No One-Size-Fits-All: Sexual Health Education Preferences in Patients with Breast Cancer

Abstract

Background Using explanatory mixed methods, we characterize the education that patients with breast cancer received about potential sexual health effects of treatment and explore preferences in format, content, and timing of education. Patients and Methods Adult patients with stage 0–IV breast cancer seen at an academic breast center during December 2020 were emailed questionnaires assessing sexual health symptoms experienced during treatment. Patients interested in further study involvement were invited to participate in semistructured interviews. These interviews explored sexual health education provided by the oncology team and patient preferences in content, format, and timing of education delivery. Results Eighty-seven (32%) patients completed the questionnaire. Most patients reported decreased sexual desire (69%), vaginal dryness (63%), and less energy for sexual activity (62%) during/after treatment. Sixteen patients participated in interviews. Few women reported receiving information about potential sexual effects of breast cancer treatment; patients who did reported a focus on menopausal symptoms or fertility rather than sexual function. Regarding preferences in format, patients were in favor of multiple options being offered rather than a one-size-fits-all approach, with particular emphasis on in-person options and support groups. Patients desired education early and often throughout breast cancer treatment, not only about sexual side effects but also on mitigation strategies, sexual function, dating and partner intimacy, and body image changes. Conclusion Few patients received information about the sexual health effects of breast cancer treatment, though many experienced symptoms. Potential adverse effects should be discussed early and addressed often throughout treatment, with attention to strategies to prevent and alleviate symptoms and improve overall sexual health.

Improving Sexual Health Across the Life Span Through Integrated Care in Obstetrics and Gynecology

“…14,[19][20][21][22][23] In addition, research on women with early breast cancer indicated a strong preference for providers to ask about sexual health early and often by incorporating this into routine screening performed over the course of care. 24 All too often, however, health care providers and trainees do not feel adequately prepared to discuss sexual health concerns with patients; primary care providers and OB/GYN's cite a perception of a lack of effective therapies as a barrier to initiating assessment of sexual health concerns. More than half of OB/GYN residents in a recent survey were unable to describe the disorders of sexual function or list medications that affect sexual function.…”

“…A proactive style, where the provider enquires about sexual functioning in the past, is “permission granting” to patients to discuss such problems in the future 14,19–23 . In addition, research on women with early breast cancer indicated a strong preference for providers to ask about sexual health early and often by incorporating this into routine screening performed over the course of care 24 …”

23rd Annual Meeting of the American Society of Breast Surgeons: Back to In-Person Scientific Exploration

“…9 Additionally, we had papers exploring aspects of breast sensuality in survivors and sexual health education. 10,11 Lastly, we had several papers examining axillary response to neoadjuvant treatment in the age of tumor genomic testing supporting de-escalation of axillary surgery in situations where it may not impact adjuvant treatment decisions. 12,13 Despite these turbulent times during the COVID-19 pandemic, the science of breast cancer surgical treatment continues as we study ways to refine our techniques and indications in the face of unforeseen challenges and improve surgical treatment for patients.…”

A guide for addressing sexual health in breast cancer patients

“…Studies have shown that breast cancer patients want more sexual health information from their healthcare providers 10–12 . Patients prefer to have the information before their treatments so that they are able to prepare, adjust, and cope with the changes in their sexual health—as one of the patients in Huynh et al's study quoted, “more preventative than reactionary.” 7,13 While providers do not need to be sexual health experts to provide guidance, they may benefit from having the knowledge or tools to counsel patients effectively 9 . In this paper, we aim to share ways for providers to address sexual health concerns for breast cancer patients at different stages of the treatment process.…”

“…Patients report that they would like information and counseling throughout their cancer experience. 7,13 Here, we provide four recommendations for all providers throughout care (Figure 1).…”