Female Sexual Health and Survivorship

Female Sexual Health and Survivorship

Don S. Dizon, MD, FACP, FASCO

Aug 14, 2011
One of the interests I have developed over time is in the arena of cancer survivorship, specifically female sexual heath after cancer and its treatment. Having worked at Memorial Sloan-Kettering both as a fellow and as a junior faculty member, I worked closely with colleagues in Gynecology, especially Drs. Michael Krychman and Jeanne Carter, and developed an awareness of the difficulty women with cancer face when it comes to sexual health.

When I left MSKCC, it became apparent that often these needs for information and for advice related to sexual function were lacking. While resources within comprehensive cancer centers were available, thanks to pioneering work in Survivorship Care by sexual health champions like Barbara Andersen at Ohio State, Leslie Schover at MD Anderson, Sharon Bober and Chris Recklitis at Dana Farber Cancer Institute, and Patricia Ganz at UCLA, for the vast majority of female cancer patients, such resources were lacking. 

Asked questions about sexual dysfunction, a vast majority of women admit to issues related to sexual function and intimacy issues after treatment. Yet, barriers may prevent them from asking for help, let alone discussing them. Issues related to providers (time, discomfort, lack of training) and to patients (importance of it as an issue related to medical issues, discomfort, embarrassment) have been reported, so how do we improve access?

We must start by recognizing that sexuality and intimacy are important aspects of being human, and that we should not assume patients cease being sexual beings after their diagnosis, no matter how old they are. Instead, we must do more to understand a woman's (and man's) own take on sexuality (Andersen's sexual self-schema) prior to treatment, so that we can better prepare them to adjust to cancer's diagnosis and ultimately, its treatment. Next, we must educate ourselves on the complexity of sexual health and intimacy, and identify resources within our own communities, where those expressing a desire to discuss issues can go for advice and guidance.

I fully recognize the time constraints we as oncologists face when it comes to patient care, and that more pressing clinical issues may predominate any one patient's appointment. But, recognizing the importance of survivorship issues is an important aspect of oncologic care today, and part of this must be learning how to approach sexuality and intimacy issues of all cancer survivors. 


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