Sexual health assessed and treated as a standard toxicity domain
Cancer treatment often damages sexual function and intimacy, and almost nobody asks. Make it a routine question with a clinic to refer to.
Sexual dysfunction after pelvic surgery, radiotherapy, endocrine therapy and stem cell transplant is very common and is among the least discussed toxicities. The proposal is routine screening with a brief validated item set at treatment milestones, a referral pathway to sexual health services (pelvic floor physiotherapy, vaginal and erectile therapies, counselling), and inclusion of sexual function as a PRO domain in trials of pelvic and endocrine treatments.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
- Survivorship and late effects are neglected · Tens of millions of people live after cancer with heart damage, infertility, second cancers and fear, and few services.
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