OncoSexology clinic in Portugal
Monteiro, L1; Ramos, R1; Silva, J1; Sofia, A1; Pereira, C1; Alves, V 1; Silva, C1; Paranhos, S1; Raposo, S1; Lerias, C1; Nave, C1
1: PORTUGUESE INSTITUTE OF ONCOLOGY LISBON, Portugal
Objectives: Cancer affects sexuality in multiple and cumulative ways. Fifty per cent of cancer patients and survivors have sexual difficulties secondary to cancer and its treatment. Loss of sexual desire, erectile dysfunction (ED) and dyspareunia are the most prevalent sexual dysfunctions. Even if cancer cured, sexual problems tend to worsen over time and become chronic if not prevented or immediately treated. Millions of patients and survivors need clear information, screening and prompt intervention on predictable sexual consequences of cancer treatment. This work highlights the OncoSexology Clinic experience in a major Portuguese oncology center.
Methods: Description of the OncoSexology Clinic created in 2009: mission, organization, professional team and main groups of patients. Before starting the outpatient clinic, this group had carried out an intensive and inclusive program of education and training in Sexual Medicine and OncoSexology basics: teaching other nurses and doctors to feel more comfortable talking with patients about sex and screening expected sexual problems in each step and type of disease.
Results: OncoSexology clinic is a multidisciplinary team including nurses, physicians and psychologists from Gynaecology, Urology, Medical Oncology, Radiotherapy, Endocrinology and Psycho-Oncology Departments. In 2017 the outpatient OncoSexology Clinic attends about 500 cancer patients, both sexes, under or immediately after oncological treatments. Most common dysfunctions are hypoactive desire, ED and dyspareunia. An intensive approach based on psychoeducation for both sexes plus 5-PDE inhibitors and alprostadil for men and vaginal lubricants, massage techniques and dilators for women, attains a high treatment success. ED treatment increases IIEF score in 80% in three months, medium. The vaginal stenosis prevention program for women with pelvic cancer and irradiation, carried out by Radiotherapy and Gynaecology nurses, enables the majority of patients to achieve sexual intercourse without pain.
Conclusions: A multidisciplinary approach empowers cancer patients to better cope and prevent the negative consequences of oncological disease and treatments in sexual life. OncoSexology is a cornerstone of twenty-first century comprehensive cancer care and allows most patients and survivors a better quality of life.
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