Development, implementation, and evaluation of a multidisciplinary oncology sexual health clinic in a Canadian cancer care setting

Abstract

Purpose

Untreated cancer-related sexual health concerns cause significant distress for cancer survivors. To appropriately address the complex sexual health needs of cancer patients, we piloted a specialized, multidisciplinary oncology sexual health clinic within a tertiary cancer center. A quality assurance evaluation was conducted.

Methods

During once monthly half-day clinics, a multidisciplinary team of psychologists, advanced practice nurses, and radiation and gynecological oncologists offered specialist integrated care to oncology patients. Patients completed assessment questionnaires prior to each clinic appointment and a follow-up telephone interview approximately 4 months after their initial appointment.

Results

Over the 2-year pilot, 224 patients were referred to the cancer center’s broader sexual health program; 100 patients were triaged to the clinic. A total of 79 new and 58 follow-up appointments were offered. Average wait time for an initial visit was 97 days. Patients’ most frequent concerns included vulvovaginal atrophy, dyspareunia, reduced sexual desire, and erectile dysfunction. Self-reported sexual distress was well above the clinical cutoff at baseline (N = 77, M = 29.78, SD = 12.74). A significant reduction in sexual distress was observed at follow-up (N = 67, M = 21.90, SD = 11.34, t(66) = 7.41, p < 0.001).

Conclusions

Referral rates indicate a high demand for specialized sexual health services within cancer care. Ongoing specialist care is needed to appropriately address the multifaceted sexual concerns of cancer survivors and to adequately manage high distress and symptom comorbidity.

Implications for Cancer Survivors

Results inform a more comprehensive characterization of the presenting concerns of cancer survivors seeking multidisciplinary sexual health care.

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Funding

L. Walker’s salary is funded by the Arnie Charbonneau Cancer Institute and by the Daniel Family Chair in Psychosocial Oncology. This project was funded in part by the Calgary Foundation and the Alberta Cancer Foundation.

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Correspondence to Lauren M. Walker.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Application of the Alberta Innovates A pRoject Ethics Community Consensus Initiative (ARECCI) ethics screening tool for quality assurance indicated that research ethics board approval was not required for this quality assurance initiative. All clinical outcomes reported were collected as part of clinical service delivery. All procedures performed in this study were in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent for clinical service was obtained from all individual participants who attended the clinical program.

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Walker, L.M., Sears, C.S., Booker, R. et al. Development, implementation, and evaluation of a multidisciplinary oncology sexual health clinic in a Canadian cancer care setting. J Cancer Surviv (2021). https://doi.org/10.1007/s11764-020-00967-8

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Keywords

  • Sexual health
  • Program development
  • Oncology
  • Multidisciplinary care
  • Cancer survivorship
  • Sexuality