Sexual health issues in cancer

Although emotional and physical symptom screening in cancer is now a standard of care [1], systematic response to distress screening and evidence-based psychosocial interventions are often not fully integrated into care (Matthew, pp. 38–43). Sexual health and relationship needs in cancer are now widely recognized to be important (Matthew, pp. 38–43; Bober et al., pp. 44–54), but they lag even further behind; sexual health is not routinely assessed or addressed in cancer care (Matthew, pp. 38–43). Owing to these gaps in knowledge and practice, we included a section on sexual health in cancer in this quarter's issue of Current Opinion in Supportive and Palliative Care. Our section includes several articles focusing on a variety of different topics but unified by the common thread of sexual health issues in cancer. The main goal in this section is to summarize the psychosexual issues experienced by men and women with cancer and the current evidence to help clinicians better assess and manage these difficulties. Given that knowledge, clinical assessment, level one interventions, access to specialized service, and research in sexual health issues in cancer need to be improved and expanded, it is hoped that this issue will help clinicians in their daily care of their patients with cancer. Four studies explore areas relevant to all people with cancer; relationship and fertility issues, sex and sexuality in the elderly, the palliative setting and lesbian, gay, bisexual, and transgender (LGBT), and a review of online interventions (Wittman, pp. 75–80; Benedict et al., pp. 87–94; Griebling, pp. 95–101; Wooten et al., pp. 81–86). Two studies explore women's sexual health in cancer (Male et al., pp. 66–74; Bober et al., pp. 44–54). In turn, two studies explore men's sexual health in cancer; Matthews (pp. 38–43) writes a comprehensive overview of the principles of sexual health treatments in men and Wassersug (pp. 55–65) uses clinical examples to illuminate men's experience on androgen deprivation therapy after prostate cancer. All of us will have met at least one young adult cancer survivor who did not fully understand or receive fertility preservation counseling at the time of treatment, leading to immense distress and regret, and significant impact on the rest of their life. Supporting couples’ intimacy during cancer with open communication and adaptive coping has been accepted as a standard of care; now we need to be able to speak about sexual matters, help couples adjust their expectations, accept their ‘new sexual health normal’ and access the specialized support they need. A review by Bober et al. (pp. 44–54) suggests the use of material resources and robust referral networks to achieve this aim. There is a need for increased knowledge and more attuned practice in special populations: in young adults, LGBT, the elderly, those in the palliative setting. Griebling (pp. 95–101) concludes that sexuality and intimacy remain important for the elderly and for many people facing terminal illness. He emphasizes that LGBT people may face unique challenges in this regard and that healthcare professionals should avoid heteronormative stereotypes and focus on individual goals of care to optimize quality of life for all. According to Male et al. (pp. 66–74) most women are dissatisfied with sexual healthcare in breast cancer and about one-third experience issues in sexual health, body image, and sexual identity. Bober et al. (pp. 44–54) recommend a practical approach of a framework, checklist and resources to achieve a standard assessment of sexual health, including vaginal health, in women. Although there are differences in men's and women's difficulties in sexual health in cancer, it is clear from Male et al. (pp. 66–74) and Matthews (pp. 38–43) that the high prevalence of sexual health problems in both male and female patients affects their quality of life and impacts their physical and emotional functioning, as well as their self-concept and relationships. Sexual rehabilitation programs embedded in usual care may help with stigma and access (Mathews, pp. 38–43). The Wootten et al.'s (pp. 81–86) review of online psychosexual interventions is promising, but there is a clear need for large randomized controlled trials. Last, Wassersug (pp. 55–65) provides a thought provoking definition of intimacy as ‘sharing something with someone that you don’t share with anyone else’. He identifies the role of novel sexual practices to help those on androgen deprivation therapy to reestablish rewarding sexual activity. Acknowledgements None. Financial support and sponsorships None. Conflicts of interest There are no conflicts of interest.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.