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

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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, Borgstein, Paul J., Heuff, Gijsbert, Lopes Cardozo, Alexander M.F., Plaisier, Peter W., Rijna, Herman, van der Meij, Suzan, van Dulken, Eric J., Vrouenraets, Bart C., Broomans, Eva, Aaronson, Neil K.·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: Oldenburg, Hester S.A.
Hahn, Daniela E.E.
Kieffer, Jacobien M.
Bijker, Nina
Plaisier, Peter W.
Aaronson, Neil K.
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: green
pure.amsterdamumc.nl
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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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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