Women diagnosed with vulvar cancer are often treated with surgery that involves the removal of substantial sections of the external genitalia. Because survival rates are extremely high for women with early stages of the disease, it is important to understand the psychosocial issues that women experience following treatment.
Ellen Barlow, RN, of The Royal Hospital for Women in Australia, and her colleagues interviewed 10 women who had previously been treated for early stage vulvar cancer, with a focus on investigating the women's experiences of sexuality and body image.
The researchers found that the majority of women experienced little to no long-term disruption to sexuality and body image following conservative surgery to treat their cancer. Women's sexual satisfaction was affected more by intimacy and relationship status than physical arousal. Women tended to feel negative emotions if they experienced more radical vulvar excision, multiple vulvar procedures, and/or swelling of the lower limbs (a potential complication of surgery). Some women expressed fear of possible removal of their clitoris, and all sexually active women expressed fear of pain on resumption of sexual intercourse.
"The findings indicate surprisingly good outcomes for sexuality and body image in women having conservative surgery for early stage vulvar cancer and support the concept of performing the most conservative vulvar resection consistent with cure of their disease," said Barlow. The authors noted a need for improved communication about sexuality and body image, specifically about resumption of sexual intercourse. They also stressed that women should be counselled on how to prevent or alleviate sexual issues that may arise as a consequence of their treatment.
Barlow et al., (2014). Sexuality and body image following treatment for early-stage vulvar cancer: a qualitative study. J. Adv. Nurs., EPub Ahead of Print, DOI: 10.1111/jan.12346 [Abstract]