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A study to find the best way to assess sexual problems caused by radiotherapy to the pelvis (SLIPER)
This study looked at how health care professionals assess female sexual problems after pelvic radiotherapy.
This study looked at side effects of radiotherapy to the ‘pelvic’ area. The women who took part had had radiotherapy for cervical cancer, womb cancer (endometrial or uterine cancer), rectal cancer, anal cancer and bladder cancer.
Radiotherapy to this part of the body can cause side effects such as vaginal dryness, narrowing or shortening of the vagina, or bleeding. These side effects can affect people psychologically and can have an impact on sexual relationships.
The aims of this study were to
- Find out how health care professionals assess side effects of pelvic radiotherapy
- See if health care professionals addressed the impact that side effects had on sexual relationships
- Develop an assessment tool and better ways to support women who have sexual difficulties after radiotherapy
Summary of results
This study showed that sexual issues were not discussed as often as other issues following pelvic radiotherapy. But the research team didn’t feel developing an assessment tool would be useful without further work and training for health care professionals first.
The research team gathered information in two ways, observation and interview.
They observed outpatient clinic appointments of 50 women with cervical or womb cancer, and 19 with rectal or anal cancer. And they interviewed 24 women, 5 partners and 20 health professionals.
Everyone taking part had had radiotherapy 3 months, 6 months, 1 year or 2 years before their clinic appointment or interview.
The results showed that discussions in clinic appointments usually concentrated on symptoms, checking for signs of cancer and treating the short term side effects of treatment.
The team found that bowel side effects were discussed in over 8 out of 10 clinic appointments (81%), and bladder side effects in 7 out of 10 (70%). But vaginal changes were only discussed in just over 4 out of 10 (42%). And sexual issues were discussed in less than 3 out of 10 (25%).
Health professionals said that they were less confident discussing sexual issues with older women, if the woman had more advanced cancer or if the woman’s partner was also there.
Some patients and health professionals felt that sexual issues were not a priority. They felt that clinic appointments should focus on helping with short term side effects and looking for signs that the cancer has started to grow.
The research team concluded that more work is needed to look at the best way to assess and manage sexual difficulties after pelvic radiotherapy. They felt that healthcare professionals would need more training, and follow up clinics would need to be structured differently, for these issues to addressed more effectively.
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (
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Isabel D White
Cancer Research UK
National Institute for Health Research Cancer Research Network (NCRN)
University of Surrey