Cancer has become a manageable chronic disease. Comprehensive oncological care increasingly also focuses on survivorship issues. Sexuality is an important area of quality of life. Sexual dysfunction is now known as one of the more common, enduring consequences of cancer treatment. Unfortunately, sexual assessment and/or sexual counseling is not routinely provided in the oncology outpatient clinical setting. Time constraints, physician's discomfort to discuss sexual issues and a lack of sexuality training to deal with sexual problems after cancer may be crucial in not addressing sexual health concerns.
Most sexual problems in the oncology setting do not require extensive medical or psychological treatment, but rather a brief counseling program. This includes education on the impact of cancer treatment on sexual functioning, suggestions for resuming sex comfortably, ways of improving sexual communication, advice to mitigate side-effects of physical handicaps and promote self-help strategies. Brief sexual counseling can be best provided by a specialist nurse as a key professional in a multidisciplinary team for sexual medicine. However, to effectively treat complex sexual problems after cancer, a specialist sexologist is needed, trained in more complex psychotherapeutic skills to provide sex therapy, e.g. skills to screen for major cognitive impairments and psychiatric disorders; skills in dyadic communications; ability to combine sex-therapy with behavioral marital therapy strategies, systematic desensitization or cognitive-behavioral treatment for depression and phobic anxiety (Schover en Jensen, 1988).
In the Netherlands Cancer Institute a special outpatient clinic for sexuality and cancer has been established to address cancer patient\'s unique sexual needs. The multidisciplinary sexual health care team consists of a sexual medicine gynecologist and urologist, certified specialist nurse, a social worker and a certified sexologist-psychologist. The sexologist\'s role and approach in a three step- managed care model and treatment strategies to overcome major sexual problems after cancer will be highlighted.
Conflict of Interest: None disclosed
Financial Support/Funding: None disclosed
Recorded: Sydney, Australia, April 2007
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