Interventions to address sexual problems in people with cancer.

L Barbera,D Elterman,W Wolfman,K Mcpherson,A Matthew,A Katz,C Zwaal

doi:10.3747/co.24.3583

L Barbera, D Elterman + Show 5 more

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https://doi.org/10.3747/co.24.3583

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Abstract

Sexual dysfunction in people with cancer is a significant problem. The present clinical practice guideline makes recommendations to improve sexual function in people with cancer. This guideline was undertaken by the Interventions to Address Sexual Problems in People with Cancer Expert Panel, a group organized by the Program in Evidence-Based Care (pebc). Consistent with the pebc standardized approach, a systematic search was conducted for existing guidelines, and the literature in medline and embase for the years 2003-2015 was systematically searched for both systematic reviews and primary literature. Evidence found for men and for women was evaluated separately, and no restrictions were placed on cancer type or study design. Content and methodology experts performed an internal review of the resulting draft recommendations, which was followed by an external review by targeted experts and intended users. The search identified 4 existing guidelines, 13 systematic reviews, and 103 studies with relevance to the topic. The present guideline provides one overarching recommendation concerning the discussion of sexual health and dysfunction, which is aimed at all people with cancer. Eleven additional recommendations made separately for men and women deal with issues such as sexual response, body image, intimacy and relationships, overall sexual functioning and satisfaction, and vasomotor and genital symptoms. To our knowledge this clinical practice guideline is the first to comprehensively evaluate interventions for the improvement of sexual problems in people with cancer. The guideline will be a valuable resource to support practitioners and clinics in addressing sexuality in cancer survivors.

Highlights

The diagnosis and treatment of cancer can affect numerous domains of sexual function, as has been well documented in the literature and shown to be common[1,2,3,4,5]
Eleven additional recommendations made separately for men and women deal with issues such as sexual response, body image, intimacy and relationships, overall sexual functioning and satisfaction, and vasomotor and genital symptoms
A handful of systematic reviews have been published[12,13,14,15,16,17,18,19], but they tend to focus on a single cancer or intervention type

Summary

Introduction

The diagnosis and treatment of cancer can affect numerous domains of sexual function, as has been well documented in the literature and shown to be common[1,2,3,4,5]. Practitioners remain reluctant to raise the issue[6,7]. They cite barriers such as feelings of discomfort with the topic and lack of time, knowledge, and training[8,9,10,11]. Studies of interventions to improve sexual function are more limited, but do exist. No guidelines have comprehensively addressed sexual issues in people with cancer. We recently completed a systematic review[20] which served as the evidentiary base for a clinical practice guideline sponsored by Cancer Care Ontario (cco) and the Program in Evidence-Based Care (pebc). The present clinical practice guideline makes recommendations to improve sexual function in people with cancer

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Conclusion