Sexual health can be an uncomfortable or embarrassing topic to discuss for many people, and for patients with cancer, survivors and their partners, it can feel even more awkward. In fact, sex ranks among the top five unmet needs of survivors, and a new digital health startup, Will2Love, has been launched to help fill this void.
Sixty percent of cancer survivors — 9.3 million individuals in the United States alone — end up with long-term sexual problems, but fewer than 20 percent get professional help, according to Leslie R. Schover, PhD, Will2Love’s founder. Among the barriers she cites are overburdened oncology clinics, poor insurance coverage for services related to sexual health and an overall lack of expertise on the part of providers, many of whom don’t know how to talk to patients and survivors about these issues.
Sexual issues can affect every stage of the cancer journey. Schover, who hosted a recent webinar for health care practitioners on the topic, has been a pioneer in developing treatment for cancer-related problems with sexuality or fertility. After decades of research and clinical practice, she has witnessed firsthand how little training is available in the area of sexual health.
“Sex remains a low priority, with very little time devoted to managing sexual problems even in specialty residencies,” she adds.
The problem is twofold: how to encourage oncology teams to do a better job of assessing and managing sexual problems and how to help those impacted by cancer to discuss their sexual concerns.
Schover says that simple, open-ended questions such as: “This treatment will affect your sex life. Tell me a little about your sex life now,” can help to get the conversation started.
Sexual side effects after cancer treatment vary from person to person, and also from treatment to treatment. Common side effects for men and women include difficulty reaching climax, pain during sexual intercourse, lower sexual desire and feelings of being less attractive. Men specifically can experience erectile dysfunction and dry orgasm, while women may have vaginal dryness and/or tightness, as well as loss of erotic sensation such as on their breasts following breast cancer treatment.
Sexual dysfunction after cancer can often lead to depression and poor quality of life for survivors and their partners.
Cancer treatment can impact hormonal cycles, nerves directing blood flow to the genitals, and the pelvic circulatory system itself, explains Schover. In addition, side effects like prolonged nausea, fatigue, and chronic pain also can disrupt a patient’s sex life.
“Simply to give medical solutions rarely resolves the problems because a person or couple needs to make changes in the sexual relationship to accommodate changes in physical function,” Schover stresses. “That kind of treatment is usually best coming from a trained mental health professional, especially if the couple has issues with communication or conflict.”
Schover hopes that Will2Love will bring much-needed attention to the topic by providing easily accessible resources for patients, survivors, their partners and health care providers. (Box)
Currently visitors to the website can subscribe to its e-newsletter and receive a free introductory five-part email course covering topics related to what your doctor may not be telling you about sex, fertility and cancer. After the fifth lesson, users will receive a link to the Will2Love “Sex and the Survivor” video series. “Sexual health is a right,” Schover stresses, and oncology professionals, patients and survivors need to be assertive to get the conversation started.