Sexual intimacy is essential in a healthy adult life, but cancer treatment and its aftermath can make maintaining sexual health during survivorship a challenge.
In addition to the personal challenges survivors face, the cancer care team often is facing a lack of education about this issue, though there is an opportunity to communicate with survivors and their partners.
Itís bigger than just function
For those with cancer that affects sexual function, such as prostate cancer, discussing the sexual impact that the cancer is having or will have in their sexual life may be easier to approach, but that doesnít mean anyone is approaching it! In fact, I think itís the elephant in the room everyone is ignoring.
Ignoring It Won't Make It Go Away
Loss of erection for men, vaginal atrophy in women, and an inability to orgasm in both are just the beginning of the sexual issues survivors and their partners face. Radiation and chemotherapy treatment can lead to nerve damage that causes a loss of penile or clitoral stimulation. A decrease in testosterone levels in men and post-menopausal women undergoing treatment and no longer on hormone replacement therapy can lead to a decrease in libido as well as sexual function.
Finally, cancer and its treatment scars the body and the mind. A lack of self-confidence, a poor self-image, and depression are common among survivors. And when there is still a lot of life ahead of you, the idea of not having a healthy sexual life can be devastating.
Getting over it
One of the biggest hurdles facing survivors is their cancer care team isnít talking to them about sex. Whether itís a lack of education or embarrassment on the clinicianís part, the only ones being damaged are the patient and his or her partner.
Organizers of the 2011 Cancer Survivorship and Sexual Health Symposium found an overwhelming response from clinicians seeking to understand this issue and handle the sexual health of their patients better.
According to the organizersí Website, ďThe program was hosted by a multidisciplinary faculty with expertise in menís and womenís sexual health and adolescent medicine. The goal of the program was to define sexual dysfunctions experienced by cancer survivors, and introduce sexual medicine into the care plans for cancer survivors.Ē
You can register online (for free) to access all the Webinars from the symposium.
Leslie R. Schover, Ph.D., a professor at the Department of Behavioral Science, Division of OVP, Cancer Prevention, and Population Sciences at the University of Texas MD Anderson Cancer Center in Houston, has created several resources on sexual health and cancer survivors.
- National Cancer Instituteís Sexuality and Reproductive Issues: Factors Affecting Sexual Function in People with Cancer
- Tendrils: Sexual Renewal for Women After Cancer. This program provides detailed information about why many cancer treatments interfere with womenís sexual pleasure. It also gives suggestions on how survivors can get back to having an active sex life if they stopped having sex during cancer treatment, how to cope with vaginal dryness and avoid pain during sex, and, most importantly, how to recapture a sense of desire and pleasure.
MD Anderson and the LiveStrong Foundation have several videos for patients on this subject:
To access more informational videos from MD Anderson, please go to Sexuality & Cancer.
A searchable digital textbook, From Cancer Patient to Cancer Survivor: Lost in Transition, is available online.
Communication starts with us
If nurses and other members of the cancer care team would treat the discussion of sexual health like they would other side effects of chemotherapy and radiation, the taboo attitude surrounding the topic could be lifted.
- Be matter-of-fact. Treating sex with this attitude worked in seventh-grade health class, and itíll work now.
- Ask open but pointed questions. Directly asking Mr. Q about his sexual function and/or Ms. K about her loss of libido may feel uncomfortable, but it will at least open a door for communication, becauseÖ
- You will be met with silence. Again, just as it was in the seventh grade, talking about sex is uncomfortable.
- Be armed with resources. Leave resources behind for your patients to review.
- Continue to talk about it. Your patients need you to offer a tenacious yet kind persistence in this matter.