Sexual Health and Cancer: What Providers Need to Know

A woman with cancer sits with her female doctor as she explains about the woman’s treatment plan. The patient is dressed comfortably in a light gray sweater and has a head scarf on. She is looking downward and distraught as the doctor speaks. The doctor has her back to the camera and is wearing a white lab coat.
Sexual dysfunction may be common in cancer patients and survivors, but their sexual health is often overlooked.

Research has suggested that sexual dysfunction may be common among cancer patients and survivors. Studies have shown sexual dysfunction in up to 75% of patients with breast cancer, 77% of women with lung cancer, and up to 85% of patients with cervical cancer.1-3

“The most common sexual health issues reported by cancer patients include loss of sexual desire, vaginal dryness and pain, difficulty with arousal and orgasm, and difficulty accepting changes in the body by patient and partner,” explained Heather R. Macdonald, MD, of Hoag Health Center and the University of Southern California in Irvine.

Dr Macdonald noted that various cancer treatments have been shown to affect sexual health. Surgery, chemotherapy, hormone therapies, and radiation can negatively affect sexual health by impacting the patient’s general wellbeing or by changing the body’s function or appearance.

She added that “much of our sex drive is mental and emotional and is negatively impacted by fatigue, stress, anxiety, fear, and pain — all common to the cancer experience.” 

Barriers to Addressing Sexual Health 

Though studies have shown high rates of sexual dysfunction in cancer patients and survivors, research has also suggested that sexual health is often overlooked in the context of cancer.

In a study of 405 cancer survivors, 27.9% reported that their provider had inquired about their sexual health, and inquiries were more likely for male patients than for female patients (53% vs 22%; P <.001).4

In a survey of 120 medical oncologists, 81.5% said they discussed sexual function with fewer than half of their patients.5 And in a survey of 599 pediatric oncologists and advanced practice providers, 41.9% said they had no role or a small role in sexual health care.6

A literature review suggested that young adult cancer patients and survivors want more support and information about sexual health from their providers.7 The results also suggested that patients want oncology providers to initiate conversations about sexual health.

However, there are multiple reasons why oncology providers may fail to address sexual health, said Brooke Cherven, PhD, RN, CPON, of Emory University School of Medicine in Atlanta.

“Providers and patients are understandably focused on treating and curing cancer, and sexual health may not be prioritized in the presence of competing demands related to symptoms and treatment,” Dr Cherven said.

Another barrier to sexual health discussions is a lack of knowledge and training among providers. In the aforementioned survey of 120 medical oncologists, 64.6% said they lacked knowledge about sexual health, and 72.9% wanted additional training in sexual function counselling.5

Yet another barrier is discomfort related to talking about sexual health, which has been reported by patients and providers alike.6,7 Dr Macdonald said patients may be reluctant to raise concerns about their sexual health because they are picking up on providers’ discomfort in addressing personal issues.

“If clinicians signal that we are available to discuss sexual health side effects of treatments, patients are more likely to voice their questions,” she said.

This article originally appeared on Cancer Therapy Advisor


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2. Rodriguez T. Sexual dysfunction common but unique in women with lung cancer. Cancer Therapy Advisor. Published August 15, 2022.

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