A clinical trial recently launched at West Chester Hospital for the UC Cancer Institute is comparing the effectiveness of two options in managing painful sexual intercourse — or dyspareunia — symptoms in breast cancer survivors.
The trial, which is funded by the UC Cancer Institute’s Survivorship program, compares laser treatment versus topical lidocaine, a local anesthetic that numbs the area to which it is applied.
A large and growing population of breast cancer survivors experience burdensome urogenital symptoms including dyspareunia, according to Dr. James Whiteside, associate professor of obstetrics and gynecology and co-investigator on the clinical trial.
As topical estrogen doesn’t always work, studies have evaluated the feasibility and effectiveness of carbon dioxide lasers for the treatment of vulvovaginal atrophy in postmenopausal women, Whitesie said. Results suggest improvements in symptoms and favorable microscopic changes, he said.
CO2 lasers can be used in soft tissue surgeries or skin resurfacing, with effects similar to those of chemical peels and dermabrasion, by removing skin layers or tissue by vaporization.
Lidocaine was used in a small, randomized trial, which showed it was more effective than placebo in addressing painful intercourse, “but it’s not perfect” and does not help with non-sexually related problems of dry skin, Whiteside said.
“The idea of the laser of giving you sort of a non-hormonal solution seemed an appealing option,” he said. “There’s a lot of people using this laser right now and … to my knowledge, they aren’t any comparative trials.
Whiteside said prevalence studies have shown that painful intercourse was a “pretty common” issue faced by about a quarter of postmenopausal breast cancer survivors.
Dr. Jaime Lewis, assistant professor of surgery and co-investigator on the clinical trial, said patients in this study who are breast cancer survivors experiencing dyspareunia will be randomized into two groups: those treated with the laser or those using topical lidocaine gel.
Whiteside said the trial, which is “just getting started,” has 10 participants but is looking for a 70 participant sample size to be divided evenly into two groups. Both groups will follow up at one week, one month, three months and six months.
“If outcomes are favorable, this could lead to a new treatment for survivors experiencing a painful condition and could improve their quality of life,” she said.