Mary Lou Willard French Professor of Nursing
University of Michigan School of Nursing
Ann Arbor, Michigan
Changes in sexual health and functioning have been reported in over 50 percent of women who have been diagnosed with breast or gynecologic cancer. Declines in sexual health can last well beyond the course of cancer treatment. These issues are unfortunately not a part of standard cancer care in most cases. Many of the changes in self-image and sexual health that women experience as a result of their breast cancer diagnosis or treatment are related to hormone changes. Hormonal changes have broad effects, making finding solutions a complex challenge. Research by Dr. Barton and others has suggested that the severity of vaginal symptoms, fatigue, body image, and partner issues predict overall sexual health. Her current research is addressing all four of those issues. Her team recently completed a large study that provides new knowledge about improving vaginal symptoms of dryness and pain and a feasibility study evaluating a hypnosis intervention for self-image. The hypnosis intervention was received very well by women and the results demonstrate a very strong and positive effect on self-image. In the coming year, Dr. Barton’s team will initiate a larger randomized study to more definitely prove the value of this hypnotic relaxation intervention.
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.