The best way to learn of referrals for patients with sexuality issues stemming from cancer is to ask colleagues. Schneider suggesting ask other clinicians, “When you have a patient who tells you ‘This is harming my marriage or my relationship,’ to whom would you refer the patient and why?”

Schneider explained that many sex therapists do not have experience helping patients with chronic illness. Further, training in human sexuality is lacking in both medical and nursing schools. A 1-hour elective course may be the extent of training in sexuality issues offered in school programs.

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Two professional societies offer educational programs in sexual medicine and related matters. The Sexual Medicine Society of North America (SMSNA) produces educational programs on sexual medicine for men. The International Society for the Study of Women’s Sexual Health (ISSWSH) focuses on women’s sexuality and sexual health. These organizations also offer resources and can help with referrals. Nurses can reach out to these organizations for information, resources, or to talk with an experienced sexual medicine clinician.


Many support groups for cancer patients and survivors include one session on sexuality in their programs. Schneider explained that, as a sex therapist working with cancer survivors, all she does is start a conversation. “I’ll never forget one group where a woman in her early 70s was giving advice to a 33-year-old about how to be sexual. I thought, that’s what it’s about: another woman who’s gone through it and can talk about how she got to where she is,” said Schneider.

Schneider mentioned that she has worked with several patient support groups, and has given seminars for both Us TOO International and I Can Cope. Us TOO International is a nonprofit organization that provides prostate cancer education for patients, their partners, and their families. The organization has 325 chapters worldwide. I Can Cope Online is a free self-paced educational program available through the American Cancer Society (ACS). Its classes are available via the ACS Web site, and they include a module titled “Exploring Self-Esteem and Intimacy.”


A patient’s individual needs should be the starting point to guide sexual information. The strongest indicators of the need for sexuality information are the treatment received, existence of sexual function problems, and a weakening of a relationship after developing cancer.4 Those patients whose intimate relationships weakened after a cancer diagnosis felt information on sexuality was more important compared with those patients whose relationships had improved or stayed the same after a cancer diagnosis.

Oncology nurses should be aware that they do not need to have all the answers to give patients permission to raise questions about sexuality and cancer. Nurses should work together to develop a list of referrals so they can help patients care for themselves.ONA 

Kathy Boltz is a medical writer based in Phoenix, Arizona. 


1. Krebs LU. Sexual health during cancer treatment. Adv Exp Med Biol. 2012;732:61-76.

2. Ussher JM, Perz J, Gilbert E. Information needs associated with changes to sexual well-being after breast cancer. J Adv Nurs. 2013;69(2):327-337.

3. Olsson C, Berglund AL, Larsson M, Athlin E. Patient’s sexuality—a neglected area of cancer nursing? Eur J Oncol Nurs. 2012;16(4):426-431.

4. Hautamäki-Lamminen K, Lipiäinen L, Beaver K, et al. Identifying cancer patients with greater need for information about sexual issues. Eur J Oncol Nurs. 2013;17(1):9-15.