Sexual Health in Adolescents and Young Adults With Cancer

Abstract

Sexual health (SH), an integral aspect of overall health and quality of life, can be negatively affected by cancer and cancer treatment. SH is influenced by biological, psychological, social, and cultural factors, and, for adolescents and young adults (AYAs), developmental factors. The AYA population (age 15-39 years) is diverse in terms of psychosexual development, interpersonal relationships, and varying levels of independence, resulting in unique SH needs for this population. AYAs with cancer are particularly vulnerable to unmet SH needs related to contraception and infection prevention, sexual function, body image, and romantic/sexual relationships. Sexual dysfunction during and after cancer treatment is reported by 30%-100% of AYA cancer survivors. Clinical guidelines recommend discussing SH and screening for dysfunction but currently lack specifics regarding psychosexual interventions and strategies for incorporating screening into clinical care. Research and clinical priorities include improved provider-AYA communication regarding SH, standardization of SH measures and screening tools, infrastructure to support the SH needs of AYAs across pediatric and adult clinical environments, and engagement of sexual and gender minority AYAs in research. As the field of SH in cancer evolves, interventions need to be tailored to the developmental needs that are unique to AYAs and address the multidimensional aspects of SH.

Sexual quality of life of adolescents and young adult breast cancer survivors

“…Sexuality and intimacy are important aspects of AYA health care and sexual health should be discussed early in the treatment process. 35 , 78 The results of this study demonstrated that AYA breast cancer survivors experience significantly more sexual QoL challenges compared to (female) AYA survivors of other cancer types. While discussing that sexual health is important for all AYA cancer survivors, those facing challenges related to sexuality, particularly breast cancer patients, might benefit from specialized interventions such as consultations with a sexologist.…”

“…Although sexual health plays an important role in HRQoL of AYA cancer survivors, it is often inadequately addressed by health care professionals. 16 , 27 , 34 , 35 , 36 Furthermore, it is known from previously published literature that AYA cancer survivors experience ongoing problems with sexual functioning up to 2 years after their initial diagnosis. 37 Unfortunately, there is limited knowledge regarding long-term (>5 years after diagnosis) sexual health of AYA cancer survivors.…”

Adapting an Adolescent and Young Adult Program Housed in a Quaternary Cancer Centre to a Regional Cancer Centre: Creating Equitable Access to Developmentally Tailored Support

“…There can be derailment in this development and health trajectories with the occurrence of a cancer diagnosis [ 3 ]. Although a cancer diagnosis inherently disrupts life for patients of all ages, cancer has an augmented impact on AYA patients, especially regarding fertility preservation, diagnosis and treatment of mental health concerns, a pause in education or career life goals, sexual health, and premature death [ 4 , 5 , 6 ]. In Canada, the current landscape of AYA care includes the delivery of oncology support at adult cancer centers, most of whom have limited resources or programming dedicated to the unique needs of this population [ 7 ].…”