The availability of evidence-based research may help make clinicians more comfortable discussing sexual issues with cancer survivors, according to Don S. Dizon, MD, FACP, FASCO, head, women's cancers, Lifespan Cancer Institute; director, medical oncology, Rhode Island Hospital; associate professor of medicine, The Warren Alpert Medical School of Brown University.

It's highly prevalent, and depending on how you ask questions around this, 50% to 90% of people treated for breast cancer have these type of concerns. These concerns can be set off not only by the diagnosis, but by surgical, medical, and radiotherapeutic treatments.

As important as recognizing all of that is, this community needs to understand that there are ways to address those issues that are actually backed by data. We have evidence-based interventions that we can offer patients today. Discussing sexual health of a patient does not mean having to expose yourself to Pandora's box or concerns that you are absolutely unprepared to deal with. There is a way to address these concerns and bring it up that respects who you are as a physician and as a person in a very comfortable way, but also pointing people toward directions where they can actually access information or services that can help improve their life.

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The availability of evidence-based research may help make clinicians more comfortable discussing sexual issues with cancer survivors.

Don't Shy Away from the Sex Talk With Cancer Survivors

Just as some women feel after undergoing a mastectomy for breast cancer, women undergoing treatment for gynecologic cancers can feel de-feminized, too, explained Don S. Dizon, MD, FACP, FASCO, head, women's cancers, Lifespan Cancer Institute; director, medical oncology, Rhode Island Hospital; associate professor of medicine, The Warren Alpert Medical School of Brown University.

It is striking how women who have had their ovaries and/or their uterus removed due to a gynecologic cancer have the same issues with body image. The de-feminization of a woman after surgery for a gynecologic cancer can be quite significant, and I would almost say it can be stigmatizing. I think that's something that I do confront, and sometimes it's something that needs to be worked out.

Issues regarding pain are more significant after radiation to the pelvis, for example. Women who have had radiation, their vaginas can close. This is a process called agglutination where the mucosa within the vagina gets so raw that as it heals, it scars. If women aren't careful or educated about that, one of the most depressing things I've seen is a woman where it has completely closed because it's agglutinated. One can surgically open up the vaginal vault, if there is such an agglutination. But it doesn't act like a normal, healthy vagina.

There are many issues that women can face after undergoing treatment for gynecologic cancers.

Don S. Dizon, MD, FACP

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Don't Shy Away from the Sex Talk With Cancer Survivors

Pain, Stigma, and Other Gynecologic Cancer Issues