Background
Sexual wellbeing is an important but frequently under addressed component of supportive cancer care. People affected by cancer may experience changes in desire, arousal, genitourinary wellbeing, intimacy, confidence and relationships, yet many report limited opportunity to discuss these concerns in routine oncology follow up. To address this gap, a nurse led wellness clinic incorporating sexual wellbeing was developed within a radiation oncology setting.
Aim
To describe how person centred, evidence informed sexual health and wellbeing support was embedded within an existing nurse led cancer wellness clinic.
Method
Dedicated sexual wellbeing appointments were developed in response to observed unmet sexual health and wellbeing needs, clinical experience, consumer feedback and consultations with the wider multi-disciplinary team. The model uses a biopsychosocial approach, incorporating a sexual health assessment, education, symptom management, intimacy counselling and referral pathways to specialist services where required. Consultations are delivered by a nurse practitioner with postgraduate sexology training.
Results
The clinic provides a dedicated, structured and non-judgemental setting for patients concerns and symptom management. Common presentations have included endocrine therapy related genitourinary symptoms, reduced desire, dyspareunia, altered arousal and orgasm, body image disturbance, fear of intimacy and changes in partner relationships.
Preliminary clinical observations and feedback suggest that the model enhances the visibility of sexual wellbeing within comprehensive cancer care and facilitates timely symptom assessment and management. The model of care also supports patients to address pleasure, intimacy, communication and reframes sexual wellbeing as a recoverable and supported aspect of survivorship, rather than an unavoidable consequence of treatment.
Conclusion
Embedding sexual wellbeing appointments within a nurse led model of care is a clinically relevant approach to addressing an important gap in cancer care. Integrating this model into oncology pathways enhances person centred care and positions sexuality concerns as legitimate, assessable and modifiable components of comprehensive cancer care.