Article Text
Abstract
Introduction/Background Endometrial cancer(EC) represents the third most common cancer among women in Tunisia.
Surgery and radiotherapy are the mainstem in its treatment. Removal of this female organ and scars left, can have impact on patients'body-image and intimacy.
Objectif: evaluate impact on body-image of women treated for EC in the Tunisian-center and how it affects sexuality.
Methodology Descriptive study of 50 women treated for EC in complete remission, in the Radiation-oncology department of Farhat-Hached Hospital Sousse,Tunisia. Socioeconomic variables and clinical history were collected. Variable body-image was measured through validated Hopwood body-image scale(BIS).
SPSS20.0software was used for the statistical-study.
Results Mean age was 61years[40–75]. Fifty-eight percent were educated and 78%were housewives. Seventy percent were married and84% menopaused at time of diagnosis. High prevalence of body-mass-index(BMI)above30 was noted. which is another factor contributing to poor self-image.
Endometroid adenocarcinoma(68%) stage-I FIGO was most common. Wertheim-type-surgery was performed in73% of cases, with adjuvant-external-radiotherapy in98%. dose received was 50.4Gray conventionally-fractionated with sequential/concomitant chemotherapy in56% of cases. forty-six percent of patients underwent brachytherapy of vaginal-vault.
BIS score ranged from 0to30, with average of14.91. Patients with altered BIS score, had significant impact on sex-life. eighteen percent attributed avoidance of intercourse to dyspareunia, vaginal-dryness and general-fatigue. Association between body-image, marital-status and education-level were not statistically significant. However, it was revealed that obese/overweight patients presented significantly more body-image concerns than those with normal BMI.
Majority of patients with sexual-life deterioration reported poor communication with partner, and 42%said they were not sufficiently informed about short- and long-term sequelae of treatment by doctors.
Conclusion EC is currently on the rise due to increase in obesity rates, which is an additional factor affecting women's body-image. Unfortunately, Tunisian health-care-professionals don’t give appropriate importance for this, especially with sexuality and body-image, still being taboo. Therefore, we call to provide specialized-assistance and focus on aspects influencing body-image to improve quality of life of these women.
Disclosures The author declares that she has no relevant or material financial interests that relate to the research described in this paper.