Contemporary insights into rehabilitation of cervical cancer patients
D. V. Blinov,
A. G. Solopova,
E. E. Achkasov,
D. I. Korabelnikov,
S. A. Akavova,
V. N. Galkin,
Ph. V. Nenakhov,
G. K. Bykovshchenko,
D. A. Petrenko https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.426
Abstract
Cancer prevalence particularly for cervical cancer (CC) has been steadily increasing tending to rise among young women. Vigorous antitumor treatment approaches employed in CC management have detrimental effects on various aspects of a woman's life. In addition to causing morphofunctional alterations in diverse host organs and systems, such treatment protocols result in psychological and emotional disturbances, sexual dysfunction, and social maladjustment, which collectively profoundly reduce the quality of life (QoL). Integrating timely rehabilitation programs into comprehensive care of such patients can effectively alleviate or minimize complications related to antitumor treatment, improve QoL, and restore a woman's desire for satisfying sexual and social engagement.
About the Authors
D. V. Blinov
Sechenov University; Institute for Preventive and Social Medicine; Moscow Haass Medical – Social Institute
Russian Federation
Russian Federation
Dmitry V. Blinov – MD, PhD, MBA, Assistant, Department of Sports Medicine and Medical Rehabilitation, Sklifosovsky Institute of Clinical Medicine; Head of Medical and Scientific Affairs; Associate Professor, Department of Sports, Physical and Rehabilitation Medicine
Scopus Author ID: 6701744871. Researcher ID: E-8906-2017. RSCI: 9779-8290.
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991;
4–10 Sadovaya-Triumfalnaya Str., Moscow 127006;
5 bldg. 1–1a, 2-ya Brestskaya Str., Moscow 123056
A. G. Solopova
Sechenov University
Russian Federation
Russian Federation
Antonina G. Solopova – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health
Scopus Author ID: 6505479504. Researcher ID: Q-1385-2015.
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991
E. E. Achkasov
Sechenov University
Russian Federation
Russian Federation
Evgeniy E. Achkasov – MD, Dr Sci Med, Professor, Head of the Department of Sports Medicine and Rehabilitation, Sklifosovsky Institute of Clinical Medicine, Director of the Clinic for Medical Rehabilitation
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991
D. I. Korabelnikov
Moscow Haass Medical – Social Institute
Russian Federation
Russian Federation
Daniil I. Korabelnikov – MD, PhD, Professor, Department of Internal Medicine with Courses in Family Medicine, Functional Diagnostics, Infectious Diseases, Rector
5 bldg. 1–1a, 2-ya Brestskaya Str., Moscow 123056
S. A. Akavova
City Clinical Oncological Hospital No. 1, Moscow Healthcare Department
Russian Federation
Russian Federation
Saida A. Akavova – MD, Oncologist, Head of Outpatient Care Center
18A bldg. 7, Zagorodnoe Shosse, Moscow 117152
V. N. Galkin
City Clinical Oncological Hospital No. 1, Moscow Healthcare Department
Russian Federation
Russian Federation
Vsevolod N. Galkin – MD, Dr Sci Med, Professor, Chief Physician
18A bldg. 7, Zagorodnoe Shosse, Moscow 117152
Ph. V. Nenakhov
Central Clinical Hospital of the Presidential Administration of the Russian Federation; European Medical Center JSC
Russian Federation
Russian Federation
Philipp V. Nenakhov – MD, Obstetrician-Gynecologist, Surgeon; Oncologist
15 bldg. 4, Marshal Timoshenko Str., Moscow 121359;
35 Shchepkina Str., Moscow 129090
G. K. Bykovshchenko
Sechenov University
Russian Federation
Russian Federation
Georgy K. Bykovshchenko – 6th year Student
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991
D. A. Petrenko
Sechenov University
Russian Federation
Russian Federation
Daria A. Petrenko – MD, Clinical Resident, Department of Clinical Pharmacology and Propaedeutics of Internal Diseases
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991
References
1. Sung H., Ferlay J., Siegel R.L. et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. https://doi.org/10.3322/caac.21660.
2. Soerjomataram I., Bray F. Planning for tomorrow: global cancer incidence and the role of prevention 2020-2070. Nat Rev Clin Oncol. 2021;18(10):663–72. https://doi.org/10.1038/s41571-021-00514-z.
3. Oncological care for the population of Russian Federation in 2021. Eds. A.D. Kaprin, V.V. Starinsky, A.O. Shahzadova. [Costoyanie onkologicheskoj pomoshchi naseleniyu Rossii v 2021 godu. Pod red. A.D. Kaprina, V.V. Starinskogo, A.O. Shahzadovoj]. Moscow: MNIOI im. P.A. Gercena – filial FGBU «NMIC radiologii» Minzdrava Rossii, 2022. 239 p. (In Russ.).
4. Clinical guidelines. Cervical cancer. [Klinicheskie rekomendacii. Rak shejki matki]. Moscow: Ministerstvo zdravoohraneniya Rossijskoj Federacii, 2020. 48 p. (In Russ.). Available at: https://oncology.ru/specialist/treatment/references/actual/537.pdf. [Accessed: 10.05.2023].
5. Khokhlova S.V., Kolomiets L.A., Kravets O.A. et al. Practical recommendations for the treatment of malignant tumors. [Prakticheskie rekomendacii po lekarstvennomu lecheniyu raka shejki matki]. Zlokachestvennye opuholi. 2021;11(3s2–1):197–217. (In Russ.). https://doi.org/10.18027/2224-5057-2021-11-3s2-13.
6. Solopova A.E., Ukraintsev N.I., Rubtsova N.A. Magnetic resonance imaging in the initial staging of cervical cancer: updating the 2021 ESUR guidelines. [Magnitnorezonansnaya tomografiya v pervichnom stadirovanii i monitoringe raka shejki matki: obnovlenie rekomendacij ESUR (2021)]. Akusherstvo i ginekologiya. 2022;(8):36–46. (In Russ.). https://doi.org/10.18565/aig.2022.8.36-46.
7. Bhatla N., Tomar S., Meena J. et al. Adjuvant treatment in cervical, vaginal and vulvar cancer. Best Pract Res Clin Obstet Gynaecol. 2022;78:36–51. https://doi.org/10.1016/j.bpobgyn.2021.07.005.
8. Corte L.D., Barra F., Foreste V. et al. Advances in paclitaxel combinations for treating cervical cancer. Expert Opin Pharmacother. 2020;21(6):663–77. https://doi.org/10.1080/14656566.2020.1724284.
9. Seland M., Skrede K., Lindemann K. et al. Distress, problems and unmet rehabilitation needs after treatment for gynecological cancer. Acta Obstet Gynecol Scand. 2022;101(3):313–22. https://doi.org/10.1111/aogs.14310.
10. Blinov D.V., Solopova A.G., Plutnitskiy A.N. et al. Strengthening health care to provide rehabilitation services for women with cancer diseases of the reproductive system. [Organizaciya zdravoohraneniya v sfere reabilitacii pacientok s onkologicheskimi zabolevaniyami reproduktivnoj sistemy]. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2022;15(1):119–30. (In Russ.). https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.132.
11. Lev-Sagie A. Vulvar and vaginal atrophy: physiology, clinical presentation, and treatment considerations. Clin Obstet Gynecol. 2015;58(3):476–91. https://doi.org/10.1097/GRF.0000000000000126.
12. Nappi R.E., Palacios S., Panay N. et al. Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey. Climacteric. 2016;19(2):188–97. https://doi.org/10.3109/13697137.2015.1107039.
13. Krychman M., Graham S., Bernick B. et al. The Women's EMPOWER Survey: women's knowledge and awareness of treatment options for vulvar and vaginal atrophy remains inadequate. J Sex Med. 2017;14(3):425–33. https://doi.org/10.1016/j.jsxm.2017.01.011.
14. Zhang J., Ju X., Feng Z. et al. Progressive resistance exercise training to prevent lower-limb lymphedema after cervical cancer surgery: A feasibility study. Asia Pac J Oncol Nurs. 2021;9(1):32–8. https://doi.org/10.1016/j.apjon.2021.12.002.
15. Pieterse Q.D., Kenter G.G., Maas C.P. et al. Self-reported sexual, bowel and bladder function in cervical cancer patients following different treatment modalities: longitudinal prospective cohort study. Int J Gynecol Cancer. 2013;23(9):1717–25. https://doi.org/10.1097/IGC.0b013e3182a80a65.
16. Bona A.F., Ferreira K.R., de Moura Carvalho R.B. et al. Incidence, prevalence, and factors associated with lymphedema after treatment for cervical cancer: a systematic review. Int J Gynecol Cancer. 2020;30(11):1697–704. https://doi.org/10.1136/ijgc-2020-001682.
17. Hu H., Fu M., Huang X. et al. Risk factors for lower extremity lymphedema after cervical cancer treatment: a systematic review and meta-analysis. Transl Cancer Res. 2022;11(6):1713–21. https://doi.org/10.21037/tcr-22-1256.
18. Barker C.L., Routledge J.A., Farnell D.J. et al. The impact of radiotherapy late effects on quality of life in gynaecological cancer patients. Br J Cancer. 2009;100(10):1558–65. https://doi.org/10.1038/sj.bjc.6605050.
19. Ji J., Zhu H., Zhao J.Z. et al. Negative emotions and their management in Chinese convalescent cervical cancer patients: a qualitative study. J Int Med Res. 2020;48(9):300060520948758. https://doi.org/10.1177/0300060520948758.
20. Mantegna G., Petrillo M., Fuoco G. et al. Long-term prospective longitudinal evaluation of emotional distress and quality of life in cervical cancer patients who remained disease-free 2-years from diagnosis. BMC Cancer. 2013;13:127. https://doi.org/10.1186/1471-2407-13-127.
21. Park S.Y., Bae D.S., Nam J.H. et al. Quality of life and sexual problems in disease-free survivors of cervical cancer compared with the general population. Cancer. 2007;110(12):2716–25. https://doi.org/10.1002/cncr.23094.
22. Bjelic-Radisic V., Jensen P.T., Vlasic K.K. et al. Quality of life characteristics inpatients with cervical cancer. Eur J Cancer. 2012;48(16):3009–18. https://doi.org/10.1016/j.ejca.2012.05.011.
23. Froeding L.P., Ottosen C., Rung-Hansen H. et al. Sexual functioning and vaginal changes after radical vaginal trachelectomy in early stage cervical cancer patients: a longitudinal study. J Sex Med. 2014;11(2):595–604. https://doi.org/10.1111/jsm.12399.
24. Wiegel M., Meston C., Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005;31(1):1–20. https://doi.org/10.1080/00926230590475206.
25. Solopova A.E., Dudina A.N., Bychenko V.G., Rubtsova N.A. Ovarian malignancy risk stratification. The integration of MRI into O-RADS. [Stratifikaciya riskov zlokachestvennosti obrazovanij yaichnikov. Integraciya MRT v sistemu Q-RADS]. Akusherstvo i ginekologiya. 2020;(9):28–37. (In Russ.). https://doi.org/10.18565/aig.2020.9.28-37.
26. Solopova A.E., Dadak C., Makatsaria A.D. et al. Imaging modalities in ovarian cancer: role in patients management. REJR. 2018;8(3):30–47. https://doi.org/10.21569/2222-7415-2018-8-3-30-47.
27. Liu Z., Shi H. Prognostic role of squamous cell carcinoma antigen in cervical cancer: A meta-analysis. Dis Markers. 2019;2019:6710352. https://doi.org/10.1155/2019/6710352.
28. Prilepskaya V.N. HPV-associated cervical diseases: screening, methods of examination, principles of treatment. [VPCh-associirovannye zabolevaniya shejki matki: skrining, metody obsledovaniya, principy lecheniya]. Ginekologiya. 2019;21(3):6–8. (In Russ.). https://doi.org/10.26442/20795696.2019.3.190595.
29. Begovich E., Solopova A.G., Khlopkova S.V. et al. Possibilities and prospects of epigenetic rehabilitation in patients with external form of genital endometriosis. [Vozmozhnosti i perspektivy epigeneticheskoj reabilitacii u pacientok s naruzhnoj formoj genital'nogo endometrioza]. Vrach. 2022;33(5):5–8. (In Russ.). https://doi.org/10.29296/25877305-2022-05-01.
30. Li M., Tian Q. Risk factors for postoperative pelvic floor dysfunction in patients with cervical cancer: evidences for management strategies. Transl Cancer Res. 2021;10(10):4338–46. https://doi.org/10.21037/tcr-21-365.
31. Kizer N.T., Thaker P.H., Gao F. et al. The effects of body mass index on complications and survival outcomes in patients with cervical carcinoma undergoing curative chemoradiation therapy. Cancer. 2011;117(5):948–56. https://doi.org/10.1002/cncr.25544.
32. Schlumbrecht M.P., Sun C.C., Huang M.S. et al. Lifestyle modification in cervical cancer survivors: an ongoing need. Int J Gynecol Cancer. 2014;24(3):570–5. https://doi.org/10.1097/IGC.0000000000000081.
33. Wang S., Wen H., Gao Y. et al. Assessment of pelvic floor function and quality of life in patients treated for cervical cancer: A multicenter retrospective study. Gynecol Obstet Invest. 2021;86(4):353–60. https://doi.org/10.1159/000517995.
34. Li X., Liu L., He J. et al. Analysis of the effectiveness of the application of pelvic floor rehabilitation exercise and the factors influencing its self-efficacy in postoperative patients with cervical cancer. Front Oncol. 2023;13:1118794. https://doi.org/10.3389/fonc.2023.1118794.
35. Li H., Zhou C.K., Song J. et al. Curative efficacy of low frequency electrical stimulation in preventing urinary retention after cervical cancer operation. World J Surg Oncol. 2019;17(1):141. https://doi.org/10.1186/s12957-019-1689-2.
36. Cullen K., Fergus K., DasGupta T. et al. Toward clinical care guidelines for supporting rehabilitative vaginal dilator use with women recovering from cervical cancer. Support Care Cancer. 2013;21(7):1911–7. https://doi.org/10.1007/s00520-013-1726-6.
37. Sacomori C., Araya-Castro P., Diaz-Guerrero P. et al. Pre-rehabilitation of the pelvic floor before radiation therapy for cervical cancer: a pilot study. Int Urogynecol J. 2020;31(11):2411–8. https://doi.org/10.1007/s00192-020-04391-5.
38. Huang Y.C., Chang K.V. Kegel Exercises. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023.
39. Vlasina A.Yu., Solopova A.G., Ivanova E.A., Blbulyan T.A. Anticancer diet, or principles of rational nutrition in gynecological cancer patients during rehabilitation. [«Protivorakovaya dieta», ili principy racional'nogo pitaniya onkoginekologicheskih bol'nyh v period reabilitacii]. Vrach. 2020;(4):3–7. (In Russ.). https://doi.org/10.29296/25877305-2020-04-01.
40. Wu X., Liu Y., Zhu D. et al. Early prevention of complex decongestive therapy and rehabilitation exercise for prevention of lower extremity lymphedema after operation of gynecologic cancer. Asian J Surg. 2021;44(1):111–5. https://doi.org/10.1016/j.asjsur.2020.03.022.
41. Cross D., Waheed N., Krake M., Gahreman D. Effectiveness of supervised Kegel exercises using bio-feedback versus unsupervised Kegel exercises on stress urinary incontinence: a quasi-experimental study. Int Urogynecol J. 2023;34(4):913–20. https://doi.org/10.1007/s00192-022-05281-8.
42. Solopova A.G., Blinov D.V., Begovich E. et al. Neurological disorders after hysterectomy: from pathogenesis to clinical manifestations. [Nevrologicheskie rasstrojstva posle gisterektomii: ot patogeneza k klinike]. Epilepsiya i paroksizmal'nye sostoyaniya. 2022;14(1):54–64. (In Russ.). https://doi.org/10.17749/2077-8333/epi.par.con.2022.115.
43. Shi Y., Cai J., Wu Z. et al. Effects of a nurse-led positive psychology intervention on sexual function, depression and subjective well-being in postoperative patients with early-stage cervical cancer: A randomized controlled trial. Int J Nurs Stud. 2020;111:103768. https://doi.org/10.1016/j.ijnurstu.2020.103768.
44. Makatsariya A.D., Blinov D.V., Bitsadze V.O., Khizroeva J.K. Treatment of postmenopausal vulvovaginal atrophy with estriol: a scientific update for 2014–2018. [Lechenie estriolom vul'vovaginal'noj atrofii v postmenopauze: obnovlenie nauchnyh dannyh 2014–2018 gg]. Obstetrics, Gynecology and Reproduction. 2019;13(3):227–38. (In Russ.). https://doi.org/10.17749/2313-7347.2019.13.227-238.
45. Solopova A.G., Blinov D.V., Demyanov S.V. et al. Epigenetic aspects in rehabilitation of female cancer patients. [Epigeneticheskie aspekty reabilitacii onkoginekologicheskih bol'nyh]. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2022;15(2):294–303. (In Russ.). https://doi.org/10.17749/2070-4909/farmakoekonomika.2022.141.
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Blinov D.V., Solopova A.G., Achkasov E.E., Korabelnikov D.I., Akavova S.A., Galkin V.N., Nenakhov P.V., Bykovshchenko G.K., Petrenko D.A. Contemporary insights into rehabilitation of cervical cancer patients. Obstetrics, Gynecology and Reproduction. 2023;17(3):343-356. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.426
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