The need for care for people affected by cancer experiencing sexual health concerns has long been recognised. In 2006, the Oncology, Sex and Relationships (OSR) Clinic was established at The Royal Women’s Hospital (RWH), Melbourne, complementing the hospital’s Sexual Counselling Service, which had operated since 1977. The OSR Clinic was later integrated into the broader Psychosexual Medicine Service.
Today, RWH provides two services for people affected by cancer. The Menopause Symptoms After Cancer (MSAC) Clinic manages vasomotor symptoms, genitourinary syndrome of menopause, and genital graft-versus-host disease following stem cell transplantation. The Psychosexual Medicine Service integrates counselling, psychotherapy, and sexual medicine to support women and their partners experiencing changes in sexual function, intimacy, relationships, and wellbeing after cancer treatment.
Psychosexual medicine is delivered by doctors and nurse practitioners with specialist training in counselling, psychotherapy, and sexual medicine. Consultations address physical and psychosocial contributors to sexual difficulties through a biopsychosocial approach. Assessment includes exploration of relationships, family dynamics, culture, and emotional wellbeing. Physical examination, when appropriate, is conducted in a trauma-informed and culturally sensitive manner. Partners may participate with patient consent.
At the Princess Margaret Cancer Centre (PMCC), Toronto, sexual rehabilitation services have evolved through the Sexual Health Clinic and the Sexual Health and Rehabilitation eClinic (SHAReClinic), an innovative hybrid model combining virtual and in-person care. SHAReClinic provides personalised education, health coaching, counselling, and medical assessment for patients affected by cancer types, delivered by a multidisciplinary team including physicians, psychologists, nurses, and sexual health counsellors. The model emphasises accessibility, scalability, partner involvement, and comprehensive biopsychosocial care.
This presentation compares the development, philosophy, and clinical experiences of the Melbourne and Toronto programs, highlighting the strengths, limitations, and lessons of two distinct models of sexual health care for people affected by cancer today.