In 2017, the American Cancer Society estimated there were more than 250,000 new cases of female breast cancer and almost 108,000 new cases of gynecologic cancers (i.e., cervical, uterine/endometrial, ovarian, vulvar and vaginal) in the United States. The 5-year survival rate across all stages of breast cancer was 90 percent. In comparison, overall 5-year survival rates across all stages of specific gynecologic cancers varied widely, ranging from 46 percent for ovarian cancer to 82 percent for uterine/endometrial cancer. It is within this specific context that the physician-survivor team of Saketh Guntupalli, MD, and Maryann Karinch co-wrote Sex and Cancer.

This book is relatively short, at fewer than 170 pages of text, appendices, glossary, notes and index. Television star Camille Grammer provides an uplifting and passionate Forward to the text that sets the tone and expectations for what follows. The book is written in an engaging and conversational tone, even when the authors are describing complex scientific terms such as immunotherapy or statistical terms such as a t-test. Even better, it “reads as authentic” because the co-authors integrate medical information, data from research studies and highly personal, evocative patient and partner narratives.

The book is divided into two parts: “Understanding the Impact” and “Overcoming the Impact.” Part I contains five chapters that take readers on a journey from “What Happens First?” (diagnosis narratives) to “The New Normal” of post-treatment life, intimacy and sexual health. This section provides information about specific reproductive and gynecologic cancers and treatments. There are also chapters describing a basic 3-stage medical model of the female sexual response cycle; sexual dysfunctions, questionnaires and assessment tools; and treatment-related physical, hormonal, and psychological/emotional effects, including changes to sexual functioning. Stress as a barrier to achieving optimal health outcomes and stimulus for sexual dysfunction is also covered.

Part II contains three chapters and focuses in much greater detail on the psychosocial and relational challenges surrounding treatment-related sexual effects, particularly loss of sexual functioning, increased sexual bother and negative body image. Interventions such as Kegel exercises, vaginal dilators, sensate focus/body mapping and therapy are offered as methods on a “Continuum of Solutions” (Chapter 7). Sex and Cancer’s Chapter 8 focuses on the “New Normal” of life post-diagnosis and treatment. Survivors are encouraged to reframe their experiences, become “lifelong students” of intimacy and sexuality, and redefine sex and intimacy in their relationships.

Future editions would benefit from expanding the section on “Conclusion: Focus on the Partners.” While the book weaves stories from male and female partners’ points of view throughout, a more fully actualized chapter devoted specifically to these “co-survivors” would have added an additional layer of richness to the text. In doing so, the authors could have focused on partners’ “new normal,” and provide suggestions and resources related to quality of life- and intimacy-enhancing interventions such as respite care, support groups, and individual partner and couples-focused therapy during and after the treatment phase.

Overall, Sex and Cancer is a good read. It contains a great deal of detailed, yet accessible, information suitable for a variety of readers ranging from the newly diagnosed patient to the long-term survivor, partners, friends and relatives. Oncology social workers and sexuality educators, counselors and therapists who are new to reproductive and gynecologic cancers might benefit from this brief introduction to diagnosis, treatment, and sexual and other disease- and treatment-related side effects. The ethnographic case studies provide vivid pictures of life before and after reproductive and gynecologic cancer diagnoses; they shine a lens on the “the good, the bad, and the ugly” psychosocial and relational sides of these diseases. Best of all, Sex and Cancer builds awareness of this understudied area of cancer survivorship and gives patients, partners and providers permission to move beyond conversations on life-sustaining medical treatments to life-enhancing and affirming interventions.