Leslie R. Schover

Will2Love LLC

The recent NCCN Guidelines for Survivorship recommend systematic evaluation and multidisciplinary treatment of cancer-related sexual dysfunctions. However, most oncology professionals fail to routinely assess sexual problems and lack expertise to treat them. An Internet-based intervention was designed to educate female patients and their partners a...

After treatment for prostate cancer, multidisciplinary sexual rehabilitation involving couples appears more promising than traditional urologic treatment for erectile dysfunction (ED). The authors of this report conducted a randomized trial comparing traditional or internet-based sexual counseling with waitlist (WL) control. Couples were randomized...

African American breast cancer survivors may be at high risk for reproductive health problems, including menopause symptoms, sexual dysfunction, and distress about cancer-related infertility. The authors partnered with Sisters Network Inc. to create the Sisters Peer Counseling in Reproductive Issues After Treatment (SPIRIT) program, a culturally se...

Sexual problems related to cancer are usually caused by physiological damage from treatment but are exacerbated by psychosocial issues such as poor individual coping, relationship conflict, or preexisting sexual dysfunction. Sexual dysfunction affects almost two‐thirds of the estimated 17 million cancer survivors in the United States, including wel...

Sexual dysfunction affects over 60% of cancer survivors. Internet interventions have improved sexual function, but with considerable clinician guidance, restricting scalability. This pragmatic trial evaluated an online, self-help intervention. As with many unguided digital interventions, attrition was high. Given low numbers in other groups, this p...

Background: Sexual concerns are distressing for breast cancer survivors and interfere with their intimate relationships. This study evaluates the efficacy of a four-session couple-based intervention delivered via telephone, called Intimacy Enhancement (IE). The IE intervention is grounded in social cognitive theory and integrates evidence-based te...

Male sexual dysfunction and its association with psychological and physical well-being have been underreported in childhood cancer survivors (CCSs). To our knowledge, this study provides the first data on a large population of systematically and clinically assessed CCSs, enumerating the prevalence and consequences of erectile dysfunction (ED) and i...

BACKGROUND Although survivors of adolescent‐onset cancers are at risk of infertility, the majority desire children. Fertility preservation options are available for adolescents, but sperm banking remains underused. To the authors' knowledge, patient factors that influence decisions to bank sperm are poorly understood. METHODS A cross‐sectional stu...

Objective: To investigate the influence of parental sociodemographic, communication, and psychological factors on sperm collection attempts among at-risk adolescent males newly diagnosed with cancer. Design: Prospective, single group, observational study design. Setting: Pediatric oncology centers. Patient(s): Parents (N = 144) of 122 newly...

Purpose To estimate the prevalence of sperm banking among adolescent males newly diagnosed with cancer and to identify factors associated with banking outcomes. Patients and Methods A prospective, single-group, observational study design was used to test the contribution of sociodemographic, medical, psychological/health belief, communication, and...

PurposeA randomized pilot trial evaluated the hypothesis that early intervention lessens sexual dysfunction in the first year on aromatase inhibitors. A secondary aim was comparing the efficacy of two vaginal moisturizers. Methods Fifty-seven postmenopausal women with early stage breast cancer starting aromatase inhibitors were randomized to three...

Purpose: The purpose of this study was to examine provider communication and sociodemographic factors which associate with sperm banking outcomes in at-risk adolescents newly diagnosed with cancer. Methods: A prospective single-group quasi-experimental study design was used to test the contributions of provider factors on sperm banking outcomes....

Sexual dysfunction is a common and distressing consequence of breast cancer (BC) treatment. In the present study, we investigated the sexual functioning of BC patients and its association with women’s personal characteristics and cancer treatments. In this cross-sectional study, sexual function was assessed using the Female Sexual Function Index (F...

Background: Sexual dysfunction is a frequently reported consequence of rectal/anal cancer treatment for female patients. Purpose: The purpose of this study was to conduct a small randomized controlled trial to assess the efficacy of a telephone-based, four-session Cancer Survivorship Intervention-Sexual Health (CSI-SH). Methods: Participants (...

Since prostate cancer becomes more common with age, at least one-third of men have sexual problems at diagnosis. All localized treatments for prostate cancer greatly increase the prevalence of sexual dysfunction, which include loss of desire, erectile dysfunction, and changes in orgasm. Even men on active surveillance have a higher rate of problems...

The diagnosis and treatment of prostate cancer is followed by substantive sexual morbidity. The optimal approach for intervening remains unclear. A three-arm randomised control trial was undertaken with 189 heterosexual couples where the man had been diagnosed with prostate cancer and treated surgically. The efficacy of peer-delivered telephone sup...

Introduction/Objectives: Research demonstrates that after a breast cancer diagnosis, young women, especially those of racial and ethnic groups, may experience a more negative impact on their quality of life, emotional functioning, and reproductive health than older women. For women under the age of 45, African American women have the highest breast...

Introduction: Sexual dysfunction has only recently been recognized as a highly prevalent side effect of adjuvant aromatase inhibitor (AI) therapy for breast cancer. Aims: A cross-sectional survey using standardized measures of female sexual function was designed to provide a detailed view of sexual problems during the first 2 years of adjuvant AI t...

Purpose Infertility is a frequent consequence of cancer therapy and is often associated with psychological distress. Although adult survivors prioritize fertility and parenthood, this issue remains unexplored among adolescent males. This study examined future fertility as a priority (relative to other life goals) at time of diagnosis for at-risk a...

Premature ovarian failure is a major risk factor for sexual dysfunction in women who receive treatment for premenopausal breast cancer. Women should be counseled on prevention of vulvovaginal dryness and atrophy when chemotherapy is initiated.

Background: Women with premenopausal breast cancer may face treatment-related infertility and have a higher likelihood of a BRCA mutation, which may affect their attitudes toward future childbearing. Methods: Premenopausal women were invited to participate in a questionnaire study administered before and after BRCA genetic testing. We used the I...

Sexual dysfunction is a common consequence of cancer treatment, affecting at least half of men and women treated for pelvic malignancies and over a quarter of people with other types of cancer. Problems are usually linked to damage to nerves, blood vessels, and hormones that underlie normal sexual function. Sexual dysfunction also may be associated...

Background: Pregnancy-associated early breast cancer (PAEBC) has increased in incidence as more women pursue childbearing at an older age. The objective of this study was to measure the impact of diagnosis and treatment on emotional health and evaluate the positive emotional outcomes in a group of women with PAEBC. Methods: Between 1989 and 2010, 8...

Significantly elevated rates of cervical cancer and low rates of Papanicolaou (Pap) smear screening have been documented among HIV-infected women. However, little is known about women's perceptions of cervical cancer screening utilization. Hence, this study describes barriers and facilitators related to cervical cancer screening in a sample of HIV-...

Given their early age at diagnosis, young breast cancer survivors (YBCSs) face issues that differ widely from their older counterparts. We mailed a survey to 2209 patients who were ≤ 45 years at the time of breast cancer (BC) diagnosis. Each survey was composed of the Quality of Life in Adult Cancer Survivors instrument, Menopause Symptom Scale, an...

Preimplantation genetic diagnosis (PGD) allows couples to avoid having a child with an inherited condition, potentially reducing cancer burden in families with a hereditary cancer predisposition. This study investigated and compared awareness and acceptance of PGD among patients with different hereditary cancer syndromes. Questionnaires were mailed...

Needs assessments are essential to developing lifestyle interventions for minority populations. To our knowledge, no physical activity (PA) needs assessment studies have been conducted for African-American (AA) breast cancer survivors. The purpose of this study was to determine the PA intervention preferences of AA breast cancer survivors and deter...

Many breast cancer survivors report a loss of sexual desire and arousability, consonant with the new DSM-V category of female sexual interest/arousal disorder. The cause of decreased sexual desire and pleasure after treatment for cancer is unknown. One possibility is that cancer, or treatment for cancer, damages brain circuits that are involved in...

In an effort to address reports from men that their sex life is worse after treatment for rectal cancer, this qualitative study was designed to better understand their experience with sexual dysfunction following rectal cancer treatment, thus providing information on the adaptation of a psycho-educational sexual health intervention for male rectal...

Background: The experience of the diagnosis of prostate cancer is distressing for both men and their partners. The present study describes the prevalence of psychological distress in men with prostate cancer and their partners, and the predictors of adjustment outcomes. Methods/design: A cross-sectional survey of 189 prostate cancer patients who...

Background: Uncontrolled studies show fatigue, anorexia, depression, and mortality are associated with low testosterone in men with cancer. Testosterone replacement improves quality of life and diminishes fatigue in patients with non-cancer conditions. The primary objective was to evaluate the effect of testosterone replacement on fatigue in hypog...

Introduction Sexual dysfunction represents a complex and multifactorial construct that can affect both men and women and has been noted to often deteriorate significantly after treatment for rectal and anal cancer. Despite this, it remains an understudied, underreported, and undertreated issue in the field of cancer survivorship. Aim This study ex...

Purpose: Colorectal cancer patients usually receive treatments (e.g., pelvic surgery or radiotherapy, colostomy) that increase their risk for sexual problems. Previous research has mainly focused on demographic and medical risk factors. Because little is known about the role of psychosocial variables in sexual dysfunction, this research sought to...

Thirty-three African American breast cancer survivors age 45 or younger participated in semistructured phone interviews about psychosocial concerns. Twenty-six percent believed treatment interfered with employment. One third wanted additional emotional support at and after diagnosis. One half felt cancer negatively influenced romantic relationships...

s: Thirty-Fourth Annual CTRC‐AACR San Antonio Breast Cancer Symposium‐‐ Dec 6‐10, 2011; San Antonio, TX Background: Breast cancer is associated with treatment-related infertility and has been demonstrated to be a major concern for premenopausal survivors. Detection of a BRCA deleterious mutation may also affect attitudes regarding future childbear...

To understand the influence of cancer-related infertility on women's long-term distress and quality of life. Women diagnosed at age 40 or less with invasive cervical cancer, breast cancer, Hodgkin disease, or non-Hodgkin lymphoma were interviewed an average of 10 years later. We predicted that women whose desire for a child at diagnosis remained un...

Background: The present study assessed the feasibility of delivering peer support for couples coping with prostate cancer within a trial design. Methods/design: Ten peer volunteers completed training in research protocols and delivering tele-based couples support to men with prostate cancer and their partners. Twenty couples received an eight se...

BACKGROUND:African American breast cancer survivors may be at high risk for reproductive health problems, including menopause symptoms, sexual dysfunction, and distress about cancer-related infertility. The authors partnered with Sisters Network Inc. to create the Sisters Peer Counseling in Reproductive Issues After Treatment (SPIRIT) program, a cu...

9045 Background: Approximately 25% of women diagnosed with breast cancer are age 50 years (yrs) or younger. Studies have shown that, in comparison to older patients, the diagnosis and treatment of breast cancer has greater impact on mental health, social functioning, and psychological well-being in younger women. Methods: Utilizing the Breast Cance...

With the population of cancer survivors nearing 12 million, an ever-increasing number of women will face vaginal health issues related to their disease and/or treatment. Abrupt menopause triggered by cancer treatment, for example, can cause intense and prolonged estrogen deprivation symptoms, including vaginal dryness and discomfort. Simple strateg...

There are many data on sexual problems subsequent to cancer and its treatment, although the likelihood of problems in specific individuals depends on multiple variables. To gain knowledge about the risks of sexual problems among persons with cancer and to provide recommendations concerning their prevention and optimal treatment. A committee of mult...

Hematopoietic stem-cell transplantation (HSCT) is associated with high rates of gonadal failure, which is distressing for younger patients desiring to start a family. The perceived importance and optimal timing of discussing fertility- and menopause-related information with women undergoing aggressive treatment such as HSCT is not well defined. Que...

Sexual function in male lymphoma survivors was examined and compared with that of age-matched controls. This cross-sectional study included serum gonadal hormone levels (testosterone, sex hormone-binding globulin, luteinizing hormone [LH], and follicle-stimulating hormone) and responses to questionnaires assessing sexual function (Brief Sexual Func...

We conducted pilot studies of the feasibility and efficacy of an interactive, computerized educational tool, Banking on Fatherhood (BOF). Two small randomized trials were conducted, with 20 male cancer patients eligible to bank sperm in Study 1 and 19 oncology fellows or residents in Study 2. In each trial, half of the subjects viewed BOF before co...

The increased survival rates for pediatric cancer patients and for some malignancies that are common in young adults, such as testicular cancer and Hodgkin disease have led to an increased focus on preserving fertility. Research on the psychosocial aspects of cancer-related infertility is a recent development, but we know that both young men and wo...

9510 Background: Sexual function in male lymphoma survivors (LS) was examined and compared to age-matched controls from the general population (CTR). Methods: The study includes 294 LSs, diagnosed 1980–2002, treated at the Norwegian Radium Hospital, ≤50 years at diagnosis, with recent gonadal hormone levels [testosterone (T), SHBG, LH, and FSH]. Se...

2Associate Professor and Chairman, Department of Urology, The University of Texas System Cancer Center, M.D. Anderson Hospital and Tumor, Institute, Houston, Texas

Lung cancer morbidity and mortality may increase the risk for distress in couples facing this malignancy. We examined the prevalence of psychological and relationship distress in lung cancer patients and their spouses, predictors of psychological distress for both, and whether relationship satisfaction moderated the relation between patient and spo...

Reproductive health problems, including sexual dysfunction and impaired fertility, are distressing and persistent after cancer treatment. However, recent reports suggest that reproductive health remains neglected in oncology settings. We conducted a survey to ascertain the prevalence of reproductive health problems in men and women treated in a com...

TheidentificationoftheBRCA1andBRCA2genemutationswas amilestoneinthefighttoeradicatebreastcancer.Wehopedwewould soonbeabletopreventnotonlyhereditarybreastandovariancancers (HBOC), but sporadic tumors as well. In this struggle, unfortunately, victories are rarely as sweeping as they first appear. It has been more than 10 years since genetic tests for...

The 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp) is a popular measure of the religious/spiritual (R/S) components of quality of life (QoL) in patients with cancer. The original factor analyses of the FACIT-Sp supported two factors: Meaning/Peace and Faith. Because Meaning suggests a cognitive aspect...

To contrast the limited evidence that androgen therapy is an effective treatment for low sexual desire in women with the extensive literature suggesting that androgens promote breast cancer. Evidence from population studies of women is reviewed on the association between endogenous androgen levels and sexual function or satisfaction. Recent randomi...

Premature ovarian failure is a common consequence of systemic treatment for premenopausal breast cancer. Vasomotor symptoms and sexual dysfunction occur frequently in women who have an abrupt menopause from chemotherapy or ovarian suppression. However, current fertility may be impaired even in women who are menstruating after chemotherapy, and surv...

Many cancer treatments induce gonadal failure, which can cause infertility and menopausal symptoms in women. Improvements in treatments for hematologic malignancies have extended survival, thus making treatment-induced gonadal failure (TIGF) a more widespread problem. We reviewed the published literature on TIGF with the goal of providing practical...

Prostate cancer is the most common male cancer in the Western world. The most substantial long term morbidity from this cancer is sexual dysfunction with consequent adverse changes in couple and intimate relationships. Research to date has not identified an effective way to improve sexual and psychosocial adjustment for both men with prostate cance...

Evidence suggests that cancer diagnosed during adolescence and young adulthood may present considerable challenges to what would otherwise be a relatively smooth developmental trajectory, particularly in areas related to reproductive health. We created and pilot tested a two-session, individually-delivered, counseling intervention to enhance psycho...

The objective of this study was to determine whether hypogonadism and autonomic dysfunction contribute substantially to cancer-related fatigue, decreased sexual desire, and depression in male patients with advanced, incurable cancer. Forty-eight patients who had received no major antineoplastic intervention for at least 2 weeks were tested for auto...

A woman's ability to become pregnant, carry the pregnancy successfully, and give birth to a healthy child are all paradoxi- cally threatened by many of the cancer treatments that enable girls to survive to adulthood. Like Hurricane Katrina, pediatric cancer is a tempest that leaves a concealing fl ood of acute treat- ment effects in its wake. Chron...

Our goal was to identify the treatment, personal, interpersonal, and hormonal (testosterone) factors in breast cancer survivors (BCSs) that determine sexual dysfunction. The treatment variables studied were type of surgery, chemotherapy, radiation, and tamoxifen. The personal, interpersonal, and physiologic factors were depression, body image, age,...

Research has suggested that sexual relationships between psychology educators and their students often have adverse consequences. Therefore, ethical guidelines setting limits on such relationships are proposed. Coping strategies are offered for students who experience sexual harassment from educators. The task of the administrator in handling compl...

To develop guidance to practicing oncologists about available fertility preservation methods and related issues in people treated for cancer. An expert panel and a writing committee were formed. The questions to be addressed by the guideline were determined, and a systematic review of the literature from 1987 to 2005 was performed, and included a s...

We designed a peer counseling program to improve sexual function, increase knowledge about reproductive health, and decrease menopausal symptoms and infertility-related distress for African American breast cancer survivors. Women were randomly assigned to immediate counseling or a 3-month waitlist. Three peer counselors conducted a 3-session interv...

The majority of prostate carcinoma survivors experience enduring sexual difficulties and associated distress in the years after definitive treatment. A counseling intervention aimed at improving levels of sexual satisfaction and increasing successful utilization of medical treatment for erectile dysfunction (ED) was developed and pilot-tested for b...

Behavioral scientists use health behavior theories to assess beliefs, feelings, and coping styles that predict cancer screening, choice of cancer treatments, or postcancer quality of life. However, research testing these theories is typically based on middle-class, White populations. Research needs to be culturally appropriate and relevant for mino...

This chapter will review risk factors and management for three types of reproductive complications of cancer treatment: infertility, menopausal symptoms, and sexual dysfunction. Each problem area affects unique, albeit overlapping, populations of cancer patients and survivors.

To compare quality of life and sexual functioning in cervical cancer survivors treated with either radical hysterectomy and lymph node dissection or radiotherapy. Women were interviewed at least 5 years after initial treatment for cervical cancer. Eligible women had squamous cell tumors smaller than 6 cm at diagnosis, were currently disease-free, a...

As more people achieve long-term survival after cancer, sexual dysfunction and infertility have increasingly been recognized as negative consequences that impact quality of life. Sexual dysfunction is a frequent long-term side effect of cancer treatment, but damage to different underlying physiological systems is salient in men versus women. Men fr...

Although research on cancer survivors' experiences and attitudes about infertility is relatively new, existing literature suggests that only about half of men and women of childbearing age receive the information they need from their health care providers at the time of diagnosis and treatment planning. Thus, better patient education strategies are...

Prostate cancer survivors appear to have higher rates of seeking medical help for erectile dysfunction (ED) than other cohorts of sexually dysfunctional men; however, factors associated with help-seeking for ED after prostate cancer have not been investigated. A group of 1,188 men with ED after prostate cancer responded to a postal survey about the...