Medical and psychosocial issues in gynecologic cancer survivors

An emerging body of research has documented the quality of life of women with gynecologic cancer around the time of diagnosis and during treatment. However, we know much less about the quality of life and psychosocial and medical needs of gynecologic cancer survivors after treatment.1,2 In particular, there are very few studies documenting the risk of possible late medical effects of gynecologic cancer treatment such as osteoporosis and second primary cancers. More is known about self-reported symptoms and psychosocial sequelae, such as sexual functioning and psychologic distress, but even these studies rarely focus on survivors more than 5 years after diagnosis. Additionally, much of the extant research has limitations such as small sample sizes, nonstandardized measures, and crosssectional designs, often without appropriate comparison groups. Finally, there is a dearth of research testing interventions to ameliorate problems experienced by gynecologic cancer survivors. While in some areas additional research is needed to better describe the sequelae and determine who is at risk for adverse late effects, in others areas (e.g., sexual functioning), adequate data describing the problem are available, and a stronger focus on treatment interventions is needed. (See also Chapter 90, Reproductive Complications and Sexual Dysfunction in the Cancer Patient.)