Sexuality and cancer.

Gladys Mukosi.

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CANCER AND SEXUALITY :

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Why is nobody not talking about it?

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CANCER IMPACTS SEXUALITY.

DURING HISTORY TAKING;

I am 28 yrs, single with no child. I just had to take this treatment regardless of…

Patient breaks into tear…..mm mm.

My last surgery :–

Radical prostatectomy….

Radical hysterectomy…..

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(The doctor removed my urinary system, gastro intestinal system and my vagina)

Sexual Disfunction.

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• Is defined as a problem in any phase of sexual cycle that prevent an individual or couple from experiencing satisfaction from sexual activity.

SEXUAL DISFUNCTION IN CANCER.

• Range of SD in cancer patients is quite high.
• Dizn et al found that up to 70% women with cancer reported significant SD.
• Significant embarrassment on the part of patients to bring up issues of sexuality.
• Impression that “ there is nothing that could be done.”
• Sadly only 14% of physicians who treat cancer brought up sexuality as an issue.

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�What are the solutions to these issues:�

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• Communication is key:
• There is a disconnect between what patients want in their intimate lives and what partners expect.
• Women want intimacy and closeness with their partners.
• Managing expectations is important.

What are the solutions to these issues.

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Manage expectations!

Patients and provider must get out of the, mindset way of how we look at sex.

Foreplay – Intercourse – Orgasm – Done.

• Intimacy can be many things and sex can be pleasurable for parties when couple think

“outside of the box”

SEX AND SEXUALITY.

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Sex is about behavior/ the act.

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Sexuality is part of who you are.

Causes of Sexual issues in Cancer patients.

• The Cancer itself.
• Chemotherapy lowers estrogen levels and cause a ovarian insufficiency.
• Radiation therapy to the pelvis cause vaginal dryness and stenosis.
• Surgery for gynecological organs.
• Hormone therapy cause low estrogen level leading to hot flashes, irregular or no menstrual period, vaginal dryness.
• Treatment of other cancers.

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Holistic approach in care.

• The oncology team should initiate discussions of sexuality and cancer during treatment planning and follow-up visits.

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• Psychosocial and medical assessment should take place when a concern or problem is identified.

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• Referrals should be offered for multidisciplinary treatment.

Manage related side effects:

• Manage pain, fatigue, hair loss and other physical symptoms.

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• Condoms may be used to prevent partner’s exposure to some types of chemotherapy that may remain in vagina secretions.

• Contraceptives are advised to prevent pregnancy while a patient is receiving treatment and for a period of time following treatment.

Cont;- Management.

• vaginal gels or creams to stop a dryness, itchiness, or burning sensation.
• vaginal lubricants or moisturizers.
• vaginal  estrogen cream may be appropriate for some types of cancer.
• Vaginal dilators to help prevent or reverse scarring.
• Pelvic muscles, improve bladder retention, improve bowel function and increase blood flow, which can improve your sexual health

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Feeling powerful. Physical health,

Happiness, Vitality,

Pleasure, BENEFITS OF SEX. Happiness Connection, Feeling alive, Pleasure,

Physical & Psychological wellbeing.

Patient Obstacles.

Feeling guilt, its not important.

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Fear of disappointment, pessimistic

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Don’t want to appear greedy.

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Don’t want to be a bad patient.

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Providers Obstacles.

Feeling its not their space.

Denial- don’t ask don’t tell.

Incompetent.

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Conclusion.

Good health = Good sex.

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Sex is a really important issue, but we don’t take it into account when measuring QOL.

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Sex may change but it will never die.

Now we know.

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