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The Oncology and Sexuality, Intimacy, and Survivorship Program Model: An Integrated, Multi-disciplinary Model of Sexual Health Care within Oncology

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Abstract

Cancer-related sexual dysfunction is documented as one of the most distressing and long-lasting survivorship concerns of cancer patients. Canadian cancer patients routinely report sexuality concerns and difficulty getting help. In response to this gap in care, clinical practice guidelines were recently published in the Journal of Clinical Oncology. A sweeping trend is the creation of specialized clinics for patients’ sexual health concerns. However, this much-needed attempt to address this service gap can be difficult to sustain without addressing the cancer care system from a broader perspective. Herein, we describe the implementation of a tiered systemic model of cancer-related sexual health programming in a tertiary cancer center. This program follows the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model, used previously for guiding individual practitioners. Visually, the model resembles a pyramid. The top 2 levels, corresponding to Intensive Therapy and Specific Suggestions, are comprised of group-based interventions for common cancer-related sexual concerns and a multi-disciplinary clinic for patients with complex concerns. The bottom 2 levels, corresponding to Permission and Limited Information, consist of patient education and provider education and consultation services. We describe lessons learned during the development and implementation of this program, including the necessity for group-based services to prevent inundation of referrals to the specialized clinic, and the observation that creating specialized resources also increased the likelihood that providers would inquire about patients’ sexual concerns. Such lessons suggest that successful sexual health programming requires services from a systemic approach to increase sustainability.

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Acknowledgments

We would like to thank Carly Sears for her careful review and assistance with manuscript submission and revisions.

Author information

Authors and Affiliations

  1. University of Calgary, Calgary, AB, Canada

    Lauren M. Walker, Joanne Stephen, Sarah Glaze, Corinne Doll, Tien Phan & John W. Robinson

  2. Tom Baker Cancer Centre, Calgary, AB, Canada

    Lauren M. Walker, Sarah Glaze, Reanne Booker, Corinne Doll, Tien Phan, Kerrie Brennan & John W. Robinson

  3. University of Alberta, Edmonton, AB, Canada

    Ericka Wiebe, Jill Turner & Amy Driga

  4. Cross Cancer Institute, Edmonton, AB, Canada

    Ericka Wiebe, Jill Turner, Amy Driga, Elisha Andrews-Lepine & Ashley Ayume

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  1. Lauren M. Walker
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  2. Ericka Wiebe
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Correspondence to Lauren M. Walker.

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Walker, L.M., Wiebe, E., Turner, J. et al. The Oncology and Sexuality, Intimacy, and Survivorship Program Model: An Integrated, Multi-disciplinary Model of Sexual Health Care within Oncology. J Canc Educ 36, 377–385 (2021). https://doi.org/10.1007/s13187-019-01641-z

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