Debra L. Barton, RN, PhD, FAAN
McMahan-McKinley Endowed Professor in Gerontology
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’s team developed an interactive workbook for couples to address communication and intimacy, as well as a phone app for sleep. Both interventions are being evaluated for how helpful they are and whether they positively impact desired outcomes. Thus far, participants are highly appreciative of both the workbook and the phone app, providing data that they are helpful but also convenient and easy to use.
In addition to evaluating the effectiveness of the combined workbook and sleep app interventions, the team also developed a study to evaluate another two-component intervention for sexual health that addresses vaginal symptoms, self-image and libido. This study is going through institutional approval processes and should open in 2022. Importantly, this work will provide the foundation on which the team will eventually add the couples' component, to have a truly comprehensive intervention bundle for sexual health.
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. — Dr. Barton
Debra Barton, RN, PhD, FAAN 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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