A narrative review on the roles of nursing in sexual dysfunction among oncological patients with updated recommendations

Background

Sexual dysfunction is a prevalent yet often overlooked issue among cancer patients, significantly affecting their quality of life, emotional well-being, and intimate relationships. Despite the high prevalence (87%) of sexual dysfunction among cancer survivors, it remains underdiagnosed and undertreated in oncology care. Nurses play a pivotal role in addressing these concerns; however, multiple barriers (lack of training, cultural stigma, and institutional limitations) hinder effective intervention.

Methods

A comprehensive literature review was conducted using peer-reviewed articles from major databases. The review focused on the prevalence, impact, and management of sexual dysfunction in cancer patients, as well as the role of oncology nurses in addressing this issue.

Results

Integrating sexual health care into oncology nursing practice is essential for improving the well-being of cancer patients. Addressing barriers through education, policy reforms, and multidisciplinary collaboration can empower nurses to provide comprehensive sexual health support. The BETTER (Bring up, Explain, Tell, Timing, Educate, and Record) sexual health discussion program functions effectively to help nurses conduct sensitive educational sessions on sexual wellness with their patients. The effective implementation of PLISSIT (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) enables oncology nursing practitioners to conduct meaningful sexual health discussions. The Enhancing Research Impact in Child Health (ENRICH) program offers specialized fertility and sexuality training to oncology nurses.

In Canada, the TrueNTH (True North) Sexual Health and Rehabilitation eTraining program for prostate cancer care providers was evaluated in a multi-center study, showing significant improvement in knowledge and self-efficacy post-intervention, with 98.2% of participants reporting satisfaction with the training [90]. Similarly, a multidisciplinary oncology sexual health clinic in Alberta, Canada reported that, among 130 referrals over two years, 64 patients received consultations for common sexual concerns such as dyspareunia, low desire and vaginal dryness. Data showed that 100% of female patients and 80% of male patients had diagnosable sexual dysfunctions. In the U.S., the iSHARE (improving Sexual Health and Augmenting Relationships through Education) intervention was developed at Fox Chase Cancer Center to train breast cancer clinicians in sexual health communication.

Several national and international guidelines now recommend sexual rehabilitation as a critical component of comprehensive cancer care for adult patients. The American Society of Clinical Oncology (ASCO), in partnership with Cancer Care Ontario (CCO), published a clinical practice guideline. Similarly, the National Comprehensive Cancer Network (NCCN) advises routine screening for sexual problems during follow-up visits and recommends early referrals to specialists in sexual health when dysfunction is identified.

Conclusion

Future efforts should focus on institutional changes that prioritize sexual health as a fundamental component of cancer care, ensuring better patient outcomes and quality of life.

Prof. Patricia Tai, a gold medal graduate from University of Hong Kong (ranked 35/100 globally), trained under renowned experts Prof. John Ho (nasopharyngeal cancer), Prof. David McDonald (brain tumor response: McDonald’s criteria), and Mr. Jake Van Dyk (medical physics). An international skin cancer specialist, she is the author of five UpToDate chapters (Wolters Kluwer, United States). She is also the Clinical Professor of University of Saskatchewan in Western Canada. She has 148 full publications, 126 conference abstracts, and 168 presentations. With 13 academic awards, her contributions to oncology and medical research continue to benefit the field