Do experts in breast cancer ingetrate patients' sexual issues in routine management - medical self-assessment-results at the 15th international maritime meeting of the Austrian society for senology, Mallorca, Spain
Ucsnik, L1; Bolliger, M1; Kottmel, A2; Körbel, TH3; Bitzer, J4; Teleky, B1; Singer, CH5
1: Medical University Vienna, Univ.Clinic f. Surgery, Austria; 2: Private Practice for Gynecology and Sexual Medicine, Austria; 3: Medical University, Vienna; 4: Private Practice, Switzerland; 5: Medical University Vienna, Univ.Clin f. Gynecology/Obstetrics, Head of Dpt for Senology, President of the Austrian Society for Senology
Introduction: Breast cancer and its various treatment-options have well-known impact on sexual health, sexual function, thus quality of patients’life. We wanted to analyse breast cancer experts’ integration of sexual health issues in daily patient management.
Method: At the 15th international, interdisciplinary maritime congress in Mallorca, Spain, May 2017, participants from Austria and Swizerland and various medical disciplines were asked to fill in a 24-item-self-assessment evaluating the management of breast cancer patients’ sexual health and demographic information.
Results: 24 of the 160 experts in breast cancer (return rate 15%) participated, 50% female, 38% male. 38% each active in public hospital and practice, 21% each in university and private hospital. 42% of the experts were more than 21 years clinically experienced in breast cancer treatment. 42% of the doctors stated they asked up to 20% of the patients about sexual issues. 17% of them did not ask the patients. 67% of the experts assessed they were asked by up to 20% of the patients about sexual health problems, 4% of the patients didn’t ask at all. 50% of the doctors suggested that 21-40% of the patients did have issues, but the experts did not tackle the topic. 3 main reasons for the patients not addressing the problems rated by the doctors: other topics more important (75%), lack of time (46%), language barrier (38%). The experts evaluated settings important for actively addressing sexuality in the context of treatment by the doctor: menopause (75%), concrete diagnose (71%), control examinations (50%), before (46%) and after (33%) surgery, rehabilitation (21%), pain therapy (17%). The doctors stated neither public (46%) nor university (29%) hospitals or practices (42%) had established specialized sexual-medicine appointments. 4% of the experts were trained in sexual medicine (in 1-2courses, ESSM-fellowship).
Conclusion: Up to 80% of the breast cancer patients were not asked by experts about sexual health problems although more than 50% of them thought patients’ sexuality was troubled. Established sexual-medicine consultation is required for patients as well as concepts to overcome language-barriers. Professionally designed training-concepts in sexual-medicine are needed to hopefully break the silence towards sexuality in breast cancer patients.
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