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The issue of cancer and sexuality in women is something that most doctors don’t even address, yet it is something that most women deal with after their diagnosis, surgery, and treatment for cancer. Many patients can’t even look at themselves in the mirror, let alone find a way to be intimate with a partner. But, the more we talk about this issue that affects so many, the more likelihood of the standard of care improving.
An Undertreated Issue: Cancer and Sexuality
The American Society of Clinical Oncology (ASCO) recently reported on a survey taken of breast cancer patients younger than 46 years of age, where 64% reported significant impacts to their sexual health, while 86% of them reported that their healthcare provider was unable to address these issues.1 Since this issue impacts so many patients, why is it that it is such an undertreated issue?
Likely this is due to a lack of training and available resources for physicians, but could also be due to societal stigmas and norms. Regardless of the why, this is clearly an issue that so many women face, and so we need be having these conversations so that healthcare teams begin addressing this more proactively for their patients.
In addition to the fact that sexual health during and after cancer treatment is rarely discussed, there are also some surprising misconceptions surrounding this issue as well. In research for this post, I discovered that questions surrounding the possibility of “catching cancer” through intimacy are common Google searches. It seems as a society we have a lot to learn on this topic!
What Can Be Done?
Following a cancer diagnosis, most patients go through some form of treatment, be it chemotherapy, radiation, or surgery. Many people are aware that these different treatments can be very harsh on the body, but what fewer people are aware of is that they can also have sexual health implications. This can be in the form of dysfunction as well as a lack of desire. This affects women of all races and socioeconomic statuses and is also relevant regardless of sexual orientation or gender identity.
So what should be done about this?
ASCO recommends that cancer care teams begin asking their patients about sexual health concerns right around the time of diagnosis, as well as throughout treatment and follow-up care. There should be standardized assessments of these side effects, so that care plans may be created. And, a multi-disciplinary approach is necessary for this - involving not just the oncologist, but gynecologists, urologists, mental health experts, and sexual therapists is critical to fully meet the needs of patients experiencing these issues.2
At the oncology level, if patients are uncomfortable bringing up this issue with their physician, other members of the healthcare team can often act as a confidant for patients such as nurses, nurse practitioners, and PAs.
The Dana-Farber Cancer Institute in Boston takes another angle to this topic on its blog, discussing how partners can support patients suffering from this issue. Some of their suggestions include planning times to share and discuss this issue in a supportive and encouraging way, and seeking out support groups for both patient and partner. You can read more here.
Sexual Health and Cancer: The Mental Health Impact
Another common side effect of cancer that is often neglected and not discussed is mental health issues. A patient’s mental health can be directly related to these changes to their sexual health during and after treatment. Counseling services can really help in this instance - either one-on-one or in a support group setting, depending on the patient’s comfort level. The more we can discuss this issue openly, the greater the chance that the standard of care is improved for patients overall!
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