Books


Sexuality

Introduction

  • Body image changes probably occur in most patients with cancer and can greatly impact quality of life
  • The outward effects of cancer and its treatment can impact significantly on body image, self esteem and sexual desire
  • both men and women may be profoundly affected by hair loss due to chemotherapy
  • both men and women often lose interest in sex during cancer treatment, at least for a time
  • loss of desire may result from anxiety, depression, nausea, pain or many other symptoms
  • cancer treatment that interferes with the normal hormone balance can also lessen desire


Assessment

  • body image assessment may include gathering information about self-esteem, general coping skills, significance to the patient, importance of affected body parts, level of social interaction, social support systems, patient expectations and need for information
  • sexual assessment involves a series of discussion about the specific effects of treatment on sexual function and the options for adoption or resumption of sexual activity
  • consider the psychosocial and physical characteristics of the couple prior to the diagnosis as well as problems presented by the cancer
  • a brief sexual assessment might include the following questions:
    • has being ill interfered with your being a husband, father, wife, mother?
    • has your illness changed the way you see yourself as a man/woman?
    • has your illness affected your sexual function?
  • assess need for position changes
  • see A Cancer Source Book for Nurses, 7th edition, for an excellent discussion of assessment parameters regarding changes in sexual function and sexual desire


Intervention

  • initial interventions should include educational preparation for the impending body image change
  • help family members and social support system members to examine the meaning of the changes and communicate acceptance to the patient
  • consider referral to local hospitals, community organizations or American Cancer Society for peer support groups
  • many types of wigs, scarves, caps and head coverings are available, most oncology offices, cancer centers and American Cancer Society can provide information about businesses that cater to cancer patients as well as help for low income patients
  • American Cancer Society provides programs such as "Look Good, Feel Better" to help women with hair and makeup tips during treatment
  • nursing management of patient's sexual concerns are based on four components: assessment, education, counseling and referral
  • give the patient permission to express sexual concerns
  • encourage the patient to ask his or her doctor and nurse about the usual and expected effects of cancer treatment on his or her sex life
  • encourage the patient to keep an open mind about ways to feel sexual pleasure
  • consider sexual counseling with a sex therapist for problems caused by anxiety
  • staying active is a good way to fight depression and reduce stress, consult with the doctor on appropriate types of exercise
  • encourage touching, explore hidden fears about contagion and radioactivity, if appropriate


References

Burke, MB (1997). Sexuality, Sexual Dysfunction, and Cancer in Varricchio, C. (Ed) A Cancer Source Book for Nurses, 7th ed. Atlanta: The American Cancer Society.

Burns, N. and Holmes, BC (1996) Body Image Changes in McCorkle, R., Grant, M., Frank-Stromborg, M., Baird, S. Cancer Nursing: A Comprehensive Textbook, 2nd ed. Philadelphia: WB Saunders Company, 1996

Lamb, MA (1996) Sexuality in McCorkle, R., Grant, M., Frank-Stromborg, M., Baird, S. Cancer Nursing: A Comprehensive Textbook, 2nd ed. Philadelphia: WB Saunders Company, 1996

Schover, LK (1988) Sexuality and Cancer: For the Man/Woman Who Has Cancer and His/Her Partner. American Cancer Society

Smith, DB (1994) Sexuality in Gross, J., Johnson, BL. Handbook of Oncology Nursing, 2nd ed. Boston: Jones and Bartlett, 1994





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