Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Rates of sexual history taking and sexual dysfunction counselling with cancer care (#327)

Verity Chadwick 1 , Michaela Kim 2 , Georgia Mills 2 3 , Catherine Tang 4 , Antoinette Anazodo 2 5 6 , Rachel Dear 2 7 , Rachael Rogers 2 8 , Orly Lavee 2 3 , Samuel Milliken 2 3 , Georgia McCaughan 3 , John Moore 2 3 , Nada Hamad 3 9 10 , Joshua Hurwitz 11
  1. Royal North Shore Hospital, St Leonards, NSW, Australia
  2. School of Medicine, University of New South Wales, Sydney, NSW, Australia
  3. Department of Haematology, St Vincent’s Hospital, Darlinghurst, NSW, Australia
  4. Department of Haematology and Flow Cytometry, Laverty Pathology, Macquarie Park, NSW, Australia
  5. Kids Cancer Centre, Sydney Children’s Hospital, Sydney, NSW, Australia
  6. Nelune Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia
  7. Department of Oncology, St Vincent’s Hospital, Sydney, NSW, Australia
  8. Department of Reproductive Medicine, Royal Hospital for Women, Sydney, NSW, Australia
  9. St Vincent's Clinical School, University of New South Wales , Randwick, NSW, Australia
  10. School of Medicine, University of Notre Dame, Daringhurst, NSW, Australia
  11. Medical Oncology, The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia

Introduction: Cancer treatment can significantly affect patient sexual function, through physical alterations and psychosocial impacts.

Aim: To investigate the incidence of sexual history documentation and counselling before, during and after cancer treatment.

Methods: Our group conducted a retrospective chart review at a major Australian cancer centre of premenopausal females aged 18-49 years diagnosed with cancer between 2017 and 2020. Data collected included primary diagnosis, stage of cancer, treatment(s) received, rates of remission or progression, involvement of a specialist gynaecologist, details of any sexual function/dysfunction discussions, and what treatment was offered.

Results: A total of 143 patients met inclusion criteria. Only 9.8% had their sexual history taken by their haematologist or oncologist, and 4.2% had their sexual histories documented by a gynaecologist. 40 patients had documented sexual dysfunction, most commonly vaginal dryness (55%), dyspareunia (28%), body image concerns (28%), bacterial vaginosis (20%), decreased libido (18%), vaginal GVHD (3%), and muscle spasms affecting coitus (3%). When these issues were discussed, they were often addressed by requesting gynaecologist, sexual health specialist and/or psychologist reviews, or by prescribing ointments, antifungals, antidepressants, lubricants, laser treatments, insertion of an intrauterine device, dilators, vaginal moisturisers, topical oestradiol or inserts.

Discussion: This rate of sexual function history taking is exceptionally low. Women’s sexual function concerns are rarely raised by physicians or volunteered by patients. To overcome existing barriers, there needs to be improved education of physicians on sexual dysfunction, implementation of systems to facilitate sexual history taking, and the provision of patient information sheets to facilitate knowledge and discussion.