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National Cervical Cancer Coalition


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PostPosted: Mon Mar 26, 2007 11:05 pm 

Joined: Mon Mar 26, 2007 10:44 pm
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I am a female and only 22 years old. I have been dealing with this for 3 years now. A little over 3 years ago, my gyno diagnosed me with HPV, which caused my genital warts. Not until 2 years later did the warts finally clear. My boyfriend of 4 years has been extremely supportive and patient. Right after I was diagnosed, my sexual desire hasn't only taken a drastic nose dive--but it is DEPLETED. I cannot even remember the last time my boyfriend or myself has been able to peak my arrousal..seriously. Prior to this, I was always a highly sexual person, so I cannot say that I have always been like this. I miss that feeling. I have tried talking to my gyno about this several times, but she tells me that it will soon pass as soon as "I feel like a woman again and get my confidence back." How do I do this??? She has no suggestions. I can't afford to talk to a therapist as I am a graduate student with low funds. Saying that I am DESPERATE for relief is an understatement. My boyfriend is at the end of the rope with this situation, and I can't say that I blame him. PPPPPLLLLLLEEEEEAAAAAASSSSSEEEE HHHHHEEEEELLLLLLLPPPPPPPPPPPP


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PostPosted: Tue Mar 27, 2007 8:49 am 
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Hello Kay,

Thanks for your post and I hope some of the others on the board will offer some insight.

Let me say up front I'm hoping some of the women who post on this board will weigh in with insight for you, as they can certainly provide better guidance than what I'll be able to offer you.

I don't have a great deal of expertise in this area, but it seems as if your doctor isn't approaching your diminished sex drive as a physical problem, referring instead to your "confidence" and the emotional factor. It is clear the psychological impact of HPV is significant for many people, and for some can truly be a major issue. Too often there simply aren't adequate resources at hand to cope, either.

Have you checked with your school to see if they offer counseling for students? When I was in college, for example, my Dad passed away and the counseling services at my school were available at little or no cost to help students like me through tough times. Also, sometimes community-based agencies (city/county health department) will offer counseling, and many counselors work on a sliding-scale basis. Student health should be a good place to start for a referral.

We published an article in our journal, HPV News, about women and coping with gynecologic cancers - most women with HPV don't ever receive a cancer diagnosis, to be sure, and it doesn't sound as if that's exactly what you're dealing with, but you might find the article helpful. I'll put it up as another post.

FYI anyone who is interested, HPV News is published bimonthly, is distributed in pdf format via email, and subscriptions can be purchased for $25 at www.hpvenews.com. Subscriptions support the work of the HPV Resource Center, including this message board!

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PostPosted: Tue Mar 27, 2007 8:55 am 
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Spiritual Coping and Gynecologic Cancers - Interview with Nadia Boscaglia, D.Psych (Clin) Part 1

A diagnosis of HPV and related cervical diseases can be emotionally distressing and often raises awkward questions within a relationship. The psychosocial impact of HPV and gynecologic diseases increasingly is the focus of study as health care providers and policy makers strive to better understand the emotional needs of women who are diagnosed.

One researcher in the field is Nadia Boscaglia, D.Psych (Clin), a Clinical Psychologist at Monash University in Australia who has studied the relationship between spiritual beliefs on anxiety and depression among women with gynecologic cancers (GynCa). A recent paper published by Dr. Boscaglia and colleagues in the International Journal of Gynecologic Cancer found that while numerous factors affect a woman’s emotional state following GynCa diagnosis (younger age and more advanced disease were associated with increased anxiety levels), a woman’s spiritual outlook is also an important variable, as lower levels of generalized spirituality in one’s life were associated with higher levels of depression.

Dr. Boscaglia recently spoke with HPV e-NEWS to provide an overview of her work and explain how spiritual coping can either help or hinder a woman’s psychological adjustment to a GynCa diagnosis.

HPV e-NEWS: What led you to this area of research?

Nadia Boscaglia: When I embarked on a Doctorate in Clinical Psychology at Monash University I knew that I wanted to do research in an area that examined the psychology of people with a serious illness. I came across a supervisor, Associate Professor David Clarke, who shared my interests, and under his guidance the research developed.

My research interest in spirituality and religion and its association with mental health grew out of my interactions with people with serious physical illnesses. It seemed to me that while some people were able to maintain a positive spirit, others became demoralized and bitter. Importantly, whether or not one became demoralized and bitter appeared to be independent of the degree of physical pain and/or disability. Further, I noticed that a frequent comment amongst those who were distressed was, “Why is God punishing me?” From these observations, I became curious about whether an individual’s spirituality served some sort of mental-health protective role in the face of serious illness. Not being particularly religious or spiritual myself, I was also interested in how spirituality might work to protect people’s mental health.

Women often experience a tremendous sense of shame, stigma, and anger following an HPV diagnosis; this must be even more acute for those coping with gynecologic cancers.

Indeed. A diagnosis of gynecologic cancer may bring with it disturbances to body image, feelings of helplessness, guilt, alienation, fear, and a sense of loss of femininity and motherhood. Additionally, the prevalence of psychological distress in women with gynecologic cancer tends to exceed that of the general population. Certainly in our research, 27% of 140 women within one year of diagnosis of gynecologic cancer reported at least mild (if not moderate or severe) symptoms of depression. It should be remembered however, that most women diagnosed with gynecologic cancer do not experience significant depression or anxiety – just as for other sites of cancer, approximately three quarters of patients do not develop a mood or anxiety problem.

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Last edited by Fredo on Tue Mar 27, 2007 9:00 am, edited 1 time in total.

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PostPosted: Tue Mar 27, 2007 8:57 am 
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Spiritual Coping and Gynecologic Cancers - Interview with Nadia Boscaglia, D.Psych (Clin) Part 2

Is there a significant correlation between a spiritual aspect to one's life and better coping skills with GynCa?

The relationship between spirituality and coping strategies is a complex one. The first thing to consider is that, in different situations, different coping strategies will be more (or less) effective. What ‘works’ for a certain individual in one situation need not necessarily be successful for another person, nor for that same person in a different situation. Having said this, in our research, we found that acceptance and humor were the only two coping strategies to be inversely correlated with distress (that is, those who used humor and acceptance to cope were less demoralized, anxious, and depressed). Surprisingly, these correlations were small (r < .25), and bore no correlation with measures of spirituality.

What we did find, however, is that having a sense of spirituality (i.e., beliefs and involvement) contributed to an overall view of the world as meaningful, and in turn, women who tended to view the world as meaningful were less distressed in their first year after diagnosis.

What types of spiritual practice are associated with more positive coping?

In terms of the intercorrelations between ‘secular’ and religious/spiritual coping strategies, women tended to use groups of strategies together, rather than use strategies in isolation. “Negative spiritual coping” (Pargament, 1998) is the act of using one’s religious/spiritual beliefs and attitudes in an unhelpful way when faced with a difficult situation. By unhelpful, I mean contributing to, rather than protecting from, distress. Typically, those who used negative spiritual coping patterns were also more likely to vent their negative emotions, blame themselves for their cancer, use denial, question why God was “punishing” them, or use alcohol or drugs to cope. In contrast, those who used positive spiritual coping strategies (e.g., seeking a sense of connection with a higher being in the fight against cancer) were more likely to ‘look for something good in what is happening.’ In effect, the coping strategies seemed to cluster together as part of one’s overall mindset about the cancer.

What is the message to health care providers?

Given that we found a high rate of depressive symptoms amongst our research participants, there is strong message here to conduct screening for mood disorders in women attending gynecological oncology outpatient clinics. This can be done in a matter of minutes, using a screening questionnaire, or as part of an outpatient consultation with the Oncologist or Gynecologist. Following on from this, there should be clear lines of referral for distressed women who wish to seek psychiatric/psychological treatment.

The outcomes of our research also highlight the relative importance of psychosocial factors, as opposed to medical or disease factors, in the prediction of distress in cancer patients: although physical pain may be relieved or absent, psychological distress and suffering may be present.

Finally, given that we found weak to moderate correlations between negative spiritual/religious coping and distress, this research suggests that health care providers who work with seriously ill women may profit from enquiring about a patient’s spirituality/religion. This is not to suggest that doctors, gynecologists, or psychologists take on the role of spiritual guide! Rather, the simple act of asking a patient whether she has religious/spiritual beliefs can aid the development of the therapeutic alliance, help the health care provider to understand the patient’s perspective, and enhance the patient’s sense that she is being treated in a holistic manner (D’Souza, 2003). Additionally, if required, those who exhibit spiritual/religious distress can be referred to the hospital chaplain (or other appropriate individuals).

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PostPosted: Tue Mar 27, 2007 9:01 am 
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Joined: Wed Oct 04, 2006 4:08 pm
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Location: North Carolina
Spiritual Coping and Gynecologic Cancers - Interview with Nadia Boscaglia, D.Psych (Clin) - Part 3


Would you recommend some coping techniques for our readers?

As I stated earlier, different strategies will work for different people, hence, do whatever works for you. There are however two points that, from both a clinical and research perspective, are worth mentioning.

First, if you do not understand something in a medical consultation, or have concerns about any aspect of treatment, ask for clarification. Research findings indicate that (1) many patients with gynecologic cancer do not understand doctors’ explanations of illness/treatment and are reluctant to ask questions (Andersen, 1996), and (2) that having unresolved cancer-related concerns is associated with emotional distress and a greater likelihood of developing depression (Farrell et al., 2005; Harrison et al., 1994). Having your concerns and worries responded to is extremely important. I often encourage my patients to construct a ‘question list’ for their doctor before a visit, so that all concerns can be addressed (rather remembering them on the way home from the consulting suite).

Second, do not be afraid to try out new methods of coping and stress management. Our state of mind and our bodily workings are exquisitely and intimately interrelated – if you can manage to reduce your distress, you will be better equipped to deal with any illness. Indeed, amongst cancer patients, techniques such as guided imagery and progressive muscle relaxation have been shown across many studies to have small to medium effects on a range of measures including nausea, pain, depression, anxiety, and hostility (Luebbert et al., 2001).

N. Boscaglia et al.
The contribution of spirituality and spiritual coping
to anxiety and depression in women with a recent
diagnosis of gynecological cancer.
International Journal of Gynecological Cancer.
2005; 15:755-61

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