Interventions to address sexual problems in people with cancer: American Society of Clinical Oncology clinical practice guideline adaptation of Cancer Care Ontario guideline Journal Article


Authors: Carter, J.; Lacchetti, C.; Andersen, B. L.; Barton, D. L.; Bolte, S.; Damast, S.; Diefenbach, M. A.; DuHamel, K.; Florendo, J.; Ganz, P. A.; Goldfarb, S.; Hallmeyer, S.; Kushner, D. M.; Rowland, J. H.
Article Title: Interventions to address sexual problems in people with cancer: American Society of Clinical Oncology clinical practice guideline adaptation of Cancer Care Ontario guideline
Abstract: Purpose The adaptation of the Cancer Care Ontario (CCO) guideline Interventions to Address Sexual Problems in People With Cancer provides recommendations to manage sexual function adverse effects that occur as a result of cancer diagnosis and/or treatment. Methods ASCO staff reviewed the guideline for developmental rigor and updated the literature search. An ASCO Expert Panel (Table A1)was assembled to reviewthe guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the 2016 CCO guideline are clear, thorough, and based upon the most relevant scientific evidence. ASCO statements and modifications were added to adapt the CCO guideline for a broader audience. Recommendations It is recommended that there be a discussion with the patient, initiated by a member of the health care team, regarding sexual health and dysfunction resulting from cancer or its treatment. Psychosocial and/or psychosexual counseling should be offered to all patients with cancer, aiming to improve sexual response, body image, intimacy and relationship issues, and overall sexual functioning and satisfaction. Medical and treatable contributing factors should be identified and addressed first. In women with symptoms of vaginal and/or vulvar atrophy, lubricants in addition to vaginal moisturizers may be tried as a first option. Low-dose vaginal estrogen, lidocaine, and dehydroepiandrosterone may also be considered in some cases. In men, medication such as phosphodiesterase type 5 inhibitors may be beneficial, and surgery remains an option for those with symptoms or treatment complications refractory to medical management. Both women and men experiencing vasomotor symptoms should be offered interventions for symptomatic improvement, including behavioral options such as cognitive behavioral therapy, slow breathing and hypnosis, and medications such as venlafaxine and gabapentin.Additional information is available at: Www.asco. org/survivorship-guidelines and www.asco.org/guidelineswiki. © 2017 by American Society of Clinical Oncology.
Keywords: treatment outcome; cancer patient; breast cancer; aromatase inhibitor; estrogen; dyspareunia; gynecological examination; sexual satisfaction; vagina pain; patient education; practice guideline; patient care; sexual dysfunction; sexuality; screening; urine incontinence; health care personnel; lidocaine; postmenopause; venlafaxine; hypnosis; erectile dysfunction; testosterone; sexual function; paroxetine; physiotherapy; patient counseling; phosphodiesterase v inhibitor; body image; psychotherapy; sexual behavior; vasomotor disorder; gabapentin; scientific literature; clonidine; feces incontinence; breathing exercise; stress incontinence; lower urinary tract symptom; intimacy; vulva disease; sexual education; vagina atrophy; lubricating agent; hypoactive sexual desire disorder; prasterone; cognitive behavioral therapy; human; priority journal; article; flibanserin; ospemifene
Journal Title: Journal of Clinical Oncology
Volume: 36
Issue: 5
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2018-02-10
Start Page: 492
End Page: 511
Language: English
DOI: 10.1200/jco.2017.75.8995
PROVIDER: scopus
PUBMED: 29227723
DOI/URL:
Notes: Article -- Export Date: 1 March 2018 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Katherine N Duhamel
    87 Duhamel
  2. Jeanne Carter
    107 Carter