Cancer agency encourages dialogue on sexual health
Parents know how awkward the conversation can be. It seems some doctors and patients can also find it difficult to talk about sex — especially patients being treated for cancer.
Cancer Care Ontario is hoping to break down some of the barriers with new guidelines aimed at encouraging patients and healthcare providers to have open discussions about sexual issues that can relate to cancer diagnoses and treatments. The guidelines are the first of their kind in Canada.
Researchers at Cancer Care Ontario say they realized there was a gap in care involving sexual health and cancer treatment, which the recently released guidelines aim to help close.
It might not be the first thing patients think about after they’ve been diagnosed with cancer, but the sexual implications of cancer diagnoses and treatment are real and affect the majority of patients. Many patients have questions involving everything from body image and change in libido to changing sexual function as a result of cancer treatment.
In the past, it has often been up to patients to raise the issue and doctors sometimes weren’t sure how to handle the questions.
The guidelines, said Dr. Lisa Barbera, clinical lead on patientreported outcomes and symptom management with Cancer Care Ontario, put the onus on the doctor to raise the subject, rather than the patient. They also recommend doctors raise the subject more than once during treatment. Crucially, it recommends a discussion takes place.
There are various sexual dysfunction and sexual health issues that can occur in people with cancer. Eighty five per cent of women with cancer and up to 95 per cent of men may experience difficulties with sexual function, according to Cancer Care Ontario. Sexual health related distress occurs in more than half of patients diagnosed with cancer.
Around 85,000 new cases of cancer were diagnosed in Ontario in 2016. Over their lifetimes, one in two Ontarians will develop cancer, according to Cancer Care Ontario.
Cancer is also changing: patients are living longer and for many of them, cancer is a chronic condition that they will continue to live with.
Barbera said there has been some research documenting the barriers to open discussions between patients and care providers about cancer and sex.
The guidelines, she said, offer providers information on issues including erectile dysfunction, body image, and painful intercourse, and information about interventions that help.
“Raising the issue, acknowledging this is an issue, and having a discussion about it is helpful and will help with outcomes.”
Barbera, who treats gynecological cancer, said she tells patients that they will likely experience sexual dysfunction and sexual health problems and gives them an opportunity to raise questions and express their concerns. She raises it again once treatment is complete.
“I think it is important for patients that if the treatments are going to impact their sexual function, they need to at least have a headsup. If they have a lot of questions about what the impact will be, that conversation should happen.”