Top

Journal of Cancer Survivorship

Published in:

Open Access 01-12-2020 | Care | Review

Can the provision of sexual healthcare for oncology patients be improved? A literature review of educational interventions for healthcare professionals

Authors: L.F. Albers, L.A. Grondhuis Palacios, R.C.M. Pelger, H.W. Elzevier

Published in: Journal of Cancer Survivorship | Issue 6/2020

Abstract

Purpose

Sexual health is an important quality-of-life concern for cancer patients and survivors, but a difficult discussion topic for patients and healthcare professionals. The most important barriers causing healthcare professionals to avoid the topic are lack of education and lack of knowledge. How effective education about sexual health is for oncology healthcare professionals is not clear. The aim of this review is to examine the effectiveness of interventions in improving the provision of sexual healthcare for cancer patients.

Methods

A systematic literature review was conducted according to PRISMA guidelines using the following data sources: PubMed, PsychInfo, Embase and Emcare. Quantitative research was included which contained pre-intervention and post-intervention outcomes. The assessment of the studies was conducted independently by two reviewers. A third reviewer was involved if there was no consensus.

Results

Seven studies were included. In total, 572 oncology healthcare professionals participated, including physicians, nurses and allied healthcare professionals. Interventions consisted of 6 face-to-face sessions and one online program. Primary objectives of the studies were the assessment of improvement in knowledge about sexual health, improvement of practice, frequency of discussing sexual health and comfort level and the decline of perceived barriers to discussing sexual health. Studies showed that interventions resulted in improved realization of the objectives.

Conclusions

Although improvement in the knowledge of healthcare professionals was achieved, it was not possible to give an overall recommendation for the development of interventions due to the limited number of studies and heterogeneity of the data.

Implications for Cancer Survivors

Sexual health is an important area of survivorship that is often neglected. Many oncology healthcare professionals lack training and knowledge to provide such care. More evidence-based practices are needed to improve sexual healthcare for cancer survivors.

Available only for authorised users

Acquati C, Zebrack BJ, Faul AC, Embry L, Aguilar C, Block R, et al. Sexual functioning among young adult cancer patients: a 2-year longitudinal study. Cancer. 2018;124(2):398–405. https://doi.org/10.1002/cncr.31030.CrossRefPubMed

Aerts L, Christiaens MR, Enzlin P, Neven P, Amant F. Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study. Breast. 2014;23(5):629–36. https://doi.org/10.1016/j.breast.2014.06.012.CrossRefPubMed

Albaugh JA, Sufrin N, Lapin BR, Petkewicz J, Tenfelde S. Life after prostate cancer treatment: a mixed methods study of the experiences of men with sexual dysfunction and their partners. BMC Urol. 2017;17(1):45. https://doi.org/10.1186/s12894-017-0231-5.CrossRefPubMedPubMedCentral

Almont T, Bouhnik AD, Ben Charif A, Bendiane MK, Couteau C, Manceau C, et al. Sexual health problems and discussion in colorectal cancer patients two years after diagnosis: a national cross-sectional study. J Sex Med. 2019;16(1):96–110. https://doi.org/10.1016/j.jsxm.2018.11.008.CrossRefPubMed

Almont T, Couteau C, Etienne H, Bondil P, Guimbaud R, Schover L, et al. Sexual health and needs for sexology care in digestive cancer patients undergoing chemotherapy: a 4-month cross-sectional study in a French University hospital. Support Care Cancer. 2018;26:2889–99. https://doi.org/10.1007/s00520-018-4125-1.CrossRefPubMed

Ben Charif A, Bouhnik AD, Courbiere B, Rey D, Preau M, Bendiane MK, et al. Sexual health problems in French cancer survivors 2 years after diagnosis-the national VICAN survey. J Cancer Surviv. 2016;10(3):600–9. https://doi.org/10.1007/s11764-015-0506-3.CrossRefPubMed

Dizon DS, Suzin D, McIlvenna S. Sexual health as a survivorship issue for female cancer survivors. Oncologist. 2014;19(2):202–10. https://doi.org/10.1634/theoncologist.2013-0302.CrossRefPubMedPubMedCentral

Farthmann J, Hanjalic-Beck A, Veit J, Rautenberg B, Stickeler E, Erbes T, et al. The impact of chemotherapy for breast cancer on sexual function and health-related quality of life. Support Care Cancer. 2016;24(6):2603–9. https://doi.org/10.1007/s00520-015-3073-2.CrossRefPubMed

Gilbert E, Ussher JM, Hawkins Y. Accounts of disruptions to sexuality following cancer: the perspective of informal carers who are partners of a person with cancer. Health. 2009;13(5):523–41. https://doi.org/10.1177/1363459308336795.CrossRefPubMed

10.

Hawkins Y, Ussher J, Gilbert E, Perz J, Sandoval M, Sundquist K. Changes in sexuality and intimacy after the diagnosis and treatment of cancer: the experience of partners in a sexual relationship with a person with cancer. Cancer Nurs. 2009;32(4):271–80. https://doi.org/10.1097/NCC.0b013e31819b5a93.CrossRefPubMed

11.

Kedde H, van de Wiel HB, Weijmar Schultz WC, Wijsen C. Sexual dysfunction in young women with breast cancer. Support Care Cancer. 2013;21(1):271–80. https://doi.org/10.1007/s00520-012-1521-9.CrossRefPubMed

12.

Twitchell DK, Wittmann DA, Hotaling JM, Pastuszak AW. Psychological impacts of male sexual dysfunction in pelvic cancer survivorship. Sex Med Rev. 2019;7:614–26. https://doi.org/10.1016/j.sxmr.2019.02.003.CrossRefPubMedPubMedCentral

13.

Ben Charif A, Bouhnik AD, Courbiere B, Rey D, Preau M, Bendiane MK, et al. Patient discussion about sexual health with health care providers after cancer-a national survey. J Sex Med. 2016;13(11):1686–94. https://doi.org/10.1016/j.jsxm.2016.09.005.CrossRefPubMed

14.

Bober SL, Varela VS. Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol. 2012;30(30):3712–9. https://doi.org/10.1200/jco.2012.41.7915.CrossRefPubMed

15.

Stabile C, Goldfarb S, Baser RE, Goldfrank DJ, Abu-Rustum NR, Barakat RR, et al. Sexual health needs and educational intervention preferences for women with cancer. Breast Cancer Res Treat. 2017;165(1):77–84. https://doi.org/10.1007/s10549-017-4305-6.CrossRefPubMedPubMedCentral

16.

Sadovsky R, Basson R, Krychman M, Morales AM, Schover L, Wang R, et al. Cancer and sexual problems. J Sex Med. 2010;7(1 Pt 2):349–73. https://doi.org/10.1111/j.1743-6109.2009.01620.x.CrossRefPubMed

17.

Gilbert E, Perz J, Ussher JM. Talking about sex with health professionals: the experience of people with cancer and their partners. Eur J Cancer Care. 2016;25(2):280–93. https://doi.org/10.1111/ecc.12216.CrossRef

18.

Hautamaki-Lamminen K, Lipiainen L, Beaver K, Lehto J, Kellokumpu-Lehtinen PL. Identifying cancer patients with greater need for information about sexual issues. Eur J Oncol Nurs. 2013;17(1):9–15. https://doi.org/10.1016/j.ejon.2012.03.002.CrossRefPubMed

19.

Flynn KE, Reese JB, Jeffery DD, Abernethy AP, Lin L, Shelby RA, et al. Patient experiences with communication about sex during and after treatment for cancer. Psycho-oncology. 2012;21(6):594–601. https://doi.org/10.1002/pon.1947.CrossRefPubMed

20.

Reese JB, Sorice K, Lepore SJ, Daly MB, Tulsky JA, Beach MC. Patient-clinician communication about sexual health in breast cancer: a mixed-methods analysis of clinic dialogue. Patient Educ Couns. 2019;102(3):436–42. https://doi.org/10.1016/j.pec.2018.10.003.CrossRefPubMed

21.

Stead ML, Brown JM, Fallowfield L, Selby P. Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. Br J Cancer. 2003;88(5):666–71. https://doi.org/10.1038/sj.bjc.6600799.CrossRefPubMedPubMedCentral

22.

Sporn NJ, Smith KB, Pirl WF, Lennes IT, Hyland KA, Park ER. Sexual health communication between cancer survivors and providers: how frequently does it occur and which providers are preferred? Psycho-oncology. 2015;24(9):1167–73. https://doi.org/10.1002/pon.3736.CrossRefPubMed

23.

Hordern AJ, Street AF. Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs. Med J Aust. 2007;186(5):224–7.CrossRef

24.

Adams E, Hill E, Watson E. Fertility preservation in cancer survivors: a national survey of oncologists' current knowledge, practice and attitudes. Br J Cancer. 2013;108(8):1602–15. https://doi.org/10.1038/bjc.2013.139.CrossRefPubMedPubMedCentral

25.

Depke JL, Onitilo AA. Sexual health assessment and counseling: oncology nurses' perceptions, practices, and perceived barriers. J Community Support Oncol. 2015;13(12):442–3. https://doi.org/10.12788/jcso.0174.CrossRefPubMed

26.

Frederick NN, Campbell K, Kenney LB, Moss K, Speckhart A, Bober SL. Barriers and facilitators to sexual and reproductive health communication between pediatric oncology clinicians and adolescent and young adult patients: the clinician perspective. Pediatr Blood Cancer. 2018;65(8):e27087. https://doi.org/10.1002/pbc.27087.CrossRefPubMed

27.

Jonsdottir JI, Zoega S, Saevarsdottir T, Sverrisdottir A, Thorsdottir T, Einarsson GV, et al. Changes in attitudes, practices and barriers among oncology health care professionals regarding sexual health care: outcomes from a 2-year educational intervention at a university hospital. Eur J Oncol Nurs. 2016;21:24–30. https://doi.org/10.1016/j.ejon.2015.12.004.CrossRefPubMed

28.

Krouwel EM, Albers LF, Nicolai MPJ, Putter H, Osanto S, Pelger RCM, et al. Discussing sexual health in the medical oncologist’s practice: exploring current practice and challenges. J Cancer Educ. 2019. https://doi.org/10.1007/s13187-019-01559-6.

29.

Krouwel EM, Hagen JH, Nicolai MP, Vahrmeijer AL, Putter H, Pelger RC, et al. Management of sexual side effects in the surgical oncology practice: a nationwide survey of Dutch surgical oncologists. Eur J Surg Oncol. 2015;41(9):1179–87. https://doi.org/10.1016/j.ejso.2015.06.009.CrossRefPubMed

30.

Krouwel EM, Nicolai MP, van der Wielen GJ, Putter H, Krol AD, Pelger RC, et al. Sexual concerns after (pelvic) radiotherapy: is there any role for the radiation oncologist? J Sex Med. 2015;12(9):1927–39. https://doi.org/10.1111/jsm.12969.CrossRefPubMed

31.

Krouwel EM, Nicolai MP, van Steijn-van Tol AQ, Putter H, Osanto S, Pelger RC, et al. Addressing changed sexual functioning in cancer patients: a cross-sectional survey among Dutch oncology nurses. Eur J Oncol Nurs. 2015;19(6):707–15. https://doi.org/10.1016/j.ejon.2015.05.005.CrossRefPubMed

32.

Reese JB, Beach MC, Smith KC, Bantug ET, Casale KE, Porter LS, et al. Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study. Support Care Cancer. 2017;25(10):3199–207. https://doi.org/10.1007/s00520-017-3729-1.CrossRefPubMedPubMedCentral

33.

Schouten B, Bergs J, Vankrunkelsven P, Hellings J. Healthcare professionals’ perspectives on the prevalence, barriers and management of psychosocial issues in cancer care: a mixed methods study. European Journal of Cancer Care. 2019;28(1):e12936. https://doi.org/10.1111/ecc.12936.CrossRefPubMed

34.

Almont T, Farsi F, Krakowski I, El Osta R, Bondil P, Huyghe E. Sexual health in cancer: the results of a survey exploring practices, attitudes, knowledge, communication, and professional interactions in oncology healthcare providers. Support Care Cancer. 2019;27(3):887–94. https://doi.org/10.1007/s00520-018-4376-x.CrossRefPubMed

35.

Canzona MR, Garcia D, Fisher CL, Raleigh M, Kalish V, Ledford CJ. Communication about sexual health with breast cancer survivors: variation among patient and provider perspectives. Patient Educ Couns. 2016;99(11):1814–20. https://doi.org/10.1016/j.pec.2016.06.019.CrossRefPubMed

36.

Ussher JM, Perz J, Gilbert E. Perceived causes and consequences of sexual changes after cancer for women and men: a mixed method study. BMC Cancer. 2015;15:268. https://doi.org/10.1186/s12885-015-1243-8.CrossRefPubMedPubMedCentral

37.

Oxford levels of evidence based medicine. Centre for Evidence Based Medicine. Available from: www.cebm.net.

38.

Kim JH, Shin JS. Effects of an online problem-based learning program on sexual health care competencies among oncology nurses: a pilot study. J Contin Educ Nurs. 2014;45(9):393–401. https://doi.org/10.3928/00220124-20140826-02.CrossRefPubMed

39.

Hordern AGM, Hegarty S, Jefford M, White V, Sutherland G. Discussing sexuality in the clinical setting: the impact of a brief training program for oncology health professionals to enhance communication about sexuality. Asia-Pac J Clin Oncol. 2009;5:270–7.CrossRef

40.

Reese JB, Lepore SJ, Daly MB, Handorf E, Sorice KA, Porter LS, et al. A brief intervention to enhance breast cancer clinicians’ communication about sexual health: feasibility, acceptability, and preliminary outcomes. Psycho-oncology. 2019;28(4):872–9. https://doi.org/10.1002/pon.5036.CrossRefPubMedPubMedCentral

41.

Grondhuis Palacios LA, Hendriks N, den Ouden MEM, Reisman Y, Beck JJH, den Oudsten BL, et al. Investigating the effect of a symposium on sexual health care in prostate cancer among Dutch healthcare professionals. J Clin Nurs. 2019;28:4357–66. https://doi.org/10.1111/jocn.15012.CrossRefPubMed

42.

Wang LY, Pierdomenico A, Lefkowitz A, Brandt R. Female sexual health training for oncology providers: new applications. Sex Med. 2015;3(3):189–97. https://doi.org/10.1002/sm2.66.CrossRefPubMedPubMedCentral

43.

Afiyati YKB, Ruwaida I, Rachmawati I, Agustini N. Improving quality of life on cancer patient by implementation of psychosexual health care. Jurnal Ners. 2016;11(1):7–16.CrossRef

44.

Kim S, Kang HS, Kim J-H. A sexual health care attitude scale for nurses: development and psychometric evaluation. Int J Nurs Stud. 2011;48(12):1522–32. https://doi.org/10.1016/j.ijnurstu.2011.06.008.CrossRefPubMed

45.

Davis D, Galbraith R. Continuing medical education effect on practice performance: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines. Chest, 2009;135(3 Suppl):42s–8s. https://doi.org/10.1378/chest.08-2517.

46.

Winterling J, Lampic C, Wettergren L. Fex-talk: a short educational intervention intended to enhance Nurses' readiness to discuss fertility and sexuality with cancer patients. J Cancer Educ. 2019. https://doi.org/10.1007/s13187-019-01493-7.

47.

Duimering A, Walker LM, Turner J, Andrews-Lepine E, Driga A, Ayume A, et al. Quality improvement in sexual health care for oncology patients: a Canadian multidisciplinary clinic experience. Supportive Care in Cancer. 2019;28:2195–203. https://doi.org/10.1007/s00520-019-05040-4.CrossRefPubMed

48.

Roberts K, Chong T, Hollands E, Tan J, Mohan G, Cohen PA. Screening for sexual health concerns in survivors of gynecological cancer. Support Care Cancer. 2019;28:599–605. https://doi.org/10.1007/s00520-019-04872-4.CrossRefPubMed

49.

Jung D, Kim JH. Effects of a sexual health care nursing record on the attitudes and practice of oncology nurses. Sex Reprod Healthc. 2016;9:21–6. https://doi.org/10.1016/j.srhc.2016.06.001.CrossRefPubMed

50.

Barbera L, Fitch M, Adams L, Doyle C, Dasgupta T, Blake J. Improving care for women after gynecological cancer: the development of a sexuality clinic. Menopause. 2011;18(12):1327–33. https://doi.org/10.1097/gme.0b013e31821f598c.CrossRefPubMed

Title: Can the provision of sexual healthcare for oncology patients be improved? A literature review of educational interventions for healthcare professionals
Authors: L.F. Albers
L.A. Grondhuis Palacios
R.C.M. Pelger
H.W. Elzevier
Publication date: 01-12-2020
Publisher: Springer US
Keyword: Care
Published in: Journal of Cancer Survivorship / Issue 6/2020
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-020-00898-4

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Implications for Cancer Survivors

Please log in to get access to this content

Other articles of this Issue 6/2020

Breast cancer survivors living with chronic neuropathic pain show improved brain health following mindfulness-based stress reduction: a preliminary diffusion tensor imaging study

“Katz activities of daily living disability in older cancer survivors by age, stage, and cancer type”

Recommendations for the surveillance of cancer-related fatigue in childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group

The use of survivorship care plans by female racial and ethnic minority breast cancer survivors: a systematic review

Looking under the hood of “the Cadillac of cancers:” radioactive iodine-related craniofacial side effects among patients with thyroid cancer

Gynaecological cancer leads to long-term sick leave and permanently reduced working ability years after diagnosis

Keynote webinar | Spotlight on antibody–drug conjugates in cancer