Physical examination of the female cancer patient with sexual concerns: What oncologists and patients should expect from consultation with a specialist

Abstract

Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision-making about cancer treatment and risk-reduction options. Physical examination of the female cancer patient with sexual concerns, regardless of the type or site of her cancer, is an essential and early component of a comprehensive evaluation and effective treatment plan. Specialized practices are emerging that focus specifically on evaluation and treatment of women with cancer and sexual function problems. As part of a specialized evaluation, oncologists and their patients should expect a thorough physical examination to identify or rule out physical causes of sexual problems or dysfunction. This review provides oncology professionals with a description of the physical examination of the female cancer patient with sexual function concerns. This description aims to inform anticipatory guidance for the patient and to assist in interpreting specialists’ findings and recommendations. In centers or regions where specialized care is not yet available, this review can also be used by oncology practices to educate and support health care providers interested in expanding their practices to treat women with cancer and sexual function concerns.

Health-related quality of life before and during chemotherapy in patients with early-stage breast cancer

“…On the other hand, larger social networks are related to higher HRQoL after a diagnosis of BC, when the patient has greater social support from family and friends [28]. It is understood that sexuality, after a cancer diagnosis, can be influenced by changes in hormone levels and changes in body image perception [29]. Our findings are in agreement with the study of Hall et al [30], which indicated that most of the systemic effects of chemotherapy tend to compromise women's sexuality in the short-and long-term.…”

Sexual quality of life, body image distress, and psychosocial outcomes in colorectal cancer: a longitudinal study

“…A simple brief validated sexual concerns screener [43, 44], could be used to identify patients with sexual or body image concerns and lead to timely treatments. Recent work offers guidance to clinicians to assess and refer patients who report sexual and body image concerns once identified [44, 45], and a few small intervention studies offer promising findings for interventions addressing sexual outcomes in samples of patients with colorectal cancer [18, 41]. Interventions are particularly needed to help ensure that the sexual concerns of women treated for cancer are addressed given that compared to men with cancer, women are significantly less likely to have sexual concerns discussed in their care [46].…”

Patient-provider communication about sexual concerns in cancer: a systematic review

“…Recently, researchers have attempted to address this barrier by offering practical guidance to and promoting awareness among cancer providers, particularly on how to address sexual concerns in female cancer patients, for whom communication is especially uncommon [14, 77]. However, such guidance should complement, rather than take the place of, communication interventions targeting knowledge and skills.…”

“…If left unaddressed, sexual concerns can negatively impact patient psychological health, relationship adjustment, and overall quality of life [10–12]. The addition of sexual function to the National Comprehensive Cancer Network (NCCN) Clinical Practice Survivorship Guidelines [13] and recent efforts to systematize evaluation of sexual concerns in cancer [14] show an increasing recognition of the need to address sexual concerns in cancer care.…”