title: Women's experiences after a radical vaginal trachelectomy for early stage cervical cancer. A descriptive phenomenological study.
abstract: OBJECTIVE
  This paper reports on a phenomenological study of women's experiences 1-10 years following a radical vaginal trachelectomy and describes the impact on health, sexuality, fertility and perceived supportive care needs.
  
  
  METHODS
  Qualitative telephone interviews employing a descriptive phenomenological approach were conducted using a purposive sample of 12 women.
  
  
  RESULTS
  Several felt their cancer experience was positive; bringing them closer to family and changed their outlook on life. A few experienced delayed psychological reactions and/or fears of recurrence. Many experienced isolation and the desire to contact others with similar experiences. Women recovered well but a few experienced fears/concerns about lymphoedema and intermenstrual bleeding. Sexual function was not a long-term issue for most. Some that could feel the cerclage (stitch) during intercourse, developed techniques to reduce this. Single women felt vulnerable in new relationships. Pregnancy was an anxious time, especially for those that experienced a miscarriage or pre-term birth. Sources of support included the clinical nurse specialist, family/friends, surgical consultant, online patient forums and a support group. Women needed more information on trachelectomy statistics, pregnancy care recommendations as well as access to counselling, peer support, being seen by the same person and increased public awareness.
  
  
  CONCLUSIONS
  This study has provided an interesting and detailed insight into women's experiences in the years following a trachelectomy, with results that have important considerations for practice such as provision of statistical information; counselling; peer support; consistent pregnancy recommendations; increased public awareness and increased identification and management or prevention of long-term physical effects.
authors.affiliation: Department of Gynaecological Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK. Electronic address: Philippa.lloyd@bartshealth.nhs.uk.
authors.forename: Philippa A
authors.initials: PA
authors.lastname: Lloyd
authors.affiliation: Florence Nightingale School of Nursing and Midwifery, Kings College London, UK. Electronic address: Emma.briggs@kcl.ac.uk.
authors.forename: Emma V
authors.initials: EV
authors.lastname: Briggs
authors.affiliation: Department of Gynaecological Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK. Electronic address: Nichola.kane@bartshealth.nhs.uk.
authors.forename: Nichola
authors.initials: N
authors.lastname: Kane
authors.affiliation: Department of Gynaecological Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK. Electronic address: Arjun.jeyarajah@bartshealth.nhs.uk.
authors.forename: Arjun R
authors.initials: AR
authors.lastname: Jeyarajah
authors.affiliation: Royal Marsden NHS Foundation Trust, London, UK.
authors.forename: John H
authors.initials: JH
authors.lastname: Shepherd
mesh_terms: D000328:Adult; D004644:Emotions; D005260:Female; D005298:Fertility; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D011247:Pregnancy; D012649:Self Concept; D012657:Self-Help Groups; D019529:Sexuality / Q000523:psychology*; D006113:United Kingdom; D002583:Uterine Cervical Neoplasms / Q000523:psychology* / Q000601:surgery*; D014930:Women / Q000523:psychology*; D016387:Women's Health
keywords: Cancer survivorship; Cervical cancer; Descriptive phenomenology; Fertility sparing surgery; Trachelectomy