(158) SEX AFTER CANCER: A SYSTEMATIC REVIEW OF DILATORS AND PELVIC THERAPY IN THE MANAGEMENT OF SEXUAL ISSUES FOLLOWING CANCER TREATMENT

Abstract Introduction Sequelae of cancer treatment on vulvar and vaginal health can include tissue changes as often seen in genitourinary syndrome of menopause (GSM) as well as changes in libido and body image. Atrophic vaginitis is a survivorship issue that affects nearly 70% of postmenopausal breast cancer survivors when compared to affecting 50% of postmenopausal women without breast cancer. Chemotherapy or endocrine therapy for eligible patients with BRCA mutation also contributes to effects on vaginal health. The impacts of these changes on quality of life, sexual function, and pain, are not routinely discussed in oncological settings, leaving some patients reporting emotional repercussions. Vaginal dilators in combination with pelvic health education and physiotherapy can impact the self-image, sense of sexuality, and sexual relationships among patients following cancer treatment. Objective The purpose of this review is to: 1. Analyze the literature on use of dilators in managing vaginal pain and sexual dysfunction across various types of cancer affecting people with a vagina. 2. Review the various protocols in dilator therapy, including specifics for cancer patients 3. Review what has been shown in regard to outcomes of dilator training on sexual function in cancer patients. Methods This review synthesizes data from randomized controlled trials, observational and analytical studies and relevant literature published in the last ten years (2014-2024). Data was also collected from peer-reviewed journals. Results The findings of this review indicate that vaginal dilators may be of benefit in the management of vaginismus and vaginal stenosis which can be seen following cancer treatment. Dilators can be offered to anyone having pain with examinations and/or sexual activity, which is particularly important for women treated with pelvic or vaginal radiation therapy. Importantly, the benefit of dilator training is greatest when started early, with patients who receive early education theoretically more likely to have successful treatment outcomes. Dilators should not be recommended based on sexual activity or sexual orientation but, rather, to all at risk for vaginal changes and to be proactive in their sexual and vulvovaginal health. Conclusions Dilators are found to help improve elasticity, vaginal diameter, vaginal length, and sexual function in people with a vagina following breast, endometrial, and cervical cancer treatment. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Intimate Rose.