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THE sexual health remains an unmet need of cancer survivors and poses a significant threat to their quality of life, researchers and experts point out. Oncologists need to recognize that this is a significant problem, says Don Dizon, MD, director of the Division of Women’s Cancer at Lifespan Cancer Institute in Rhode Island. It should not stress, to assume arbitrarily that the absence sexual activity in cancer patients, regardless of their age it is not a problem for them.
“Patients are often reluctant to tell the doctor that their treatment has caused sexual side effects. On the other hand, oncologists are not trained in the care of cancer survivors and often feel insufficiently prepared to raise the topic of sexual concerns with patients,” explains the Scientific Director of the Andrology Institute, Dr. Christos Fliatouras.
In the UK last October, cancer survivors Brian Lobel and Joon-Lynn Goh teamed up for Women’s Erotic Emporium to launch sexwithcancer.com, the first online store sex in the UK for ‘people living with cancer and beyond’. The site offers practical solutions, expert advice, curated products and sex aids based on recommendations from psychosexual therapists and other experts who answered a list of the top 25 questions cancer survivors have about sex. Other products aim to start the conversation such as a badge for healthcare professionals that reads, “Sex With Cancer Champion Conversation”. This can enable the patient to ask a question and start a conversation.
The first step in improving the care of these people is to check for issues that affect them sexual health and familiarity and familiarity with the discussion, points out Areej El-Jawahri, MD, an associate professor at Harvard Medical School in Boston, Massachusetts, adding that if the health care professional feels comfortable bringing up and talking about the issue, it creates a comfortable environment for the patient to share their concerns.
El-Jawahri, who is also director of the bone marrow transplant program at the Massachusetts General Hospital Cancer Center, notes that patients with hematologic malignancies face many of the same risks. sexual health with patients with solid tumors.
Clinical practice guidelines aimed at helping oncologists address the sexual health of cancer patients as an essential part of survivorship care were published by the American Society of Clinical Oncology in 2017. Experts recommend that the discussion be initiated by a member of the health care team and offer psychosocial and/or psychosexual counseling to all cancer patients to improve sexual response, body image, intimacy, relationship problems, and overall sexual function and satisfaction.
However, the authors of a 2021 literature review published in the Journal of Cancer Survivorship concluded that healthcare professionals need to improve their communication skills both in person and online, as patients and survivors continue to highlight inadequate care that they receive.
“There appears, according to the authors,” notes Mr. Fliatouras, “to be a disconnect between support and the implementation of appropriate care, which may lie in how problems are recognized and addressed in the clinical setting.
Additionally, patient responses collected in a 2020 survey of oncologists suggest that much more work needs to be done. Of the 391 patients with breast, endometrial, bladder, prostate and rectal cancer who took part, 9 in 10 reported sexual side effects after treatment, but only 28% said they were asked about sexual health by the health professional.
In any case, it is emphasized that oncologists must be clear about the risks and toxicities associated with treatment before patients start it, including sexual side effects.”
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