Cancer treatment can cause sexual problems, which manifest during therapy, immediately after or even after a few years and can affect the well-being and emotional health of patients. The Hospital del Mar, in Barcelona, has launched a pioneering sexual rehabilitation program for women with gynecological cancer. It is the first monographic consultation in Spain dedicated to the care of patients with menopause or problems in the vaginal area caused by oncological therapy.
“For a long time, cancer treatment has focused on curing, which is the most important thing. We have reached very high cure rates in some types of tumors and now we face the challenge of reintroducing patients to normal life,” explains gynecologist Josep Maria Solé, head of the sexual rehabilitation consultation. In his opinion, this is an unresolved problem and as time passes it can become an obstacle for a person to feel completely rehabilitated.
The program is aimed at women who have or have had ovarian, cervical, endometrial, vulvar or vaginal cancer, even breast cancer in some cases. The loss of estrogen associated with chemotherapy and radiotherapy causes vaginal atrophy. This area narrows and shortens, receives less blood supply and, as a consequence, loses elasticity and lubrication, making sexual relations painful and unsatisfactory.
In many cases, such as cervical cancer, the tumor process affects young women in their sexual prime. Despite having overcome the disease, the treatment causes a strong upheaval in his life. “They cannot live a normal relationship if problems with vaginal dryness or pain affect them psychologically. And if the relationship is not pleasant, it is difficult for you to want to repeat it,” points out the doctor.
With a simple treatment, which until the launch of the hospital del Mar consultation was only applied in private centers and in healthy women, patients can recover part of the collagen – responsible for the lubrication and elasticity of the vaginal area – lost. due to the advanced onset of menopause that can be caused by treatments such as ovarian removal or radiotherapy. It is a simple and painless procedure that is performed on an outpatient basis, does not require anesthesia and after each session – consisting of the application of a fractionated CO2 laser vaginally –, which lasts less than five minutes, the patient can perform a absolutely normal life. Normally, for symptoms to improve or disappear significantly, three sessions are necessary, one every two months, and women return after a year to assess whether they need a booster dose.
“It is the first hospital in Catalonia that offers this treatment and I am not aware that it is carried out in a prescribed manner in the rest of Spain. A smaller pilot study has been carried out in women with breast cancer but it has not been continued,” says Solé. “It is a procedure that is being used in many private clinics to restore the loss of collagen that causes menopause in healthy women,” she continues.
The hospital del Mar clinic treats about 20 oncology patients a month and has launched a study to assess the real effect of this technique on this type of pathology, an aspect that is still little studied. The first impressions are positive, according to the doctors, and the typology of the patients is varied. From young women, who give more importance to sexual rehabilitation, to those over 60 years old who cannot resign themselves to completely recovering normality after the oncological process. “The fight against cancer does not stop at the treatment of malignant lesions and avoiding recurrences, but rather the fact that the person can once again have a full and satisfactory life in all aspects,” says Toni Payà, head of the obstetrics and gynecology service of the Mar.
