenziran

Ključne riječi
seksualni problemi ; seksualne nuspojave ; ijatrogeni seksualni problemi ; seksualno savjetovanje
(sexual problems ; sexual side-effects ; iatrogenic sexual problems ; sexual counselling)

Sažetak
Patients with cancers have a higher prevalence of sexual problems (the prevalence is 40-100%) compared to general population. There are many reasons for such a distribution: the disease itself (a carcinoma) can lead to sexual problems via biological, psychological (e.g. depression, anxiety) and relational (e.g. relationship discord) mechanisms. On the other hands, treatment methods can lead to sexual side-effects. The highest prevalence of sexual problems (>80%) is among the patients who underwent radical pelvic surgery. There are some gender differences in cancer survivors, regarding sexual functions. Women want to restore the relationship, and therefore have more desire problems and body image problems, whereas men want to restore function and have more erection/orgasm problems. Furthermore, there are some differences in sexual consequences of homosexual and heterosexual man and women (not just in prevalence of different cancers, but even in prognosis of sexual side-effects). Unfortunately, less than 15% of patients with different cancers talk about sexuality with their doctors. All methods of cancer treatments can lead to sexual side effects. Mastectomy reduces eroticism (because of absent erotic areas, such as nipples) and produces feelings of unattractiveness and loss of femininity. Bilateral salpingooophorectomy adversely affects sexuality due to hormonal changes. fibrosis, scarring and lymphoedema produce reactions in both the patient and their partners. Chemotherapy can lead to ovarian failure, menopausal symptoms, erythrodysesthesia, alopecia, nausea. Radiation produces fatigue, dryness of skin, loss of sensation, alopecia. Affected sexual self-confidence can also be due to missing parts, loss of bleeding, loss of sexual sensations, loss of womanhood or manhood. Treatment options for sexual problems in cancer survivors are multiple. Mindfulness techniques have been shown to have positive effects on desire and arousal problems. Local vaginal treatments (hormonal creams, lubricants, moisturizers) may treat vaginal atrophy and consequent dyspareunia. Different antidepressants which address levels of noradrenaline and dopamine (such as bupropion) increase sexual responsiveness and orgasmic capacity. There are some specific problems, specific to the location of the cancer. Breast cancer directly affects the essence of the cultural sign of womanhood. Lung cancer can lead to dyspnoea, colorectal cancers to diarrhoea or incontinence, endometrial cancers to loss of reproduction, and each of these have specific consequences in the area of sexuality. Prostate cancers lead to erectile dysfunction due to surgery and to loss of desire due to antiandrogen therapy. Bladder cancer produce specific effects due to its location and surgery techniques. One of the well-known techniques to address sexual problems in people with oncology problems is a DESIRE approach. Desire is an acronym of the following steps: discuss (sexual problems and a consequent distress), evaluate (for depression, sexual problems and relationship problems), screen for, intervene (with stress reduction, specific pharmacological agents, prioritizing intimacy), refer (to a specific professional) and educate. Each and every health care professional (i.e. medical doctors, nurses, pharmacists, physiotherapists etc.) should have basic knowledge in sexual anatomy and physiology and should be able to take sexual history and give basic counselling in the arena of sexuality. Pharmacists should be especially aware of possible adverse sexual effects of drugs and medicines used for the treatment of cancers. Hence, they should be familiar with counselling techniques and should provide education of patients regarding iatrogenic sexual problems.

Izvorni jezik
Hrvatski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA