Lately@MSKCC, April 2005 - As any woman dealing with cancer knows, the potentially disruptive effects of the disease can reach beyond the obvious challenges encountered during treatment. Among the many secondary concerns, sexual dysfunction is a common consequence of diagnosis and treatment. Although the majority of sexual health problems experienced by women can be effectively treated, this sensitive subject is often left unaddressed. In an effort to change this, Memorial Sloan-Kettering Cancer Center has created a Sexual Medicine Program, which treats both current and former cancer patients regardless of age, sexual orientation, or relationship status.
In the Shadows of Standard Cancer Care: Female Sexual Dysfunction
Health care providers may not have the time, resources, or training to deal with sexual health problems experienced by women with cancer. In addition, women may feel embarrassed discussing the subject with their caregivers. As a result of these factors, sexual problems experienced by female cancer patients are often neglected and left untreated.
"As more women are surviving cancer, we are seeing an increasing number of them having to deal with the sexual ramifications of cancer therapy," says Dr. Michael Krychman, a sexual medicine gynecologist and the Co-Director of the Sexual Medicine Program at Memorial Sloan-Kettering. "And as they become more aware of the issues involved, they are demanding help, which is why we have created our program."
The Sexual Medicine Program at Memorial Sloan-Kettering
Offering a comprehensive psychosexual and gynecological evaluation, which includes patient history, clinical physical examination, and any necessary laboratory tests, the Sexual Medicine Program can treat a woman's sexual problems with a wide array of tools -- physical therapy, hormonal manipulation, counseling (individual, cognitive, behavioral, and psychiatric), and alternative therapies. "We also delve into lifestyle issues that can affect sexuality, such as diet, exercise, and stress management," Dr. Krychman explains.
The most common sexual health problems experienced by women dealing with cancer include treatment-induced menopause and vaginal dryness, which can lead to painful intercourse and a resulting diminution in sexual desire; body image issues, due, for example, to the removal of a body part such as a breast; and fertility concerns after systemic therapy.
Dr. Krychman notes that sexual rehabilitation during and after cancer does not always involve sexual intercourse: "What it does mean is physical connectedness and intimacy." This intimate connection between a woman and her partner means that any potential sexual problems are shared by both. "Cancer does not always affect only the patient," he adds. "It also can affect the patient's partner." As a result, a patient's partner is often encouraged to participate in the sexual rehabilitation process.
In addition to the clinical care components of the Sexual Medicine Program, the Program also offers patient and public education, medical education, and clinical research -- all key elements in the effort to make both patients and healthcare providers more aware of this often neglected issue.
An Opportunity for Women of All Ages
To date, the Program has treated women of all ages, from teenagers to octogenarians. "Nowadays, married or single, young or old, heterosexual or lesbian, women feel that sexuality is a vital component to overall health and quality of life," Dr. Krychman reports. "As we are living longer, cancer survivors are demanding an improved quality of life, and a healthy sex life is an essential component of that. It is our job to help them achieve it."
For more information about the Memorial Sloan-Kettering Sexual Health Program for Women, call 212-639-8480.
