Elaboração de manual técnico de atenção à saúde sexual em mulheres com câncer de mama e ginecológico: um guia para profissionais de saúde

Abstract

BACKGROUND: Malignant neoplasms are the second largest cause of morbidity among women in Brazil. Early diagnosis and advances in cancer treatment in the early and advanced stages have, in many situations, improved prognosis and long survival, with cancer being considered a chronic disease. Despite this, the treatment of breast cancer and gynecological cancer may leave sequels or side effects on sexuality that persist for years after the end of treatments. The frequency of sexual dysfunctions in this population tends to be high and many women are embarrassed to expose their feelings to the health team and expect the professional to take the initiative. However, addressing patients' sexual complaints can be a challenge for the health professional who has not had adequate training in their formal education and for the difficulty and personal beliefs of dealing with the subject. Sexuality is an important component in the quality of life of cancer patients and promoting rehabilitation in this sphere should be one of the pillars of health policies. OBJECTIVES: To elaborate Technical Manual of orientation and management to the health professionals regarding the sexual readaptation in women with breast and gynecological cancer; specific objectives: to search the literature for the main evidence related to the management of sexual dysfunctions resulting from the treatment of cancer in women and to propose recommendations for action in clinical practice. METHOD: A systematic review of the literature was carried out reconnecting the period from 2009 to 2019 through a survey of health reference databases (MEDLINE/PUBMED, Virtual Health Library (VHL) and Cochrane Collaboration) giving preference to randomized clinical trials and observational studies that evaluated treatments for sexual dysfunction in patients with breast cancer and gynecological cancer. The evidence found was analyzed according to the GRADE System for the elaboration of recommendations in the format of a technical manual for health professionals. RESULTS: The compilation of various forms of treatment for sexual dysfunction in women with cancer allowed the construction of evidence-based tables through the GRADE system for each large group of sexual complaints (sexual desire/arousal disorder/orgasm, pelvic pain and hot flash) and making a manual with references for training health professionals that take care of these women. CONCLUSIONS: This work generated the creation of the “Technical Manual of attention to sexual health in women with breast and gynecological cancer: a guide for health care professional” that describes the bases for diagnosis and treatment of sexual dysfunction, which became the basis of the protocol for attending the sexuality outpatient clinic for women with cancer at the Getúlio Vargas University Hospital/Federal University of Amazonas.