Receiving a simple hysterectomy demonstrated lower rates of sexual dysfunction in patients with cervical cancer, compared with receiving a radical hysterectomy.
In a study published in the Journal of Clinical Oncology, researchers focused on sexual function and distress in patients with cervical cancer. The study, named SHAPE, included 700 patients with cervical cancer, with 207 patients who underwent simple hysterectomies and 198 patients who underwent radical hysterectomies.
Researchers found that patients with cervical cancer who received simple hysterectomies showed significantly improved short- and long-term sexual health and quality of life versus those who received radical hysterectomies.
Glossary
Simple hysterectomy: surgical removal of the uterus and cervix. The procedure may be done through the vagina without surgical cuts to the abdomen or through surgical cuts in the abdomen.
Radical hysterectomy: surgical removal of the uterus, cervix, a section of the vagina and a wider region of ligaments and tissues near these organs. This procedure is commonly done through a larger surgical cut in the abdomen.
Lymphedema: fluid build-up in the arms or legs that occurs when there is damage to the lymph vessels or nodes.
Peripheral neuropathy: pain, numbness and swelling in the hands and feet.
Vasomotor symptoms: common symptoms associated with menopause, including hot flashes, night sweats, blood pressure changes and heart palpitations.
“The combination of noninferiority of simple hysterectomy for oncologic outcomes, as well as improved urologic and sexual health outcomes, supports simple hysterectomy as the new standard of care for women with low-risk early-stage cervical cancer,” the researchers wrote in the study.
Sexual Function and Distress in Patients With Cervical Cancer
At baseline, the researchers found that all patients had similar overall sexual functioning, regardless of simple or radical hysterectomies. However, researchers found differences between the groups regarding desire and arousal.
Specifically, there was more favorability for sexual desire at only three months in patients who underwent simple hysterectomies. Similarly, sexual arousal in these respective patients showed favorability at three and 12 months, compared with patients who received radical hysterectomies.
READ MORE: Simple Hysterectomy May Be Effective in Low-Risk Cervical Cancer
Of note, sexual pain was significantly higher in patients from the radical hysterectomy group versus those in the simple hysterectomy group, according to the study. Sexual pain was higher at three, six and 12 months. Sexual distress was also shown to be higher in patients who underwent radical cystectomies versus those who underwent simple hysterectomies at three months.
Researchers also evaluated patients’ sexual activity, sexual worry and sexual enjoyment, according to the study. At three, six and 12 months, sexual activity was higher in patients who underwent simple versus radical hysterectomies. Sexual worry was higher at three months in patients from the radical hysterectomy group. According to researchers, sexual worry improved over time in both groups. At three months, patients from the simple hysterectomy group reported higher sexual enjoyment, the researchers stated.
Quality of Life and Menopausal Symptoms in Patients With Cervical Cancer
Regarding quality of life, patients with cervical cancer in the study were evaluated for physical functioning, pain and side effects from the surgeries.
Patients from the simple hysterectomy group demonstrated significantly better physical functioning scores at 36 months, the study noted. At three months, patients who underwent radical cystectomies experienced more pain than those who underwent simple hysterectomies, the researchers found.
READ MORE: Sexual Activity May Reduce Long-Term Side Effects After Cervical Cancer
Side effects from both types of hysterectomies included lymphedema, peripheral neuropathy and vasomotor symptoms. Researchers noted that these side effects from treatment were not related to sexual health but involved quality of life.
At baseline, patients from either hysterectomy group did not show many differences. Patients from both groups demonstrated low overall symptom burden regarding the three side effects, as noted in the study.
“There were no group differences in lymphedema and peripheral neuropathy, and symptoms in both groups improved over time,” the researchers wrote. “Menopausal symptoms (vasomotor) were worse in the radical compared with the simple hysterectomy group at six months.”
Reference
“Sexual Health and Quality of Life in Patients With Low-Risk Early-Stage Cervical Cancer: Results From GCIG/CCTG CX.5/SHAPE Trial Comparing Simple Versus Radical Hysterectomy” by Dr. Sarah E. Ferguson, et al., Journal of Clinical Oncology.
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