“I am not sure how I can make time to assess sexual health.”
“I barely have 10 minutes to do a psychosocial.”
“I have no privacy in my infusion clinic.”

These are common comments heard by health care providers, including oncology social workers, as they relate to incorporating sexual health assessments.

Problems related to sexual health are continuously cited as one of the top seven quality-of-life issues in both short- and long-term recovery after a cancer diagnosis. All the more reason that we help educate and support our patients and their loved ones at the beginning, middle, end and long after treatment has been completed. Now that distress screening is at the forefront of many of our discussions, it would be a shame if we didn’t recognize the many areas of quality of life that this screening provides us the opportunity to assess. The problem checklist provides a screenshot of common problems experienced by many of our patients and their loved ones, including the challenges many face related to their sexual health. There are a few opportunities for us to help normalize, increase communication and address or refer patients who identify sexual health concerns.

Notice the term “sexual health” is used rather than “sexuality” or “sexual concerns.” Not only is this term broader and can be left for interpretation by the patient, but it also reinforces that there are various aspects of their “health” and recovery during and after cancer that are as important.

There are two ways we, as oncology social workers, can introduce the importance of our patients’ (and their loved ones) sexual health that take almost no time and do not require us to be experts in sexual health. Many of us are the professionals who are targeted to identify and address distress and other quality-of-life issues. Oncology social workers are in an ideal position to both normalize and provide resources to our patients on the importance of their sexual health after a cancer diagnosis. We can do this by simply normalizing our language and then providing resources with information in new patient packets, on our websites, in resource packets, etc. that our patients/caregivers can access.

One of the ways we can help normalize our patients' sexual health needs is by simply including statements, written or spoken, that identify and open the door for discussion on this topic. Language we can introduce on our distress screening tools, psychosocial assessments, questionnaires or other tools we utilize for assessments:

• “Your sexual health is as important to (state your organization/hospital name) as your pain and fatigue management. Do you have any concerns or questions related to your sexual health?”
• “Your sexual health is important to your quality of life. On a scale of 1 -10, how satisfied are you with your sexual health?”
• “We at (state your organization/hospital name) value all aspects of your quality of life. Your sexual health is a critical part of your overall wellness. Although this may not be a concern right now, I put some information in your patient packet that may be helpful for your review. If you have any questions or concerns, please know I am happy to further discuss these issues or connect you with the appropriate professional to address these questions.”

In addition to providing a statement that normalizes sexual health, we can easily include resources that continue to normalize this very significant quality-of-life issue. Resources could be:

• A list specific to the resources available in your geographic area related to sexual health, including specialists such as staff members who are comfortable with or have expertise in addressing sexual health concerns/questions such as a sex therapist, an endocrinologist, a urogynecologist (or urologist or gynecologist), a pelvic floor therapist, therapists who specialize in working with couples.
• A list of resources with websites and books that can be helpful to understanding the impact of cancer and its diagnosis on sexual health as well as ways to address these challenges. The Sexuality SIG is working on compiling a list of resources that members could access and make available to their communities.

A person’s sexual health is an essential component of their overall health and one that we should be assessing and addressing. Utilizing the distress screening and problem checklist or simple assessment questions, we have an opportunity to both normalize and provide critical information to our patients/loved ones during and after a cancer diagnosis to help them thrive.