Study investigates the sexuality of individuals with breast cancer

Almost half of the women evaluated had an active sex life within a year after diagnosis, according to the USP study

By Karina Toledo

Agência FAPESP –  A study conducted at Universidade de São Paulo (USP) examined 139 women with breast cancer and observed that within a year after diagnosis, almost half had active sex lives. The study also indicated that health professionals are not prepared to counsel these patients on questions related to sexuality.

Researchers collected data from users of the Mastectomy Learning, Research and Rehabilitation Assistance Center (Rema) at the Ribeirão Preto Nursing School (EERP – USP). The average age of the participants was 54.6 years, with the youngest patient just 24 years old and the oldest 78 years old.

In addition to the quantitative study, two other qualitative studies were conducted. One of these studies evaluated 25 Rema patients in detail. The other involved 32 nurses who care for patients after mastectomies. The results are part of the “Sexuality and Breast Cancer” project, funded by FAPESP and coordinated by Professor Elisabeth Meloni Vieira of the Ribeirão Preto School of Medicine (FMRP –USP).

According to Vieira, 56.8% of the patients who participated in the quantitative study confirmed having at least one sexual partner in the last year, and 48.9% confirmed having sex in the last month. “On average, these women have sexual relations six times per month or, rather, have an active sex life,” she said.

The study also found that 33.8% of patients had sex in the past week, 5% said that their last sexual relations occurred between six months and a year earlier, and 38.8% said that they last had sex more than a year ago.

“The quantitative data are still being analyzed, but our hypothesis is that age and marital status are factors that weigh more heavily than cancer itself in the case of patients without any sexual relations in more than a year. Many were widowed, for example,” Vieira explains.

The qualitative interviews held with 25 users of Rema revealed three distinct situations. Some patients had sex lives that were affected by corporal and psychological changes caused by the disease, others did not feel any different and some stated that they had a better sex life after cancer.

“The latter said that fear of death made the relationship with their partners better, and this had an impact on their sex life. There is an idea that patients with cancer get depressed, don’t go outside and don’t have sex. That’s not true,” comments Vieira.

However, the disease is not without complications. “Many patients develop early menopause because of the hormone therapy used to battle tumors. This has consequences, such as a reduced libido and vaginal dryness,” she explains.

Furthermore, many patients have difficulties dealing with the loss of part or all of a breast, temporary balding caused by chemotherapy and swelling in their arms caused by the removal of lymphatic glands from their armpits.

“These women need to talk about this with someone. They want to know if they can have sexual relations, when and how. Health professionals must be prepared,” Vieira states.

Cooperation with French counterparts

The qualitative study conducted with nurses, including all nursing professionals in the oncological area in Ribeirão Preto, indicated that the majority of nurses avoid discussing the topic.

“They don’t talk about it and won’t let patients ask. First because they were never given orientation to do so and therefore feel insecure. Additionally, there is a preconceived notion that sick people don’t have sex, and that’s why they consider the subject unnecessary. There is also the question of shame,” explains Vieira.

For researchers, it is fundamental that specialization courses for oncological nursing include sexuality in their curricula. “Sometimes the patient just needs a vaginal lubricant, and the nurse doesn’t suggest one,” she says.

The joint study was a collaboration with France’s Institut National de la Santé et de la Recherche Médicale (Inserm) under the coordination of Professor Alain Giami. In the future, the researchers intend to compare the results of the two countries to identify similarities and differences in the construction of social representations of sexuality in the care of women with breast cancer.

“The results of the study with nurses in France were very similar to those in Brazil. But we noticed that the issue of body image weighed more heavily for Brazilian women, who typically spend the majority of the year wearing more body-conscious clothes,” Vieira says.
Breast cancer is the most common cancer among women, accounting for 22% of new cases every year. The National Cancer Institute (Inca) estimates that 56,200 people will contract the disease in 2012.