SPECIAL ISSUE: THE 50th ANNIVERSARY OF THE NATIONAL CANCER ACT OF 1971 - COMMENTARY - SEXUALITYANDCANCER: WHATWE KNOW AND WHERE WE NEED TO GO

Abstract

Sexuality in cancer patients has been studied for at least 70 years, with the earliest work done by oncologists comparing outcomes of patients receiving different treatments. However, Masters’ and Johnson’s studies of sexuality (1966) and sexual dysfunction (1970), which legitimatized the scienti c study of sexuality across persons and contexts, had a signi cant impact. In the 1970’s and early 1980’s, behavioral scientists began programmatic study of various aspects of sexuality, developed self- report and physiological measures, proposed treatments, and conducted trials to treat sexual dysfunction in otherwise healthy adults. These contributions provided important theoretical, psychometric, and clinical entrees for the study of sexuality in cancer patients. Early studies used modest research designs (retrospective, case control), but by the mid 1980s new data, particularly regarding breast cancer sexual sequalae, had accumulated. In the 1990s, discovery of factors which covaried with sexual morbidity gained momentum, and clinical approaches for addressing sexual dysfunction emerged. Since 2000, over 40 studies have tested psycho-educational and/ or psychological interventions. At this time, the discipline is in place and poised for the future to re ne existing contributions and move in new directions. Studies of patients with breast, gynecologic or prostate cancers have predominated, with some patients left understudied (e.g. hematologic) or unstudied (lung, kidney, stomach). Regarding interventions, pilot studies are needed for some (bladder, head and neck, and testicular patients), and for others (breast, gynecologic, prostate) dismantling studies to identify active treatment components are needed. But for all disease sites and study contexts, greater representation of individuals across the lifespan, racial and ethnic diversity, culture, sexual orientation, and gender identity is essential for meaningful progress going forward. And lastly, choosing prevention of sexual morbidity as the primary focus of future clinical and research efforts would be the most important and impactful direction in which we could go.

Keywords

• sexuality
• cancer
• functioning
• interventions
• outcomes