Randi Johansen Reidunsdatter

Purpose: Breast cancer (BC) treatment affects BC survivors' sexual health, causing relational challenges. Sexual health is an under-communicated topic in cancer survivorship, and partner perspectives are often neglected. This qualitative study explored (1) how sexual health is affected by BC diagnosis and treatment, and (2) how couples navigate the resulting sexual and relational challenges. Method: Semi-structured interviews were performed separately of 37 BC survivors and 19 of their partners. The study included 19 heterosexual couples and 18 BC survivors who either did not have a partner or whose partner did not participate. The participants were Norwegians aged 28 to 67 years. Thematic content analysis was carried out using systematic text condensation. Results: BC survivors experienced side effects post treatment that affected sexual health, particularly reduced sexual desire, fatigue, bodily pain, vaginal dryness and body-image concerns. Both BC survivors and partners lacked guidance regarding sexual health during BC follow-up. As a result, they developed positive and negative strategies to address their sexual and relational concerns. Positive strategies, such as redefining intimacy through alternative sexual approaches, prioritizing open communication, showing love and support, seeking help, accepting the present and maintaining hope for improvement helped couples navigate challenges constructively. In contrast, negative strategies, including skepticism toward new sexual approaches, avoiding intimacy, lack of open dialogue and feelings of guilt and rejection, often created barriers and hindered intimacy. Conclusion: Our findings highlight a significant gap in sexual health support for BC survivors in Norway, with partners often overlooked in the process. Integrating sexual health as a routine part of survivorship care through dedicated roles, clear guidelines, and consistent, timely conversations can help bridge this gap. Additionally, this study provides suggestions for topics and strategies that healthcare professionals can discuss with BC survivors and their partners as part of follow-up care. Future work should include more diverse survivor groups, evaluate implementation of stepped-care models in real-world settings, and develop multimodal interventions that combine biological, behavioral, and psychosocial components. Comparative studies across cancer types are needed to inform flexible and scalable models of sexual-health support.

Continuing Medical Education (CME) papers is a method for healthcare professionals to gain new knowledge, learn new technologies and procedures and keep up with advances in their respective fields. Healthcare professionals have a lifelong responsibility to learn throughout their professional career.CME papers generally outline a specific case, topic, or challenge in the medical field. They often conclude with an individual assessment, such as a 10-question multiple-choice exam, to test the learners understanding of the material.Unfortunately, radiographers, nurses and other medical healthcare professionals working in the Nordic countries do not have abundant access to Continuing Professional Development (CPD) programs, which are designed to help professionals to engage and enhance skills, knowledge and abilities. Even without formal CPD programs, radiographers must stay updated to maintain high professional standards. Nordic healthcare professionals can still benefit from reading and writing CME papers and participate in CME assessments.CPD are widely used in many other European countries such as UK and Ireland. Therefore, CME papers can be a way to facilitate new qualifications or knowledge.

Background and purpose: Sexual dysfunction is a common late effect of cancer reducing quality of life. This study investigated sexual health in cancer survivors shortly after diagnosis and at long-term follow-up compared to the general population. Methods: A nationwide survey stratified by sex and age was distributed to a representative sample of the Norwegian population. Of the 5,135 respondents (33% response rate), 453 were cancer survivors, and 4,682 were cancer-free controls. Time since cancer diagnosis was divided into two categories: 2 years or less (short-term) and over 2 years (long-term). Sexual health was evaluated using the EORTC questionnaires SHQ-22 and the sexual domains of the QLQ-BR23/QLQ-BR45. Multivariable linear regression analyses compared sexual health between cancer survivors and cancer-free controls, and between short- and long-term cancer survivors. Results: Cancer survivors reported significantly poorer sexual health outcomes than cancer-free controls, except for the importance of maintaining a sexually active life, rated equally important. There were minimal differences in sexual health between short-term and long-term cancer survivors. Interestingly, male cancer survivors appeared to be more affected by sexual health challenges than females, when compared to their cancer-free controls. Interpretation: This study is the first to utilize the EORTC SHQ-22 questionnaire to assess sexual health in cancer survivors and controls. Sexual health was found to be significantly worse in cancer survivors compared to age-matched controls. It is imperative to address this overlooked health issue in the follow-up programs for cancer survivors.

Bakgrunn: Forekomst av kreft er økende i befolkningen og det forventes at 1 av 5 utvikler sykdommen, og av disse vil over 50% ha behov for strålebehandling. Effekten av strålebehandling avhenger av presis levering av stråledose til tumor, og samtidig minimal stråledose til normalvev og risikoorganer. Dette krever nøyaktig pasientposisjonering, samt en behandlingsplan som er individuell tilpasset, med strenge krav og retningslinjer til dosering og marginer. Teknologisk utvikling har ført til avanserte teknikker som bildeveiledet stråleterapi, for tiden benyttes Cone-Beam Computer Tomografi. MR i kombinasjon med Linac (MRL) brukes for tiden til MR-veiledet Stråleterapi (MRgRT). MR-veiledet Stråleterapi (MRgRT) har flere fordeler, blant annet forbedret bløtvevskontrast og visualisering, samt sanntidsjustering av stråledosen som kan redusere marginene ved behandling. Denne teknologien byr også på utfordringer som for eksempel manglende elektrontetthets-informasjon og tekniske komplikasjoner med magnetfeltet. Denne artikkelen oppsummerer fordeler og utfordringer ved bruk av MRgRT, beskrevet i andre review-artikler. Metode: Vi gjennomførte et systematisk litteratursøk i Oria og PubMed. Inklusjonskriteriene var at artiklene skulle være oversiktsartikler publisert på Norsk eller Engelsk, omhandle bruk av MR i verifisering eller historisk utvikling av verifiseringsteknologier. Eksklusjonskriterier luket ut alle artikler som hovedsakelig omhandlet brachyterapi, stereotaktisk stråleterapi, protonterapi og artikler med en spesifikk krefttype som tema. Ti artikler ble inkludert, 8 fra PubMed og 2 fra Oria. Analysen av artiklene ble gjennomført ved hjelp av Evans analysemodell. Resultat: Alle artiklene beskrev fordeler og utfordringer med MRgRT, og totalt ble 6 fordeler og 13 utfordringer identifisert. Fordeler som gikk igjen var forbedret bløtvevskontrast, sanntid MR avbildning, funksjonell MR avbildning og forbedret avgrensningsmarginer. Utfordringene omhandlet fortrinnsvis MR-Linac sin påvirkning av ressursbruk som for eksempel at det er tidskrevende og dyrt, samt at det kreves kompetanse og kunnskapsheving av personalet, i tillegg behøves MR kompatibelt utstyr, og utfordringer knyttet til det tekniske ved kombinasjon av MR og Linac. Konklusjon: I fremtiden forventes MRgRT å forbedre presisjonen og individualisere kreftbehandling betydelig, dette er takket være MR`s overlegne bløtvevskontrast, samt teknologi som muliggjør blant annet sanntidsavbildning. Til tross for fordelene, kreves det mer forskning på en rekke utfordringer, blant annet behovet for automatiserte løsninger og tverrfaglig samarbeid. Det er en økende interesse og forskning på temaet, fremtidig fokus bør være på integrering i standard arbeidsflyt.

Despite the current shift in medicine towards patient-centered care, clinicians rarely utilize patient-reported outcomes (PROs) in everyday practice. We examined the predictors of quality- of-life (QoL) trajectories in breast cancer (BC) patients during the first year after primary treatment. A total of 185 BC patients referred for postoperative radiotherapy (RT) filled in the EORTC QLQ-C30 Questionnaire assessing global QoL, functioning and cancer-related symptoms before starting RT; directly after RT; and 3, 6 and 12 months after RT. We used decision tree analyses to examine which baseline factors best allowed for predicting the one-year trajectory of the global QoL after BC treatment. We tested two models: ‘basic’, including medical and sociodemographic characteristics, and ‘enriched’, additionally including PROs. We recognized three distinct trajectories of global QoL: ‘high’, ‘U-shape’ and ‘low’. Of the two compared models, the ‘enriched’ model allowed for a more accurate prediction of a given QoL trajectory, with all indicators of model validation being better. In this model, baseline global QoL and functioning measures were the key discriminators of QoL trajectory. Taking PROs into account increases the accuracy of the prediction model. Collecting this information in the clinical interview is recommended, especially for patients with lower QoL.

Objective: The aim of this study was to provide gender-, age-, and morbidity-specific Norwegian general population normative values for the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires QLQ-C30, the sexual health questionnaire QLQ-SHQ22, and the sexual domains of the breast modules QLQ-BR23 and QLQ-BR45. Methods: A random nation-wide sample stratified by gender and age groups (18–29, 30-39, 40–49, 50–59, 60–69 and ≥70 years) was drawn from the Norwegian National Population Register. Participants were notified through National online health services (HelseNorge) and by postal mail. The survey included sociodemographic background information, HRQoL assessed by the EORTC questionnaires, and morbidity by The Self-Administered Comorbidity Questionnaire. Multivariable linear regression was carried out to estimate the associations of age, sex, and morbidity with the EORTC scale and item scores. Results: Of the 15,627 eligible individuals, 5.135 (33%) responded. Women and persons with morbidities reported lower functioning and higher symptom burden than men and persons without morbidities, respectively, on nearly all EORTC scales. Sex differences were most prominent for Emotional Functioning, Pain, Fatigue , and Insomnia (QLQ-C30), Body Image, Sexual Functioning (QLQ-BR23/45), Importance of Sexual Activity, Libido , and Fatigue (QLQ-SHQ22). The score differences between persons with and without morbidity were highly significant and largest among the youngest and middle-aged groups. Conclusion: The present study is the first to provide normative values for the EORTC sexual health questionnaire QLQ-SHQ22 and the sexual subscales of the QLQ-BR23 and QLQ-BR45, for all separately in age groups by sex and morbidity.

Radiation pneumonitis (RP) and radiation fibrosis (RF) are common side effects after breast cancer (BC) radiotherapy (RT). However, there is a great variation in the frequency of RP and RF. This st...