Cervical cancer survivors: Need for rehabilitation

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Manjusha Vagal

Tata Memorial Hospital, India

: J Nurs Patient Care

Abstract

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Radiation therapy is commonly used treatment modality in gynecological cancers especially the cervical cancers in combination with other modes of treatment like surgery and chemotherapy. Many women get cured with this treatment and many have excellent long term survival however, some women suffer various side effects, especially with radiotherapy, which has a lasting effect on their quality of life. Vaginal stenosis is the most common complication of gynecological cancer management. Efforts are made to prevent and manage vaginal stenosis to enable adequate examination of the vaginal vault and the cervix during follow up period to detect treatable re-occurrence of the disease and to avoid sexual morbidity. Vaginal dilation is advised for managing vaginal stenosis after the acute inflammatory response post radiation therapy has settled. As per the international guidelines on vaginal dilation after pelvic radiotherapy, vaginal dilators of variable sizes are prescribed as per the anatomy. According to various reviewed articles a 10 minutes of dilation per day is prescribed. Along with vaginal dilator, vaginal intercourse is encouraged in early post radiation therapy to avoid sexual morbidity. Rehabilitation intervention post pelvic radiotherapy include teaching vaginal dilation exercises with the help of vaginal dilators, education on importance of dilation practice and sexual counseling and follow-up assessment of vaginal patency, etc. There is a strong need of welldesigned prospective randomized controlled trials establishing reliable evidence base to support the use of vaginal dilators in restoring vaginal patency following pelvic radiation therapy. There is need for standardized assessment techniques pertaining to dilation procedure. There is need of creating awareness amongst oncologists about vaginal dilation and sexual rehab in gynecological cancer survivors. Patients’ education on importance of vaginal patency and sexual health need serious attention. Also, there is need for detailed assessment of sexual quality of life in gynecological cancer survivors.

Biography

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Manjusha Vagal has her proficiency in rehabilitating patients with musculoskeletal conditions and in lymphedema management. Her 23 years of professional experience made her create various innovative and award winning orthotic and assistive devices and therapy protocol for functionally independent and productive living of physically challenged. Her exceptional patients’ service skills have fetched her professional excellence award.