Interventions to Address Sexual Problems in People With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Adaptation of Cancer Care Ontario Guideline
- Study type
- Clinical guideline
- Study name
- ASCO/CCO Sexual Health 2018
- Design
- Clinical practice guideline; ASCO adaptation of the 2016 Cancer Care Ontario (CCO) guideline with review of methodological rigour, an updated literature search and review by an expert panel
- Source
- JCO · 2018
In plain words
Cancer and its treatments can affect sexual desire and function, how you feel about your body and your relationship with your partner. This guideline recommends that the care team itself raises this topic with you and offers psychological or psychosexual counselling to every patient. There are medical and non-medical solutions for problems such as vaginal dryness, erection problems and hot flushes. If you have such problems, talk about them with your doctor.
Key guideline recommendations
A member of the care team should initiate the discussion with the patient about sexual health and sexual dysfunction resulting from cancer or its treatment.
Psychosocial and/or psychosexual counselling should be offered to all patients with cancer, with the aim of improving sexual response, body image, intimacy and relationship issues, and overall sexual functioning and satisfaction.
Contributing medical and treatable factors should be identified and addressed first.
In women with symptoms of vaginal and/or vulvar atrophy, lubricants in addition to vaginal moisturisers may be tried as the first option. Low-dose vaginal oestrogen, lidocaine and dehydroepiandrosterone may also be considered in some cases.
In men, medicines such as phosphodiesterase type 5 inhibitors may be helpful, and surgery remains an option for those with symptoms or treatment effects refractory to medical management.
Women and men with vasomotor symptoms should be offered interventions to improve symptoms, including behavioural options (cognitive behavioural therapy, slow breathing and hypnosis) and medicines such as venlafaxine and gabapentin.
Study population
People with cancer (women and men) who develop sexual side effects or problems with sexual function after a cancer diagnosis and/or its treatment.
Endpoints
This guideline is not a trial and has no endpoint. Its aim is to give recommendations for managing sexual adverse effects resulting from the diagnosis and/or treatment of cancer.
Clinical significance and place in guidelines
The ASCO panel judged the recommendations of the 2016 CCO guideline to be clear, thorough and based on the most relevant evidence, and with added statements and modifications made it usable for a wider audience. The guideline emphasises that the care team should initiate the conversation about sexual health, that counselling should be offered to all patients, and that treatable medical factors should be identified and addressed first. The current status of the guideline (later updates) should be checked from official ASCO sources.
Limitations
The abstract does not mention the guideline's limitations. The level of evidence and strength of each recommendation are not given in the abstract and should be checked in the full text.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.