Body Image, Self-Esteem, and Sexuality in Cancer Patients

Transcription

1 Body Image, Self-Esteem, and Sexuality in Cancer Patients

2 Frontiers of Radiation Therapy and Oncology Vo1.14 Series Editor Jerome M. Vaeth, San Francisco, Calif. Associate Editors Jerold P. Green, Alan F. Schroeder, Simeon T. Cantril and Mary Louise Meurk S. Karger Basel München Paris London New York Sydney

3 14th Annual San Francisco Cancer Symposium, San Francisco, Calif., March 23-24, 1979 Body Image, Self-Esteem, and Sexuality in Cancer Patients Volume hαιtors Jerome M, Vaeth, Robert C. Blomberg and Leta Adler, San Francisco, Calif. 16 figures and 6 tables, 1980 S. Karger Basel München Paris London New York Sydney

4 Frontiers of Radiation Therapy and Oncology Vol. 12: Renaissance of Interstitial Brachytherapy. Twelfth Annual San Francisco Cancer Symposium, San Francisco, Calif., 1977, Ed. J.M. Vaeth (San Francisco, Calif.). VIII p., 114 fig., 31 tab., ISBN Vol. 13: Combined Effects of Chemotherapy and Radiotherapy on Normal Tissue Tolerance. Thirteenth Annual San Francisco Cancer Symposium, San Francisco, Calif., Ed. J.M. Vaeth (San Francisco, Calif.). VIII p., 81 fig., 71 tab., ISBN National Library of Medicine, Cataloging in Publication San Francisco Cancer Symposium, 14th, 1979 Body image, self-esteem, and sexuality in cancer patients Volume editors, Jerome M. Vaeth, Robert Blomberg, and Leta Adler. Basel, New York, Karger, (Frontiers of radiation therapy and oncology; vol. 14) 1. Body Image congresses 2. Neoplasma psychology congresses 3. Self Concept congresses 4. Sex Disorders congresses I. Vaeth, Jerome M., ed. II. Blomberg, Robert, ed. III. Adler, Leta McKinney, ed. IV. Title V. Series W3 FR935 v /QZ 200 S b ISBN X All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 1980 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland) Printed in Switzerland by Thiir AG Offsetdruck, Pratteln ISBN X

5 Contents Preface VII Derogatis, L.R. (Baltimore, Md.): Breast and Gynecologic Cancers. Their Unique Impact on Body Image and Sexual Identity in Women 1 Schain, W.S. (Bethesda, Md.): Sexual Functioning, Self-Esteem and Cancer Care 12 Kirkpatrick, J.R. (Winnipeg, Manit.): The Stoma Patient and His Return to Society 20 Patient Perspective 23 Curtis, T.A. and Zlotolow, Ι.M. (San Francisco, Calif.): Sexuality and Head and Neck Cancer 26 Patient Perspective 33 Sewell, H.H. and Edwards, D. W. (Davis, Calif.): Pelvic Genital Cancer: Body Image and Sexuality 35 Eschenbach, A.C. von (Houston, Tex.): Sexual Dysfunction following Therapy for Cancer of the Prostate, Testis, and Penis 42 Patient Perspective 48 Audience Participation 50 Cantor, R.C. (San Francisco, Calif.): Self-Esteem, Sexuality and Cancer- Related Stress 51 Bullard, D.G.; Causey, G. G.; Newman, A.B.; Orfsoff,R.;Schanche,K., and Wallace, D.H. (San Francisco, Calif.): Sexual Health Care and Cancer: A Needs Assessment 55 Golden, J.S. and Golden, M. (Los Angeles, Calif.): Cancer and Sex 59 Adams, G.K. (San Jose, Calif.): The Sex-Counseling Role of the Cancer Clinician 66 Physician Perspective 73 Audience Participation 76

6 Contents VI Stoklosa, J.Μ. and Bullard, D.G. (San Francisco, Calif.): Talking about Sex: Suggestions for the Health Professional 79 Harris, J.R.; Levene, M.B., and Hellman, S. (Boston, Mass.): Primary Radiation Therapy for Early Breast Cancer 83 Harvey, R.A. (San Francisco, Calif.): Breast Reconstruction following Mastectomy 90 Physician Perspective 94 Patient Perspective 97 Audience Perspective 101 Furlow, W.L. (Rochester, Minn.): Sexual Consequences of Male Genitourinary Cancer: The Role of Sex Prosthetics 104 Audience Participation 107 Wilbur, J. (San Francisco, Calif.): Sexual Development and Body Image in the Teenager with Cancer 108 Patient Perspective 112 Audience Participation 113 What Health Professionals Did for Me and What I Wish They Had Done 115 Audience Participation 119 Capone, M.A.; Westie, K.S., and Good, R.S. (Miami, Fla.): Sexual Rehabilitation of the Gynecologic Cancer Patient: An Effective Counseling Model 123 Calderone, M.S. (New York, N.Y.): `Doctor, Will it Leave a Scar?' 130

7 Preface Cancer impacts all aspects of the patient's life. Most cancer patients have special concerns about their physical appearance, self-esteem and sexual lives. Too often, health professionals focus their attention only on the disease process, its diagnosis and treatment. Often, it is the lack of information and an inability to communicate with cancer patients about these concerns which lead physicians and other health professionals to neglect important aspects of patient care. The 14th Annual San Francisco Cancer Symposium, held on March 23rd and 24th, 1979, was designed to increase understanding of patient concerns and to enhance the counseling skills of health professionls who care for cancer patients. The paper by keynote speaker, Leonard Derogatis, provides an overview and a theoretical framework for considering the issues of body image, selfesteem and sexuality in the individual with cancer. The following papers discuss ways in which different cancers and their medical and surgical management affect sexuality and self-image. Wendy Schaín addresses the psychological and social consequences of ablative surgery, relating these to human developmental stages and the diverse sources of an individual's self-esteem. James Kirkpatrick addresses these issues as they relate to the patient with a stoma, Thomas Curtis considers the problems of patients with head and neck cancer and their physical rehabilitation with reconstructive surgery; Hobart Sewell presents data from his study of women with pelvic genital cancer; Andrew von Eschenbach discusses sexual dysfunction in patients with prostate, testicular and penile cancer. Although most of the papers address the Symposium theme from the point of view of the adult patient, Jordan Wilbur's paper considers some treatment approaches which take into account the special problems adolescent cancer patients confront with respect to their sexual development, body image, and selfesteem. An objective of the Symposium was to increase understanding of patient concerns and to enhance the counseling skills of health professionals. Papers

8 Preface VIII were presented by speakers with special expertise in the clinical application of behavioral science to the care of cancer patients. In separate papers, Robert Cantor and Joshua Golden place special emphasis on the importance of dealing with the marital relationship in helping the couple cope with cancer and the often debilitating and mutilating aspects of cancer treatment. Georgia Adams and Mary Ann Capone with Raphael Good, in two papers, provide specific techniques of sexual counseling. In addition, workshops and panels provided Symposium registrants with opportunities for open discussion with speakers and cancer patients, which are reported here, as well as opportunities to practice counseling skills. The Symposium closed with remarks by Mary S. Calderone. We are grateful for the partial support of the Symposium generously provided by Varian Associates. Jerome M Vaeth, MD Robert Blomberg, Dr. P.H. Leta Adler, PhD

9 Dedication We have dedicated this Volume to Donald Ο. Roy who died June 24, Mr. Roy served as the first Chairman of the Board of Directors of the West Coast Cancer Foundation from March, 1976, to July, His leadership, imagination and kindness will be missed by his many friends. Jerome M. Vaeth, MD

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