University of Tennessee
McMahan-McKinley Endowed Professor in Gerontology
Addressing the sexual health needs of patients with breast cancer after treatment to improve their quality of life and maintain or restore intimacy.
Five or more years of anti-estrogen therapies, such as tamoxifen and aromatase inhibitors, is proven to be effective at reducing the recurrence of breast cancers driven by estrogen. However, many women taking anti-estrogen therapies experience unwanted side effects, such as sexual dysfunction, changes in libido, and vaginal discomfort. These effects can be so troublesome that some women may stop therapy before completing the recommended course. Unfortunately, this important aspect of survivorship is not often addressed during routine medical care. Dr. Barton is investigating ways to help women and their partners regain intimacy, which is often put on hold during treatment. Management of these issues will help to improve patients’ quality of life during and after treatment.
Dr. Barton’s team is developing and testing numerous tools as part of a toolkit that can be individualized to a woman’s needs. They are building on effective trials where symptoms related to sexual health have improved including the use of vaginal moisturizer to improve vaginal dryness and pain, an interactive workbook for partners to improve sexual communication, and a relaxation and hypnotic intervention to improve body image.
The team will complete recruitment and analysis of two smaller trials, WISH and PEPP 2. WISH evaluates a vaginal moisturizer with or without a relaxation hypnotic intervention to improve vaginal symptoms, body image and libido. PEPP 2 evaluates how their interactive workbook can improve sexual communication and satisfaction. The research team will evaluate their findings and combine the most effective interventions into one, individualizable toolkit. An important outcome of this work is to provide community and academic oncologists with the tools needed to address the sexual health concerns of their patients.
Debra Barton, PhD has been an investigator in oncology symptom management since 2002, having developed, implemented and completed 11 large multi-site intervention trials. She has developed phase II and III clinical trials in a variety of symptoms including fatigue, hot flashes, peripheral neuropathy, sleep problems, cognitive changes related to chemotherapy, nausea and vomiting, and sexual health, using behavioral interventions such as hypnosis and imagery as well as dietary supplements. Three previously completed trials have demonstrated promising positive effects; a topical gel for peripheral neuropathy, American ginseng for cancer related fatigue and vaginal dehydroepiandosterone (DHEA) for vaginal symptoms. She also completed a pilot study showing positive effects on hot flashes from hypnosis alone that were equal to the improvement seen with an antidepressant known to help hot flashes.
Dr. Barton is currently developing a comprehensive multi-faceted intervention for improving sexual health for women with a history of cancer that involves both pharmacologic and non-pharmacologic components that address physiologic, psychosocial and cognitive variables that impact sexual health. Therefore, her approach to symptom management is to address symptoms from multiple perspectives, using more than one intervention, to reduce symptoms with minimal to no side effects.
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