Sexuality rehabilitation

Sexual dysfunction is a common problem for patients with cancer as well as cancer survivors. Unfortunately, sexual difficulties are often not identified by the cancer care team, and most patients receive little or no assistance in dealing with the effects of cancer and its treatment on intimacy. In this article, recommendations concerning assessment of sexual function are presented and various treatments are reviewed. The authors recommend that questions concerning sexual difficulties and intimacy be incorporated into the initial evaluation of patients with cancer. The assessment of sexual difficulties should continue throughout treatment and recovery. The cancer care team can initiate interventions including patient education and treatments for altered desire, erectile dysfunction, and estrogen deficiency. These interventions may result in marked improvement in symptoms. Some forms of sexual dysfunction may require referral to a specialist. Based on their experience, the authors conclude that assessment and treatment of sexual dysfunction in patients with cancer should become standard practice, and that quality of life is enhanced when attention to the sexual consequences of cancer and its treatment are addressed.