Few internists who care for cancer survivors address issues of sexual dysfunction with their patients, according to a study led by Massachusetts General Hospital (MGH) researchers. In their article appearing in a November 2009 cancer survivor supplement to the Journal of General Internal Medicine, now available online, the investigators report that more than half the internists responding to a survey indicated they rarely or never discussed sexual problems with their patients who had survived cancer.
"Sexual dysfunction is an important quality-of-life issue that many cancer survivors struggle with," says Elyse Park, PhD, MPH, of the MGH Institute for Health Policy, who led the study. "If these conversations are not happening in the primary care physician's office, they're not likely to be happening anywhere."
As more cancer patients live longer after treatment, quality-of-life concerns become more important. Sexual dysfunction is common not only among prostate and breast cancer survivors but also in significant percentages of survivors of other types of tumors. Problems may result from the cancer itself or its treatment, and patients can also experience depression, anxiety and concerns about body image that can interfere with desire, intimacy and sexual functioning. While many effective treatments are available for sexual dysfunction, the authors note, treatment can only begin if affected patients are identified. And for more and more cancer survivors, the primary care physician is their most significant health care provider.
The current report is part of a larger survey of primary care physicians' caring for cancer survivors. Among questions on the survey sent to more than 200 internists affiliated with the University of Colorado were how often they addressed issues of sexual dysfunction with adult cancer survivors and how likely they were to initiate such discussions. Only 46 percent reported they were somewhat or very likely to bring up sexual issues during a patient visit, and 62 percent indicated they rarely or never addressed the subject with cancer survivors.