Dutch Study Examines Effect of Internet-Based Cognitive Behavioral Therapy on Sexual Functioning in Breast Cancer Survivors
In a Dutch study reported in the Journal of Clinical Oncology, Hummel et al found that use of an Internet-based cognitive behavioral therapy intervention improved sexual functioning among breast cancer survivors.
Study Details
In the study, 169 women with a diagnosis of sexual dysfunction from 10 sites in the Netherlands were randomized between September 2013 and May 2015 to Internet-based cognitive behavioral therapy (n = 84) or a waiting-list control group (n = 85). The cognitive behavioral therapy consisted of weekly therapist-guided sessions, with a maximum duration of 24 weeks.
Questionnaires on sexual functioning were completed by the intervention group at baseline, midtherapy (T1), and posttherapy (T2) and at identical times by the control group. Comparative changes in measures were assessed as effect sizes; an effect size of 0.20 was considered small; 0.50, moderate; 0.80, large; and ≥ 0.50, clinically relevant. Patients had a mean age of 51 years.
Changes in Reported Functioning
Compared with the control group, the intervention group exhibited a significant improvement in overall sexual functioning (effect size for T2 = 0.43, P = .031), including an increase in sexual desire (effect size for T1 = 0.48 and for T2 = .72, P < .001), sexual arousal (effect size for T2 = 0.50, P = .008), and vaginal lubrication (effect size for T2 = 0.46, P = .013). The intervention group also reported a significant increase in sexual pleasure (effect size for T1 = 0.32 and for T2 = 0.62, P = .001), less discomfort during sex (effect size for T1 = 0.49 and for T2 = 0.66, P = .001), and less sexual distress (effect size for T2 = 0.59, P = .002). In addition, the intervention group reported greater improvement in body image (effect size for T2 = 0.45, P = .009) and fewer menopausal symptoms (effect size for T1 = 0.39, P = .007).
No significant effects were observed for orgasmic function, sexual satisfaction, intercourse frequency, relationship intimacy, marital functioning, psychological distress, or health-related quality of life.
The investigators concluded: “Internet-based [cognitive behavioral therapy] has salutary effects on sexual functioning, body image, and menopausal symptoms in [breast cancer survivors] with sexual dysfunction.”
The study was supported by the Dutch Cancer Society, the Pink Ribbon Foundation, and the Netherlands Cancer Institute.
Neil K. Aaronson, PhD, of the Netherlands Cancer Institute, is the corresponding author of the Journal of Clinical Oncology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
