Advanced Practice Providers’ Role in Intimacy in Advanced Cancer Patients

Anna Poullard, DNP, MSN, APRN-BC, Sheena Charles, MS, FNP-BC
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Abstract

The primary objectives of early phase clinical trials are to determine the safety, tolerability, and recommended doses of an investigational agent for patients with advanced cancer. Although these advances in cancer treatment have resulted in patients living longer, patients often experience psychological side effects that may affect sexual health and intimacy. It is estimated that cancer and its subsequent treatments affect the sexual health and intimacy of 40% to 100% of this patient population. Patients with advanced cancer who have undergone numerous treatments may be impacted negatively, not only physically (such as being disfigured by surgical resection) but also emotionally in relationship aspects with their intimate partners. Health-care providers who treat patients with advanced cancer enrolled in early phase clinical trials tend to focus primarily on treatment, physical side effects, and symptom management. Advanced practice providers (APPs) are accustomed to performing comprehensive physical examinations on patients; however, research indicates that intimacy and sexuality are most often excluded in discussions with patients with advanced cancer. The purpose of the article is to increase awareness of the need to address intimacy and sexuality in this patient population and to encourage APPs to make this a part of their everyday practice.
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进修医生在晚期癌症患者亲密关系中的作用
早期临床试验的主要目的是确定研究药物对晚期癌症患者的安全性、耐受性和推荐剂量。虽然癌症治疗的进步使患者的寿命延长,但患者经常会出现心理副作用,这可能会影响性健康和亲密关系。据估计,癌症及其后续治疗会影响 40% 到 100% 的患者的性健康和亲密关系。接受过多次治疗的晚期癌症患者可能会受到负面影响,不仅是身体上的(如因手术切除而毁容),还有与亲密伴侣在感情方面的。为参加早期临床试验的晚期癌症患者提供治疗的医护人员往往主要关注治疗、身体副作用和症状控制。高级医疗服务提供者(APP)习惯于对患者进行全面的身体检查;然而,研究表明,在与晚期癌症患者进行讨论时,亲密关系和性行为往往被排除在外。这篇文章旨在提高人们对在这一患者群体中处理亲密关系和性行为的必要性的认识,并鼓励全科医生将其作为日常工作的一部分。
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