Undergraduate and postgraduate education for health professionals must include teaching health professionals how to talk to patients with cancer about sex, cancer experts say.
Sexuality after cancer is a sensitive subject many patients want to discuss with their doctor or member of their treating team, say Dr Amanda Hordern of the Cancer Council Victoria, and Dr Annette Street of La Trobe University's Clinical School of Nursing.
The results of their research into communication of intimacy and sexual changes following cancer are published in the latest Medical Journal of Australia.
Dr Hordern and Prof Street found patients want open, supportive and practical communication about adjusting to intimate and sexual changes after cancer, but health professionals feel unable to adequately provide them with answers. "Most patients were searching for a health professional they could trust to provide them with information, emotional support and practical strategies... and believed if the topic was important, their doctor would raise it with them," says Dr Hordern.
One patient said, "I want to enter a partnership between the medical professional and the patient... which would see me as part owner of everything that is being done to me."
But health professionals reported that it was difficult to consider a patient's sexuality in an environment and culture that emphasised clinical, problem-based, professional communication.
"There is an underlying assumption that they [health professionals] have the time, capacity and skills to provide patients with support and information," says Dr Hordern.
"Many health professionals expressed a feeling of vulnerability, including fear of patient litigation and the reaction of their colleagues."
One health professional pointed out that if they did not have the courage or expertise to bring up the issue of sexuality, then they could not expect their patients to do so.
"Health professionals require advanced communication education, a formal referral process, and resources, strategies and tools... to facilitate a systematic approach to the kind of patient centred information and support patients need," says Dr Hordern.
"Resources need to be researched, developed and incorporated into undergraduate and postgraduate education programs to change practice."