Journal of Cancer Survivorship

, Volume 13, Issue 6, pp 932–942 | Cite as

Talking about sexual health during survivorship: understanding what shapes breast cancer survivors’ willingness to communicate with providers

  • Mollie Rose CanzonaEmail author
  • Carla L. Fisher
  • Kevin B. Wright
  • Christy J. W. Ledford



Breast cancer survivor (BCS)–provider communication about sexual health (SH) is often absent or inadequate. Patients report wanting providers to broach the topic, but providers cite barriers to initiating discussions. While the health care community works to address barriers, it is unrealistic to rely solely on provider initiation of SH conversations. This research investigates willingness to communicate about sexual health (WTCSH) to better understand what may interfere with survivors’ ability to self-advocate and receive care for these concerns.


(N = 305) BCSs completed online surveys. Hierarchical multiple regression determined the relationship between Sexual Quality of Life—Female (SQOL—F), which measures psychological and social dimensions of SH and WTCSH. Interviews were then conducted with forty BCSs. The constant comparative method was used to thematically analyze the transcripts.


The mean SQOL score was 53.4 out of 100. No statistically significant differences in SQOL or WTCSH were found by age or survivorship length. The positive relationship between WTCSH and SQOL was significant, F (6,266) = 4.92, p < .000, adj. R2 = .080). Five themes illustrated factors that shape WTCSH: (1) comfort discussing SH; (2) perception of demographic similarity/discordance; (3) patient-centered communication; (4) belief that SH is (un)treatable, and (5) ability to access timely/coordinated care.


Findings establish the significance of SH concerns and provide an in-depth understanding of intrapersonal, interpersonal, and organizational issues informing WTCSH.

Implications for Cancer Survivors

Age and gender dynamics, perceptions of provider SQOL messaging, and futility influence survivor openness. Addressing these areas may encourage disclosure among women who would otherwise continue to suffer in silence.


Breast cancer Survivorship Patient-provider communication Sexual health Oncology 



The authors would like to thank the women who participated in this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


Views expressed within this publication do not represent those of the authors and do not reflect the official position of the Uniformed Services University of the Health Sciences, or the US Government, the Department of Defense at large.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of CommunicationWake Forest UniversityWinston-SalemUSA
  2. 2.Department of Social Sciences & Health PolicyWake Forest School of MedicineWinston-SalemUSA
  3. 3.Comprehensive Cancer Center of WFUWinston-SalemUSA
  4. 4.Department of Advertising, UF Health Cancer Center, UF Health Center for Arts in MedicineUniversity of FloridaGainesvilleUSA
  5. 5.Department of CommunicationGeorge Mason UniversityFairfaxUSA
  6. 6.Department of Family MedicineUniformed Services University of the Health SciencesBethesdaUSA

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