Pelvic and Sexual Health of Women Undergoing Pelvic Radiation for Gynecologic or Lower GI Cancer
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Date
2024-05
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The Ohio State University
Abstract
Background: Over 1,000 women are diagnosed with gynecologic or lower GI cancer in the U.S. annually and endure treatments that negatively affect their pelvic health and sexual function. More than half of patients experience pelvic pain, dryness, and vaginal narrowing which negatively affect their quality of life and sexual health. Microbes that make up the vaginal microbiome can influence the health of vaginal tissue and, when there is a shift in composition, it can lead to menopausal symptoms and increased risk of disease. Research in this area aims to shed light on the mechanisms underlying pelvic and sexual side effects and develop strategies to promote pelvic and sexual health in women receiving radiation.
Purpose: The overall goal of this study is to determine how pelvic health, patient reported symptoms, and the vaginal microbiome change over the course of pelvic radiation treatment, and whether the pre-treatment microbiome composition is associated with posttreatment pelvic and sexual health outcomes.
Methods: Utilizing an existing dataset of n=22 women initiating pelvic radiation, we used multiple computational data analytics (e.g., descriptive statistics, correlations, and parametric and non-parametric tests of differences) to assess the relationships between sexual function (FSFI), pelvic assessment (vaginal length and stenosis), and microbiome at baseline and 6- months post-radiation treatment. In addition, we used mixed-effects logistic regression to relate baseline characteristics (i.e., cancer diagnosis, treatment dose, age, microbiome composition) and pelvic and sexual health outcomes (i.e., sexual function, vaginal length and stenosis).
Results: Pre-treatment vaginal microbiome samples were collected from 22 women. Half of women experienced a decrease in FSFI over the course of treatment. Women who experienced decreased FSFI had a different pre-treatment vaginal microbiome than those whose FSFI did not change. The top 6 most significantly enriched microbes were higher in women whose FSFI decreased. The microbes associated with decreased FSFI belonged to several phyla.
Conclusions: Women who experience a worsened FSFI had a different pre-treatment vaginal microbiome from women whose FSFI remained the same following pelvic radiation. This suggests that the microbiome may be used as a biomarker of altered sexual function following cancer treatment, and that altering the vaginal microbiome may be a therapeutic target to prevent a change in FSFI.
Description
Stacy Tessler Lindau Trainee Research Award
Keywords
pelvic radiation, gynecologic cancer, lowert GI cancer, female sexual function index, pelvic and sexual health