The form consists of PRO measures, including the Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), Female Sexual Function Index (FSFI), Sexual Activity Questionnaire (SAQ). A female sexual medicine clinical assessment form was used to collect medical and patient characteristics and patient-reported outcomes (PROs). Ninety-nine women with a history of colon, rectal, or anal cancer were seen for an initial consult at the Female Sexual Medicine and Women’s Health Program at Memorial Sloan Kettering Cancer Center from 01/12–07/17. All studies presented in this review used at least one validated measure.Īn IRB-approved limited waiver of authorization was obtained for our recent cross-sectional cohort study. Within the literature, the prevalence rates for specific sexual dysfunction are difficult to define, in part because of different methods for data collection and lack of baseline data on sexual activity prior to cancer treatment. The study had to incorporate the use of measures assessing sexual function. The criteria for inclusion consisted of peer-reviewed articles (cross-sectional, longitudinal, interventional, or pilot studies) addressing sexual function in women with a history of colon, rectal, or anal cancer. We searched PubMed for peer-reviewed, English-language articles published from 2008–2018 using the following search terms: “colorectal cancer,” or “rectal cancer,” or “anal cancer” and “female,” and “sexual function,” or “sexual dysfunction.” Since most of the studies we identified were not exclusively female focused, we included studies that had both male and female patients. It should be noted that urological issues such as erectile dysfunction are common among male cancer survivors and can result in significant difficulties in survivorship however in this review, we will explore the limited but recent literature on the sexual health of women diagnosed and treated for colorectal/anal cancer, as well as offer insights from our recent cohort of women who sought treatment to address vulvovaginal sexual health concerns. Colorectal/anal cancer can have adverse and persisting effects on sexual function and psychological wellbeing. As these women live longer, understanding the long-term side effects of treatment are a priority.Ĭommon physical side effects of treatment include autonomic nerve injury, bowel function issues (incontinence, increased stool frequency, flatulence), buttock pain, and vulvovaginal health issues (dryness, fibrosis, adhesions, shortening), all of which can adversely impact quality of life (QOL). Common issues of aging, such as comorbid illnesses and vulvovaginal tissue quality, can be exacerbated by cancer therapy. įemale survivors of colorectal/anal cancer are typically older adults, with an average age of 72 for colon, 63 for rectal, and early 60s for anal cancer. The use of adjuvant chemotherapy for colon cancer and neoadjuvant chemoradiation for rectal cancer has also improved survival rates. Five-year survival rates for colorectal/anal cancer have improved in recent years with screening advancements, an increase in the removal of colonic polyps (precursors to cancer), novel surgical techniques and therapies (adjuvant therapy), better preoperative staging, and targeted therapies. For anal cancer, primary radical radiotherapy and concomitant chemotherapy improves survival while also preserving the anal sphincter. The stoma opening allows for the attachment of a changeable bag through which feces can be eliminated. Treatment for colorectal/anal cancer may require a temporary or permanent stoma (an artificial opening on the abdomen through which the bowel or bladder diverts). The use of neoadjuvant or adjuvant chemotherapy (with or without radiation) to treat colorectal cancer depends on tumor location and disease stage. Management of colorectal cancer relies primarily on surgical resection of the bowel with the adjacent draining lymph nodes. Standard treatment typically includes a combination of surgery, chemotherapy, and/or radiation therapy. Treatment for colorectal/anal cancers varies by disease site and severity. In 2018, there will be an estimated 47,530 newly diagnosed cases of colon cancer, 17,100 new cases of rectal cancer, and 5,620 new cases of anal cancer among women. The incidence and mortality rates of colorectal cancer are higher in men than in women, and rates of anal cancer are slightly higher in women. Anal cancer is less common however, the number of newly diagnosed anal cancer cases is rising every year. Despite early screening/detection and cancer prevention strategies, colorectal cancer is a common malignancy among both men and women. population of cancer survivors is expected to grow to 20 million by 2026.
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