Online resources on sexuality and cancer.

Stead and colleagues' study suggests that women with ovarian cancer want their physicians to discuss sexual issues with them but that such discussions are rare. Physicians in the study were uncomfortable discussing sex and lacked knowledge about the sexual problems that cancer can cause. If the Internet is anything to go by, cancer patient groups do better than health professionals in providing frank information about cancer and sexuality. For example, could you answer your patients' questions about when to avoid sex during cancer treatment or which sexual positions might be more comfortable? CancerBACUP, a cancer support and information service (www.cancerbacup.org.uk), gives explicit answers to both of these questions (www.cancerbacup.org.uk/info/sex/sex-9.htm). It also gives “solutions to sexual problems caused by cancer and its treatment” (www.cancerbacup.org.uk/info/sex/sex-5.htm), including pain during intercourse, loss of libido, changes in body image, and erectile dysfunction. Another valuable collection of resources on sexuality and cancer is Oncolink, from the University of Pennsylvania Cancer Center, Philadelphia: cancer.med.upenn. edu/psychosocial/sexuality. The site has information aimed at both providers and patients, and it includes fertility and reproductive issues. It also links to a guide to living with cancer, called “Taking Time,” from the National Cancer Institute, National Institutes of Health (cancernet.nci.nih.gov/taking_time/timeintro.html). One section of the guide explores how patients' self-image can be affected by cancer and how this can affect their relationships. Many web sites discuss the relationship between cancer and sexual identity. One of these is the Mautner Project (www.mautnerproject.org), a US organization dedicated to lesbians with cancer, their partners, and caregivers. The project campaigns for better cancer detection services for lesbians, and its web site gives the reasons why lesbians have higher rates of breast, cervical, and ovarian cancer than heterosexual women. The Gay and Lesbian Medical Association summarizes the research to date that suggests that lesbian, gay, bisexual, and transgender people may be disproportionately affected by certain cancers (www.glma.org/policy/hp2010/PDF/Cancer.pdf) and that all health professionals should receive “cultural competence training about sexual minority status.” Regardless of a patient's specific cancer type or sexual identity, when it comes to resolving sexual difficulties and concerns, a word of advice appears repeatedly on Internet sites: “communication.” Patients are encouraged to communicate their needs to their partners, and physicians are urged to do better at communicating information about sexual issues.