*Leslie Ruth Schover, Ph.D., Paul Martinetti, MD, Evan Odensky
Department of Behavioral Science UT MD Anderson Cancer Center Houston, TX
Oral Presentation – Research Track
Saturday, Sept 29, 2012: 9:43 AM – 10:03 AM – LK130

*Presenting Speaker

Background

Tendrils: Sexual Renewal for Women after Cancer is a multimedia, interactive intervention to improve sexual function and satisfaction. The target audience includes women with anycancer site or stage, across the disease timeline. Tendrils includes text, graphics, clipart, and animations. Videotapes include interviews from cancer survivors varying in age, cancer site, and ethnicity, as well as fictional vignettes with actors.

Method
A trial to measure the efficacy of Tendrils included women who had been treated forlocalized breast or gynecological cancer one to seven years previously, were currently free of known disease, had a sexual partner, had an abnormal score on the Female Sexual Function Index (FSFI), and lived in commuting distance of the cancer center. Women wererecruited from the UT MD Anderson tumor registry via letters, during outpatient clinic visits by personal contacts, or with public service announcements and flyers. Women were adaptively randomized into two groups using minimization based on education, cancer site,age, and menopausal status. All women had access to Tendrils for 12 weeks on a password-protected website with electronic recording of usage. One group used Tendrils on a self-help basis. Women in the other group had three additional in-person sessions with a sexual counselor. Questionnaires were completed at baseline, post-treatment, and at 3- and 6-month follow-up. The primary outcome measure was the FSFI, a 19-item multiple-choice measure of female sexual function and satisfaction. Other questionnaires included the Menopausal Sexual Interest Questionnaire (MSIQ), the Brief Symptom Inventory-18 (BSI-18) assessing emotional distress, and the Quality of Life in Adult Cancer Survivors Scale (QLACS). A program evaluation questionnaire was included at post-treatment only. This abstract summarizes preliminary analyses using paired t-tests for women who provided baseline and post-treatment data. Complete data analyses will be available at the time of the Stanford X conference.

Results
Fifty-eight women completed baseline questionnaires (mean age 53±9). Fifty-nine percenthad at least a college education and 79% were Caucasian. The rate of drop-outs during the12-week treatment period was 22% with no between-group difference. On the FSFI, the self-help group’s mean (SD) was 12.6 (7.3) at baseline and 15.0 (8.2) at post-treatment (N=23,P=0.10). For the counseled group scores improved from 11.9 (5.6) to 19.5 (7.0) (N=18,P<0.0001). On the MSIQ, the self-help group’s scores were: 22.6 (9.6) at baseline and 28.1(11.4) post-treatment (N=16, P <0.05). For counseled women, MSIQ changed from 18.5(6.1) to 33.2 (11.2) (N=13, P=0.002). BSI-18 GSI summary scores decreased in both groups,indicating less emotional distress. For all women combined, the change almost achievedsignificance (P=0.06). A significant improvement was seen in (QLACS) Total score, but only in the self-help group (P=0.05).

Conclusions
Participants in both groups improved in sexual function and satisfaction, but counseling clearly enhanced this outcome, particularly on a measure of orgasmic capacity and pleasure(MSIQ subscale). Although it will be important to account for missing data, Tendrils appears to be a promising intervention for women’s cancer-related sexual problems. Women in both groups rate Tendrils positively on scales measuring content and ease of use. It may be more cost-effective to provide counseling by telephone, online video, or email.