***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Cancer diagnosis affects the psychological well-being of both patients and their partners , and effective coping has been suggested to be a conjoint process of mutual support . Ninety-four married women with early stage cancer and their partners were r and omly assigned to couples-based coping training ( CanCOPE ) , individual coping training for the woman , or a medical education control . Couples ' observed support communication and self-reported psychological distress , coping effort , and sexual adjustment were assessed at diagnosis , after cancer surgery , and at 6- and 12-month follow-ups . CanCOPE produced significant improvements in couples ' supportive communication , reduced psychological distress and coping effort , and improved sexual adjustment . Training in couples rather than individual coping was more effective in facilitating adaptation to cancer PURPOSE The analysis of complications in a prospect i ve r and omized trial comparing two preoperative brachytherapy low-dose rates in early stage cervical cancer is presented . METHODS AND MATERIAL S Between 1985 and 1988 , 204 patients with Stage I and limited Stage II cervical cancer were r and omized to receive one of two preoperative brachytherapy low-dose rates ( 0.4 and 0.8 Gy/hr ) . The objective of this trial was to determine the benefits , if any , of the higher-dose rate within the therapeutic arsenal for this patient population , in terms of survival , local control , and complications . The type and severity of all complications were evaluated according to a common glossary and a strict follow-up schedule was established given that the treatment of cervical cancer is multidisciplinary , involving gynecologists , surgeons , and radiotherapists . RESULTS Overall survival : 85 % at 2 years and local control : 93 % at 2 years , were similarly distributed between the two groups . Regardless of their nature and severity , 139 and 175 complications were observed among 63 % and 75 % of patients , in the 0.4 and 0.8 Gy/h dose rate groups respectively . Gynecologic and urinary complications were the most frequent ( 38 % and 28 % of all complications ) , followed by vascular ( 15 % ) , digestive ( 10 % ) , nervous ( 5 % ) and cutaneous ( 5 % ) . A total of 14 and 17 severe complications ( Grade 3 ) were observed in 7 % and 13 % of patients , respectively in the 0.4 and 0.8 Gy/h dose rate groups ( p = 0.12 ) . Nonparametric survival methods used to compare the time to the first complication did not show a significant difference between the two groups : 62 % and 72 % at 2 years ( p = 0.27 ) . When the first complication and its evolution were considered ( early complications ) , the prevalence of complications was not significantly different between the two groups : 28 % vs. 34 % at 2 years ( p = 0.31 ) . In this prospect i ve trial , patients were regularly followed-up and complications of varying nature and severity were observed in succession during follow-up . When successive complications and their evolution were taken into account , the prevalence of complications was significantly greater in the higher-dose rate group : 30 % vs. 45 % at 2 years ( p = 0.03 ) . CONCLUSION The results of this trial showed that long-term effects of treatment , when represented by prevalence of complications over time , were more frequent in the higher dose rate group . This underlines the importance of the regular follow-up of patients and of coding , not only the occurrence of all complications , but also their evolution over time PURPOSE The purpose of this pilot study was to evaluate the efficacy of the clitoral therapy device ( Eros Therapy ) in alleviating sexual dysfunction in irradiated cervical cancer patients . METHODS AND MATERIAL S Eligible patients had a history of cervical cancer treated with radiotherapy and self-reported sexual dysfunction of sexual arousal and /or orgasmic disorders . Patients used the noninvasive , nonpharmacologic clitoral therapy device using a h and -held , battery-powered vacuum to cause clitoral engorgement four times weekly for 3 months during foreplay and self-stimulation . Study instruments included the Female Sexual Function Index , Derogatis Interview for Sexual Functioning , and Dyadic Adjustment Scale . The outcome evaluation was performed at 3 months . RESULTS Between 2001 and 2002 , 15 women were enrolled and 13 completed the study . The median patient age and radiotherapy-enrollment interval was 43.5 years and 2 years , respectively . At baseline , all patients reported symptoms of sexual arousal and /or orgasmic disorders , and some also had sexual desire and pain disorders . At 3 months , statistically significant improvements were seen in all domains tested , including sexual desire , arousal , lubrication , orgasm , sexual satisfaction , and reduced pain . The median Female Sexual Function Index total score increased from 17 to 29.4 ( maximal score , 36 ; p < 0.001 ) . The median Derogatis Interview for Sexual Functioning total raw score increased from 46 to 95 ( maximal score , 118 ; p < 0.001 ) . At baseline , the Derogatis Interview for Sexual Functioning total T-score corresponded to the bottom 10th percentile of normal sexual functioning . At 3 months , the total T-score placed the patients at the normalcy cutoff . Gynecologic examinations revealed improved mucosal color and moisture and vaginal elasticity and decreased bleeding and ulceration . CONCLUSION Our results from this pilot study suggest that the clitoral therapy device may alleviate sexual dysfunction in irradiated cervical cancer patients . A r and omized , controlled trial is warranted to assess the full benefits of this approach Gynaecological malignancy has an immense impact on the well-being of women . For many women , however , treatment such as surgery is curative and healthcare intervention focuses on the physiological status of the women . The psychological , social and sexual consequences of the malignancy and its treatment have received little attention in research or in practice . The present study used a mixed quantitative and qualitative design to analyse a specialist nurse intervention ( including psychosexual intervention ) , and to explain the impact of the illness on women 's lives . The qualitative arm of the study collected interview data from 20 women and six partners . The r and omized controlled trial sample consisted of 36 women , with data collected using a quality of life measure ( the EORTC QLQ-C30 ) and the Lasry Sexual Functioning scale . This paper focuses on the r and omized controlled trial data , which identified that sexual functioning and quality of life were improved in the active group who received specialist psychosexual counselling . However , the validity of the sexual functioning scale is challenged by the qualitative results of the study , which emphasize the social meaning of sexuality PURPOSE The association between radiotherapy for gynecological carcinoma and sexual dysfunction is well established . Regular vaginal dilation is widely recommended to these women as a way for them to maintain vaginal health and good sexual functioning . However , the compliance rate with this recommendation is low . The purpose of this study was to test the effectiveness of a group psychoeducational program based on the " information-motivation-behavioral skills " model of behavior change in increasing the rate of compliance . METHODS AND MATERIAL S Thirty-two women with Stage I or II cervical or endometrial carcinoma who were being treated with radiotherapy were r and omized and received either the experimental group program or the control intervention that consisted of written information and brief counseling . Outcome measures included global sexual health , knowledge about sexuality and cancer , fears about sexuality after cancer , and vaginal dilation compliance . RESULTS Younger women attending the experimental program ( 44.4 % ) were significantly more likely to follow recommendations for vaginal dilation than those who received the control intervention ( 5.6 % ) . Women , regardless of age , who received the experimental intervention reported less fear about sex after cancer treatment . The older women who received the experimental intervention gained more sexual knowledge . There was no evidence that the experimental intervention improved global sexual health . CONCLUSIONS This is the first controlled study to provide evidence of an intervention 's effectiveness 1 . in increasing women 's vaginal dilation following radiotherapy for gynecological carcinoma and 2 . in reducing their fears about sex after cancer . Most women , particularly younger women , are unlikely to follow the recommendation to dilate unless they are given assistance in overcoming their fears and taught behavioral skills BACKGROUND AND PURPOSE Radiation-induced tissue fibrosis is a common adverse effect of curative treatment for pelvic cancer . Pilot studies testing alpha-tocopherol and pentoxifylline provide evidence of clinical regression of superficial radiation fibrosis after radiotherapy . PATIENTS AND METHODS Twenty-seven eligible research volunteers with a minimum of one grade 3 or 4 disability ( LENT SOMA ) due to previous radiotherapy were entered into the study . Volunteers were given dl-alpha tocopheryl acetate 500 mg twice a day orally plus pentoxifylline 400 mg twice a day orally over a period of 6 months . Clinical assessment of late side effects recorded using LENT SOMA scales was selected as the primary endpoint , taken at baseline and at 6 and 12 months post- registration . Patient self- assessment of function and quality of life was assessed as a secondary endpoint using the EORTC QLQ-C30 core question naire and the EORTC QLQ-CR38 pelvic module . Magnetic resonance imaging was undertaken in 13/23 evaluable volunteers before and after 6 months of therapy . RESULTS At 12 months post- registration there were 4 out of 23 responders . At 6 months post- registration there was a statistically significant improvement ( i.e. reduction ) in the median of the LENT SOMA summed scores in all areas assessed apart from ' male sexual dysfunction ' , ' vulva ' and ' vagina ' which were unchanged at 6 months . The median total LENT SOMA score at baseline and 6 months was 49 and 34 , respectively , with a median change in total LENT SOMA score between baseline and 6 months of 9 ( IQR 7 - 18 ) ( P<0.001 ) . The maximum LENT SOMA scores improved over the study period , with a total number of 82 maximum grade 3 or 4 normal tissue scores at baseline ( median of four complications per person ) reduced to a total number of 67 maximum grade 3 or 4 scores at 6 months post- registration ( median of 3 complications per person ) , i.e. a median reduction in severe complications of one per person . LENT SOMA scores at 12 months were similar to those observed at 6 month suggesting no further improvement nor deterioration in late side effects . These findings were , however , not reflected in the patient self- assessment of function and quality of life , raising question about the possibility of observer bias in recording LENT SOMA scores . No significant changes were reported on magnetic resonance images at 6 months from baseline . CONCLUSIONS Despite only seeing four a priori defined responders in this pilot study testing dl-alpha tocopheryl acetate plus pentoxifylline in patients suffering complications of pelvic radiotherapy , changes in LENT SOMA scores suggest beneficial effects . However , we are not convinced that these effects are real , since no significant changes in symptoms and functional status were recorded by detailed prospect i ve patient self- assessment Abstract Conization is known to be an adequate treatment for cervical dysplasia and CIS . However , there are practically no papers on the long-term morbidity after conization . A prospect i ve interview survey of sexual function was done with 64 patients with conizations , the follow-up period being 1 year . There was found to be a significant decrease in the number of patients with dysmenorrhea and dyspareunia and there was no change in libido , experience of orgasm , coital frequency , or in overall satisfaction of sex life . Thus , in these respects , conization is a suitable conservative method when treating dysplasia and CIS 
    Output:
    
Studies of a Clinical Nurse Specialist intervention , Psychoeducational Group Therapy and a Couple-Coping intervention , did not show any significant benefit .
There is no convincing evidence to support the use of any interventions for  psychosexual dysfunction in women treated for gynaecological cancer .