Clinicians should take a more active role in discussing sexual dysfunction with their patients, according to updates to National Comprehensive Cancer Network (NCCN) guidelines, which were presented at the NCCN annual meeting in Hollywood, FL (March 31—April 2).
Cancer treatments such as radiation and surgery can have a significant impact on a patients’ physical and social well-being. These side effects are especially common in men, where conditions such as erectile dysfunction, orgasmic or ejaculatory problems, low testosterone, and penile curvatures have been known to occur.
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In an effort to address these issues and improve patients’ overall quality of life, Joseph B Narus, DNP, GNP-BC, ANP, Memorial Sloan Kettering Cancer Center (New York City, NY), presented updates to the NCCN’s guidelines on sexual function in male cancer survivors.
The new guidelines, said Mr Narus, are a simplified version of the older guidelines, outlining how to approach managing patients with or at risk of sexual dysfunction. It also advises physicians on how to talk with patients who may or may not be ready to pursue treatment. Often, men make their sexual function a secondary concern to treating their disease, which is why physicians need to make sure conversations are being broached with patients before, during, and after their treatment is completed.
Sexual dysfunction is not just a problem for men with cancer, however. Michelle Melisko, MD, University of California San Francisco Helen Diller Family Comprehensive Cancer Center (San Francisco, CA), also presented updates on the guidelines pertaining to women.
The new guidelines for women reflect both changes in treatment and physicians’ understanding about sexual issues facing female survivors, including body image concerns, pain during sex, or loss of desire. They also add more detailed advice for certain medications included in older recommendations, such as flibanserin, an agent approved to treat hypoactive sexual desire disorder in premenopausal women.
Years ago, the understanding of sexual dysfunction was centered primarily around how treatment affected the body, said Dr Melisko, but, as more patients have survive their disease, awareness surrounding the larger issues associated with care is needed. Most of all, Mr Narus and Dr Melisko said the focus of the new guidelines is to make sure that patients and physicians understand that this is an important aspect of the survivorship experience.
