"Do Surgeons performing cytoreductive therapy, such as HPEC and PIPAC, in peritoneal cancer patients adress troubled sexual health in disease-management-programs? Igls-Vienna-SexMed-Survey-Program: Participants' self-assessment-results at the HIPEC/PIPAC-Symposium, Salzburg, November 2017
Ucsnik, L1; Kottmel, A2; Bitzer, J3; Teleky, B4; Emmanuel, K5; Jäger, TA5
1: Medical University Vienna, AUT; 2: Private Practice for Gynecology and Sexual Medicine, Vienna, AUT; 3: Private Practice for Gynecology, Basel, CH; 4: Medical University Vienna, Dpt for Surgery, AUT; 5: Paracelsus Private Medical University Salzburg, Dpt for Surgery, AUT
Introduction: Hypertherme peritoneal chemoperfusion, HIPEC, as well as pressurized intraperitoneal aerosol chemotherapy, PIPAC, have an impact on pelvine structures and reproductive organs during surgical procedure in cancer patients. Due to chemotoxicity, heat as well as surgery, not always be performable in a nerve-sparing way in order to reduce cancer-cells sexual health can be heavily troubled in these patients. Life-expectancy of patients increases after successful therapy. Thus, the importance of their quality of life, living with cancer and sexual health increases, too. HIPEC/PIPAC are mainly offered in defined centers providing multidisciplinary, –professional expertise and high-end health care structures to be able to treat patients state-of-the-art. Little is known about these cancer patients’ sexual health.
Material: Thus, at the HIPEC/PIPAC-symposium, Salzburg, November 2017, 10 of 53 surgeons (19,86%) from Austria and Germany, accepted the invitation to participate in the Igls-Vienna-SexMed-Survey-Program and self-assess the integration of sexual health in their patient-management-concepts via questionnaire.
Results: Up to 100% of the participants asked up to 20% of the patients about sexual problems. 70% of them assessed to be asked by up to 20% of the patients treated with HIPEC/PIPAC. 50% of the doctors did suggest that the patients treated have sexual problems, but didn’t address these. Reasons why patients did not bring up were rated in 90%, “other topics more important”, in 50% age, in 40% lack of time. 80% of the surgeons stated before surgery and 50% after surgery sexual health should actively be addressed by medical doctors. 50% referred patients with sexual issues to gynaecologists or urologists. Sexual medicine support offered was in 70% referring to the medical specialists needed and in 20% evaluation of medications’ side-effects on sexual function. 50% of the participants assessed patients’ age or culture, 40% of the doctors rated patients’ religion, lack of motivation or lack of sexual medicine expertise for adequate therapy reducing successful treatment.
Conclusion: Troubled sexual health is not yet routine part of state-of-the art HIPEC/PIPAC patient-management. 80% of the patients remained not asked about this essential aspect of quality of life and living with cancer so far. There’s awareness of the need to actively address the topic before and after surgery by the doctors. The survey’s participants expressed the need for sexual medicine training for surgeons to increase therapeutic success.
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