Debra L. Barton, RN, PhD, FAAN
Ann Arbor, Michigan
Mary Lou Willard French Professor of Oncology Nursing
Associate Dean for Research
University of Michigan School of Nursing
Ann Arbor, Michigan
Addressing the sexual health needs of breast cancer patients after treatment to improve their quality of life and maintain or restore intimacy.
Advances in breast cancer therapies have led to a growing number of survivors, 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 has identified strategies to improve vaginal symptoms and body image, demonstrating that a vaginal gel and mind-body therapy helped both symptoms, respectively. In addition, she and her team have conducted and analyzed the data from a study of 230 women with breast cancer evaluating the use of an antidepressant (bupropion) to improve sexual energy and desire. The results show that patients that have completed treatment for breast cancer have very low sexual function scores in many areas. They also completed the development of a partner intervention workbook to improve intimacy and communication.
Dr. Barton and her colleagues will continue to analyze the data from their study to gain a better understanding of the efficacy of bupropion to alleviate intimacy issues for breast cancer survivors. In addition, her team will explore methods to deliver their partner intervention workbook to breast cancer patients following treatment—since many patients do not have insurance coverage or access to specialists, they hope to make this intervention/psychosocial support available in an equitable and accessible manner to as many patients as possible. Lastly, Dr. Barton will embark on a new pilot study using an interactive phone application to deliver cognitive behavioral therapy interventions to improve sleep outcomes in cancer survivors.
If not for BCRF, important health related quality of life issues would not be addressed in innovative ways. BCRF makes it possible for research to be done more nimbly; to be able to use evidence in real time to advance symptom science and address gaps in psychosocial cancer care.
Debra Barton has been a funded 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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