Abstract
Adolescent and young adult (AYA) survivors of cancer have diverse psychosocial and medical needs, including those related to fertility and sexual health. Much of the focus of care around issues such as fertility and sexual health tends to be filtered through a biomedical lens. However, it is essential that health care providers assess and support AYA survivors using a biopsychosocial and contextual framework to ensure the most comprehensive and accurate understanding of AYA survivor needs, especially those related to psychosexual health. A trusting relationship between the multi-disciplinary medical team and the AYA survivor that allows for open discussion about the physical and psychosocial components of sexual health is key to providing best care and outcomes.
Highlights
Adolescent and young adult (AYA) cancer survivors are a distinct and diverse population among the cancer survivor community, with unique psychosocial and sexual health challenges
Recommendation based on information cited above: survivorship plans should include speaking with AYA survivors about their disclosure concerns as well as active discussion about sexual health, sexual function, and information needs about relationships during and after cancer treatments
While additional controlled studies are needed to determine if technology-based interventions are acceptable to and can improve the psychosexual care of AYA cancer survivors, there is evidence that a brief intervention consisting of two in-person individual counseling sessions conducted by a psychologist and focused on fertility, body image, and sexual function created positive changes [67,68]
Summary
Adolescent and young adult (AYA) cancer survivors are a distinct and diverse population among the cancer survivor community, with unique psychosocial and sexual health challenges. Across pediatric oncologists, primary care providers, psychologists, and related specialists, must understand both the biological effects of cancer and cancer treatment on fertility and sexual function, and the interplay between sexuality, body image, relationships, and sociocultural beliefs or context [2] These interacting variables and their impact on sexual functioning and health underscore the need for comprehensive assessment and intervention in both pediatric oncology clinics and dedicated pediatric survivorship clinic settings [3]. In addition to managing feelings of anxiety, depression, and loss of control associated with diagnosis and treatment, AYA cancer survivors must re-establish a post-treatment developmental course that may include identifying educational and career goals, building independence, assessing post-treatment fertility, developing romantic and/or sexual relationships, and making decisions about starting a family [4,7,8,9,10,11,12,13]. The biopsychosocial [14] and Hammond’s contextual [15] frameworks can help to paint a more complete picture of psychosexual concerns and guide dimensional, tailored conceptualization and care approaches for AYA cancer survivors
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