Is Tamoxifen Use a Factor Affecting Continence in Breast Cancer Patients?

Vaginal oxygen plus hyaluronic acid on lower urinary tract symptoms in breast cancer survivors

OBJECTIVE

This study aimed to evaluate the effect of vaginal oxygen and hyaluronic acid on lower urinary tract symptoms (LUTS) in breast cancer survivors.

METHOD

A prospective trial was conducted at a university hospital's Menopause Outpatient Clinic. Breast cancer patients experiencing LUTS received intravaginal natural oxygen for 15 min, coupled with a 2% hyaluronic acid solution during the last 5 min. This treatment was performed five times at 15-day intervals. Assessments were repeated at each application and 60 days after the last application. Scores on the Urogenital Distress Inventory-6 (UDI-6) short form and its single items assessing different LUTS aspects were determined.

RESULTS

Treatment in 85 breast cancer patients decreased the UDI-6 total score (from 24.8 ± 19.9 to 17.5 ± 16.2; p < 0.001) and subscales evaluating irritative (p = 0.001), stress (p = 0.006) and obstructive discomfort (p = 0.001) symptoms. In multivariate analysis, aromatase inhibitors were independently associated with a greater improvement of LUTS (coefficient of regression [CR] - 8.05, 95% confidence interval [CI] -13.41, -2.64; p = 0.004)). The use of a gonadotrophin-releasing hormone (GnRH) analog was associated with a greater improvement of irritative symptoms (CR -2.42, 95% CI -4.75, -0.08; p = 0.042), while tamoxifen reduced the improvement of stress symptoms (CR 2.49, 95% CI 0.10, 4.90; p = 0.041).

CONCLUSION

Short-term treatment with vaginal oxygen and hyaluronic acid appeared to improve LUTS of breast cancer patients.

The Long-Term Effects of Cancer Treatment on Sexuality and Couple Relationships

Breast cancer and its pharmacological treatment often induce an impairment in women's sexual functioning and couple relationships, as a consequence of physiological changes and psychosocial issues that may arise and persist long after treatment. This study aims to evaluate the sexual functioning, the quality of the couple relationship, and the overall health status of breast cancer survivors. A further objective is to determine the predictive role of specific clinical and sociodemographic variables for sexual functioning and the couple relationship. Sixty-four breast cancer survivors completed the following questionnaires: the Female Sexual Function Index (FSFI), the Dyadic Adjustment Scale (DAS), the Short Form Health Survey-12 (SF-12), and a self-report questionnaire to collect sociodemographic characteristics. Clinical information was retrieved from medical records. Compared to normative data, our sample reported significantly (p < .01) lower mean scores in the FSFI, DAS, and Physical Component (PCS) and Mental Component Summary (MCS) of the SF-12. Multiple regression analyses show a significant effect of age, hormonal therapy, and psychological well-being on sexual functioning and a significant effect of physical and mental well-being on the quality of the couple relationship. Additionally, 75% of patients qualified for sexual dysfunction as measured by the FSFI global scale, and 71.9% declared they were not adequately informed about the side effects of treatments on sexuality. The high prevalence of sexual dysfunction in breast cancer survivors underlines the need for specific attention to this problem, starting from a complete and targeted communication between patients and health providers regarding these side effects.