"...And how are things sexually?" helping patients adjust to sexual changes before, during, and after cancer...

All types of cancer treatments are likely to disrupt patients' sexual lives. The disruption may be a temporary result of the immediate stress of the situation or may be long lasting. Regardless of the specific disease site and level of treatment, sexual concerns of patients and their partners should be anticipated and addressed. When ignored, issues of adjustment to sexual changes can lead to chronic sexual dysfunction that may affect all areas of a patient's self-image and functioning. This is a concern in all patients, but particularly in those whose illness or treatment medically affects sexual function. Because of the pivotal role of the oncology team personnel, and because of their intimate knowledge of their patients' medical situation, they are the most likely candidates to offer effective solutions to their patients' difficulties in adjusting to sexual changes and therefore to significantly influence the sexual outcomes of cancer treatment. Dissemination of information about sexual concerns regarding disease and possible treatment side effects that may affect sexual interest and function is the first line of intervention in helping patients prevent the development of sexual disruption. Pragmatic advice regarding management of sexual changes throughout cancer treatment and beyond should include the timing of sexual activity, communication with partners about sexual concerns, and even the use of lubricants and vibrators to optimize the experience of pleasure for the patients and their partners.