Kemoterapi Tedavisi Gören Kanser Hastalarının Cinsellik Algılarının ve Cinsel Bakım Gereksinimlerinin Belirlenmesi

Öz

Amaç: Çalışma Akdeniz Üniversitesi Gündüz Kemoterapi Ünitesinde tedavi alan, kolorektal ve jinekolojik kanseri olan hastaların cinsellik algılarını ve cinsel bakım gereksinimlerini her iki kanser türü için ayrı ayrı belirlemek amacıyla yapılmıştır. Gereç ve Yöntemler: Araştırma verileri Ekim 2016-Nisan 2017 tarihleri arasında Akdeniz Üniversitesi Gündüz Kemoterapi Ünitesinde tedavi alan, kolorektal ya da jinekolojik kanser tanısı olan 75 hastadan toplanmıştır. Elde edilen veriler, yüzde, ortalama, standart sapma ve ki-kare testi kullanılarak değerlendirilmiştir. Bulgular: Katılımcıların %66,7’si kadın, %33,4’ü erkeklerden oluşmakta; %42,7’si jinekolojik kanser, %57,3’ü ise kolorektal kanser sebebiyle tedavi görmektedir. Kemoretapi sürecinde hem kadınların %76 , hem de erkeklerin %72 çoğunun cinsel yaşamının olumsuz etkilendiği belirlenmiştir. Kemoterapi sürecinde kadınların %90’ının, erkeklerin ise %96’sının cinsel ilişki sıklığı azalmıştır. Hastaların çoğu kemoterapi süresince kaliteli bir cinsel yaşamı olabileceğini düşünmemektedir. Kemoterapi sürecinde hastaların %74,7’sinde cinsel istekte azalma olmuştur. Hastaların %33,3’ü kemoterapi tedavisinden sonra cinsel ilişki sıklığının azaldığını, %28’i ilişki süresinin kısaldığını ve kalitesinin azaldığını, %38,7’si ise kemoterapi almaya başladıktan sonra hiç cinsel ilişkiye girmediğini belirtmiştir. Sonuç: Kemoterapi sürecinde hem kadın, hem erkek hastaların cinsel yaşamlarının olumsuz etkilendiği görülmüştür. Her iki kanser türünde de tedavi süreciyle cinsel isteklerinin, cinsel ilişki sıklıklarının, eşlerinin kendilerine olan ilgisinin azaldığı belirlenirken; tedavi sürecinde kolorektal kanseri olan hastaların cinsel yaşamlarının jinekolojik kanser hastalarına göre daha fazla kısıtlandığı görülmüştür

Anahtar Kelimeler

• Cinsellik, Kemoterapi, Kolorektal kanser, Jinekolojik kanser

Determination of Sexual Perceptions and Sexual Care Needs of Cancer Patients Receiving Chemotherapy Treatment

Abstract

Objective: The aim of this study was to determine sexuality perceptions and sexual needs of patients with colorectal and gynecological cancer who were treated at the Akdeniz University Day Chemotherapy Unit.Material and Methods: The study data was collected from 75 patients who were diagnosed with colorectal or gynecological cancer at Akdeniz University Day Chemotherapy Unit between October 2016 and April 2017. The obtained data were evaluated using percentage, mean, standard deviation values and the chi-square test.Results: While 66.7% of the participants were women, 33.4% were men; 42.7% were treated for gynecological cancer and 57.3% for colorectal cancer. The sexual activity of both women 76% and men 72% was negatively affected in the process of chemotherapy. During the chemotherapy period, 90% of the women and 96% of the men had a lower incidence of sexual intercourse. Most of the patients did not think that they could have a good sexual life during chemotherapy. During the chemotherapy period, 74.7% of the patients had a decrease in sexual desire. Some of the patients 33.3% stated that the frequency of sexual intercourse decreased after chemotherapy treatment, 28% had shortened duration of relationship and decreased quality, and 38.7% stated that no sexual intercourse took place after taking chemotherapy Conclusion: We observed that the sexual lives of both female and male patients are adversely affected in the course of chemotherapy. Sexual desire, frequency of sexual intercourse, and the spouse’s interest decreased with both types of cancer. The sexual life of patients with colorectal cancer was more restricted than that of gynecologic cancer patients during the treatment period.

Keywords

• Sexuality, Chemotherapy, Colorectal cancer, Gynecological cancer

Kaynakça

1. Bozdemir N, Özcan S. Cinselliğe ve cinsel sağlığa genel bakış. Turkish Journal of Family Medicine and Primary Care 2011; 5(4): 37-46.
2. Oskay U, Can G, Basgol S. Discussing sexuality with cancer patients: oncology nurses attitudes and views. Asian Pac J Cancer Prev 2014; 15(17): 7321-6.
3. Brotto LA, Erskine Y, Carey M, Ehlen T, Finlansoy S, Heywood M, Kwon J, Mcalpine J, Stuart G, Thomson S, Miller D. A brief mindfulness-based cognitive behavioral intervention improves sexual functioning versus wait-list control in women treated for gynecologic cancer. Gynecol Oncol 2012; 125: 320-5.
4. Gilbert E, Ussher JM, Perz J. Embodying sexual subjectivity after cancer: A qualitative study of people with cancer and intimate partners. Psychol Health 2013; 28(6): 603-19.
5. Reis N. Jinekolojik kanser ve tedavilerinin kadın cinsel sağlığına etkileri. C.Ü.Hemşirelik Yüksekokulu Dergisi 2003; 7(2): 35-40.
6. Donovan KA, Taliaferro LA, Alvarez EM, Jacobsen PB, Roetzheim RG, Wenham RM. Sexual health in women treated for cervical cancer: Characteristics and correlates. Gynecol Oncol 2007; 104(2): 428-34.
7. Whicker M, Black J, Altwerger G, Menderes G, Feinberg J, Ratner E. Management of sexuality, intimacy, and menopause symptoms in patients with ovarian cancer. Am J Obstet Gynecol 2017. doi: 10.1016/j.ajog.2017.04.012. [Epub ahead of print].
8. Frumovitz M, Sun C, Schover L, Munsell M, Jhingran A, Wharton JT. Quality of life and sexual functioning in cervical cancer survivors. J Clin Oncol 2005; 23(20): 7428–36.

9. Flynn KE, Reese JB, Jeffery DD, Abernethy AP, Lin L, Shelby RA, Porter LS, Dombeck CB, Weinfurt KP. Patient experiences with communication about sex during and after treatment for cancer. Psycho-oncology 2012; 21: 594–601.
10. Charif AB, Bouhnik AD, Courbiere B, Rey D, Préau M, Bendiane MK, Mancini J. Patient discussion about sexual health with health care providers after cancer-A national survey. J Sex Med 2016; 13(11): 1686-94.
11. Abbott-Anderson K, Kwekkeboom KL. A systematic review of sexual concerns reported by gynecological cancer survivors. Gynecol Oncol 2012; 124(3): 477-89.
12. Corney R, Crowther M, Everett H, Howells A, Shepherd J. Psychosexual dysfunction in women with gynaecological cancer following radical pelvic surgery. Br J Obstet Gynaecol Jan 1993; 100: 73–8.
13. Stead M, Fallowfi eld L, Selby P, Brown J. Psychosexual function and impact of gynecological cancer. Best Pract Res Clin Obstet 2007; 21(2): 309–20.
14. Sadovsky R, Basson R, Krychman M, Morales AM, Schover L, Wang R. Cancer and sexual problems. J Sex Med 2010;7: 349–73.
15. Katz A. The sounds of silence: Sexuality information for cancer patients. J Clin Oncol 2005; 23(1): 238-41.
16. Rassmusson ED, Plantin L, Elmerstig E. Did they think i would understand all that on my own? A questionnaire study about sexuality with Swedish cancer patients. Eur J Cancer Care 2013; 22: 361-9.
17. Marshall C, Kiemle G. Breast reconstruction following cancer: Its impact on patients’ and partners’ sexual functioning. Sex Relatsh Ther 2005; 20: 155-79.
18. Hautamäki K, Miettinen M, Kellokumpu-Lehtinen PL, Aalto P, Lehto J. Opening communication with cancer patients about sexuality-related issues. Cancer Nurs 2007; 30(5): 399-404.
19. Davison BJ, Gleave ME, Goldenberg SL, Degner LF, Hoffart D, Berkowitz J. Assessing information and decision preferences of men with prostate cancer and their partners. Cancer Nurs 2002; 25: 42-9.