{"paper_id":"515e15af-7355-4c90-97f3-e1db4fd440a6","body_text":"186\nLetter to the editor\nDOI: 10.5114/pm.2016.63501\nMenopause Rev 2016; 15(3): 186-187\nCorresponding author:\nValentina Lucia La Rosa, Unit of Psychodiagnostics and Clinical Psychology, University of Catania,  \nCatania, Italy, Via Santa Sofia 78, 95123 Catania, Italy, e-mail: psicolarosa@gmail.com\nSubmitted: 6.09.2016\nAccepted: 13.10.2016\nDear Editor ,\nWe read with great interest the review by Iżycki  \net al. [1] about the sexual, psychological, and social con-\nsequences of gynaecological cancer in patients and their \npartners.\nWe agree that the impact of gynaecological cancer \non mental health, sexual functioning, and emotional \nwellbeing of affected women and their partners is con-\nsiderable, and it is important to investigate this topic \nin order to ensure that gynaecological cancer patients \nreceive optimal care [2].\nAlthough we appreciated the reported methodol-\nogy, we would like to take this opportunity to point out \nseveral elements that would let us further realise the \nresults of this study.\nIn our opinion, it would have been more appropriate \nto further differentiate sexual and psychological conse-\nquences according to the type of gynaecological cancer \nand the type of treatment. Indeed, the literature about \nthis topic underlined that the type of cancer (endome-\ntrial, cervical, ovarian, or vulvar cancer) and the type \nof treatment (such as simple or radical hysterectomy, \nradiotherapy, and/or chemotherapy) may have differ -\nent effects on the sexual health and quality of life of \naffected women [2, 3]. For example, ovarian cancer is \nresponsible for more deaths than any other cancer of \nthe female reproductive system, and the majority of pa-\ntients present with advanced-stage disease [3-5]; there-\nfore, it is associated with more serious consequences \nfrom a  psychological point of view. Moreover, it has \nbeen demonstrated that radical surgery and radiation \ntherapy may affect sexual functioning more negatively \nthan less radical surgery [2, 6-8].\nFor these reasons, we believe that it would be ap-\npropriate to take into account several factors, such as \ntype and stage of cancer and treatment modality, in or-\nComment on: “The consequences of gynaecological cancer in patients and their \npartners from the sexual and psychological perspective”\nSalvatore Giovanni Vitale1, Valentina Lucia La Rosa2, Agnese Maria Chiara Rapisarda3,  \nAntonio Simone Laganà1\n1Unit of Gynaecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, \n Messina, Italy \n2Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy \n3Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy\nder to better understand the impact of these variables \non the sexual and psychological well-being of patients. \nNonetheless, it is important to underline that most \nof the studies done on this topic used very heteroge-\nneous samples for age, disease stage, and treatment, \nso it is necessary to conduct further studies with more \nhomogeneous samples in order to obtain more reliable \nand reproducible data.\nWe appreciate the section of the review devoted to \nthe consequences of gynaecological cancer for the part-\nners of the affected women. Indeed, the impact of can-\ncer on the partner’s sexual function, partner’s relation-\nship satisfaction, and general well-being between the \ncouple are less investigated in the literature about this \ntopic, so further studies about this topic are needed.\nIn conclusion, this review confirms that gynaecolog-\nical cancer patients are at risk of developing sexual and \npsychological problems, so it is essential to provide ad-\nequate counselling and support for these women and \ntheir partners. \nSpecifically, we believe that it is important to iden-\ntify patients who are particularly at risk of developing \nsexual and psychological problems. It would be ap-\npropriate to make an assessment including the sexual \nfunction before cancer, current sexual activity, and how \ncancer has influenced sexual health and relationship \nwith the partner. For this purpose, the Brief Index of \nSexual Functioning for Women [9] or the Female Sexual \nFunction Index (FSFI) [10] could be used. The assess-\nment should include also the presence of psychiatric \ncomorbidities and psychological diseases, such as anxi-\nety and depression, through the use of validate psycho-\ndiagnostic tests. \nAnother important point to be highlighted is the \nneed for adequate training of healthcare professionals \nin order to better provide information and support to \n\nMenopause Review/Przegląd Menopauzalny 15(3) 2016\n187\npatients during the communication of diagnosis and \nthroughout the therapeutic process. \nThe aim is to reduce as much as possible the impact \nof cancer on the sexual and psychological functioning \nof patients and their partners. \nReferences\n1. Iżycki D, Woźniak K, Iżycka N. Consequences of gynecological cancer in \npatients and their partners from the sexual and psychological perspec-\ntive. Menopause Rev 2016; 15: 112-116.\n2. Huffman LB, Hartenbach EM, Carter J, et al. Maintaining sexual health \nthroughout gynecologic cancer survivorship: A  comprehensive review \nand clinical guide. Gynecol Oncol 2016; 140: 359-368.\n3. Domenici L, Palaia I, Giorgini M, et al. Sexual Health and Quality of Life \nAssessment among Ovarian Cancer Patients during Chemotherapy.  \nOncology 2016; 91: 205-210.\n4. Bellia A, Vitale SG, Laganà AS, et al. Feasibility and surgical outcomes \nof conventional and robot-assisted laparoscopy for early-stage ovarian \ncancer: a retrospective, multicenter analysis. Arch Gynecol Obstet 2016; \n294: 615-622.\n5. Vitale SG, Marilli I, Lodato M, et al. The role of cytoreductive surgery \nin advanced-stage ovarian cancer: a systematic review. Updates Surg \n2013; 65: 265-270.\n6. Greimel ER, Winter R, Kapp KS, et al. Quality of life and sexual function-\ning after cervical cancer treatment: a long-term follow-up study. Psycho-\noncology 2009; 18: 476-482.\n7. Vitale SG, Valenti G, Gulino FA, et al. Surgical treatment of high stage \nendometrial cancer: current perspectives. Updates Surg 2016; 68: 149-\n154.\n8. Rossetti D, Vitale SG, Gulino FA, et al. Concomitant chemoradiation \ntreatment in selected stage I  endometrioid endometrial cancers. Eur \nJ Gynaecol Oncol 2016; 37: 657-661.\n9. Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index \n(FSFI): a multidimensional self-report instrument for the assessment of \nfemale sexual function. J Sex Marital Ther 2000; 26: 191-208.\n10. Taylor JF , Rosen RC, Leiblum SR. Self-report assessment of female sexual \nfunction: psychometric evaluation of the Brief Index of Sexual Function-\ning for Women. Arch Sex Behav 1994; 23: 627-643.","source_license":"CC0","license_restricted":false}