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Cited by 162Sexual function and dysfunction studiesCancer survivorship and careDigital Mental Health Interventions

Efficacy of internet-based cognitive behavioral therapy in improving sexual functioning of breast cancer survivors: results of a randomized controlled trial

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Hummel, Susanna B., van Lankveld, Jacques J.D.M., Oldenburg, Hester S.A., Hahn, Daniela E.E., Kieffer, Jacobien M., Gerritsma, Miranda A., Kuenen, Marianne A., Bijker, Nina +10 more·2017·Journal of Clinical Oncology
DOI 10.1200/jco.2016.69.6021
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Abstract

Purpose We evaluated the effect of Internet-based cognitive behavioral therapy (CBT) on sexual functioning and relationship intimacy (primary outcomes) and body image, menopausal symptoms, marital functioning, psychological distress, and health-related quality of life (secondary outcomes) in breast cancer survivors (BCSs) with a DSM-IV diagnosis of a sexual dysfunction. Patients and Methods We randomly assigned 169 BCSs to either Internet-based CBT or a waiting-list control group. The CBT consisted of weekly therapist-guided sessions, with a maximum duration of 24 weeks. Self-report questionnaires were completed by the intervention group at baseline (T0), midtherapy (T1), and post-therapy (T2) and at equivalent times by the control group. We used a mixed-effect modeling approach to compare the groups over time. Results Compared with the control group, the intervention group showed a significant improvement over time in overall sexual functioning (effect size for T2 [EST2] = .43; P = .031), which was reflected in an increase in sexual desire (EST1 = .48 and EST2 = .72; P < .001), sexual arousal (EST2 = .50; P = .008), and vaginal lubrication (EST2 = .46; P = .013). The intervention group reported more improvement over time in sexual pleasure (EST1 = .32 and EST2 = .62; P = .001), less discomfort during sex (EST1 = .49 and EST2 = .66; P = .001), and less sexual distress (EST2 = .59; P = .002) compared with the control group. The intervention group reported greater improvement in body image (EST2 = .45; P = .009) and fewer menopausal symptoms (EST1 = .39; P = .007) than the control group. No significant effects were observed for orgasmic function, sexual satisfaction, intercourse frequency, relationship intimacy, marital functioning, psychological distress, or health-related quality of life. Conclusion Internet-based CBT has salutary effects on sexual functioning, body image, and menopausal symptoms in BCSs with a sexual dysfunction.

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Authors
Hummel, S. B., van Lankveld, J. J. D. M., Oldenburg, H. S. A., Hahn, D. E. E., Kieffer, J. M., Gerritsma, M. A., Kuenen, M. A., Bijker, N., Borgstein, P. J., Heuff, G., Lopes Cardozo, A. M. F., Plaisier, P. W., Rijna, H., van der Meij, S., van Dulken, E. J., Vrouenraets, B. C., Broomans, E., & Aaronson, N. K.
Affiliations
  • The Netherlands Cancer Institute (NL)
  • Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F....
ORCID
Venue
Journal of Clinical Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2017-04-20
Volume
35
Issue
12
Pages
1328-1340
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
DOI
10.1200/jco.2016.69.6021
OpenAlex
W2593084949
Cited by
162
References
69
Citations by year
2026: 13 · 2025: 16 · 2024: 26 · 2023: 22 · 2022: 26 · 2021: 16 · 2020: 11 · 2019: 10 · 2018: 14 · 2017: 8
FWCI
9.65
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Journal of Clinical Oncology (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • DSpace (Open University in the Netherlands) (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • UvA-DARE (University of Amsterdam) (submittedVersion)
  • DSpace (Open University in the Netherlands) (submittedVersion, other-oa)
Funders
Pink Ribbon Foundation
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
internet-based cognitive behavioral therapy, breast cancer survivors, sexual dysfunction, sexual function, body image, menopausal symptoms, sexual desire, sexual arousal, vaginal lubrication, sexual distress, relationship intimacy, marital functioning, psychological distress, health-related quality of life
MeSH terms
Breast Neoplasms, Female, Humans, Middle Aged, Sexual Behavior, Sexual Dysfunction, Physiological, Therapy, Computer-Assisted, Waiting Lists, Cognitive Behavioral Therapy, Survivors, Internet, Self Report

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