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Communication About Sex is Key for Cancer Survivors and their Oncology Team

 

Communication About Sex is Key for Cancer Survivors and their Oncology TeamSexuality can be a difficult topic for women with cancer. Treatment often interferes with sexual function, leading to hormonal changes, early menopause, low desire, vaginal dryness, and painful intercourse. And patients and doctors don’t always communicate about such issues.

A recent Journal of Sexual Medicine study investigated what survivors of gynecologic cancer and breast cancer thought of their experiences getting sex health information from their healthcare team.

Scientists reviewed 20 medical papers involving 3,346 women (735 gynecologic cancer survivors and 2,611 breast cancer survivors). They noted several barriers that made it more difficult for women to get the information they needed.

Many women felt embarrassed about bringing up the subject of sexuality at their doctor’s appointments. For some, sex just wasn’t as important as other concerns. “In the scheme of things, it seemed less important,” one woman said.

For others, the idea of discussing sex brought up negative emotions. “To be honest, I have tried to avoid anything to do with it,” commented one participant. She added, “I guess it’s the head in the sand approach.”

Some women feared that sex would interfere with their cancer recovery. One woman remarked, “Since the initiation of chemotherapy, I never let my husband touch me. I am worried about the adverse effects of intercourse.”

Participants also commented on their doctors’ communication styles. Some healthcare providers showed discomfort about discussing sex. “They [providers] need to learn how to talk about these things without turning red, which is what my internist does. He turns bright red and then you’re like, ‘Oh, I better drop this,’” reported one woman.

Other participants said their doctors were not knowledgeable about sexual health and cancer. One woman reported her doctor telling her to discuss her concerns with her gynecologist or rheumatologist. Others described a “distance” between themselves and their providers.

Fortunately, some of the women were able to get the information and support they needed. Many encouraged the use of peer groups, websites, social media, and face-to-face meetings with specialists. Others appreciated when their provider showed compassion and empathy.

The authors called for easily-accessible sexual health services for women with cancer. They also recommended more training for healthcare providers on discussing sex health topics.

They added that many sexual concerns are not just physical. Women with cancer may be coping with more than sexual pain or low desire. They may also feel worried about their body image and attractiveness to a partner. They may feel anxious about their relationships and the future.

“Oncology professionals must recognize the limitations in their knowledge, skills and time to address sexual concerns, and make themselves aware of the sexual health services available in their area and refer patients accordingly,” the authors wrote.

Resources

 The Journal of Sexual Medicine

Dai, Yunyun, MD, et al.

“Patient-Reported Barriers and Facilitators to Seeking and Accessing Support in Gynecologic and Breast Cancer Survivors With Sexual Problems: A Systematic Review of Qualitative and Quantitative Studies”

(Full text article in press. Published: April 21, 2020)

https://www.jsm.jsexmed.org/article/S1743-6095(20)30139-9/fulltext