Patients regularly feedback that healthcare professionals have not discussed their sex lives. Do you discuss sexual function? If not, why not? When caring for patients and assessing their activities of daily living sexual health should be considered and an assessment completed¹.

In prostate cancer we suppress Testosterone therefore impacting libido², we offer treatment to combat this for males yet for females undergoing bladder cancer surgery cystectomy, we shy away from discussing perhaps as there are not many products to offer women. Yet we know these individuals will have their vaginas removed at the time of the pelvic exenteration this will cause vaginal shorting and contraction of the vault, notwithstanding, dryness. They can also leak lymphatic fluid (chylous leak) for women this usually leaks from the vaginal vault, which is very upsetting, for males this usually causes ascites which can be painful, yet clearly does not leak like waters breaking. Is their mental health contributing to this lack of libido?³

Talking to patients appropriately regarding their care needs should be at the forefront of nurse’s jobs, especially with regards to our Lesbian,Gay, Bisexual, Transgender (LGBTQ) communities⁴. To be able to remove the sigma of sex, penis, vagina, cum, lube, anal sex, oral sex can be difficult and embarrassing for us, just think how the patient you just catheterised feels or that cancer patient who just had surgery or perhaps the patient with Crohn’s disease who now has a stoma, how are they coping with biographical disruption? Could that catheterised patient perhaps catheterise intermittently? Would you raise these questions if you were the patient? If we do not take the lead, then no one will mention that there is a problem. Generally, it can be easily solved and there are always senior professionals and team who will take over from you.

References

¹ Karani, S. and McLuskey, J. (2020) Facilitators and barriers for nurses in providing sexual education to myocardial-infarction patients: A qualitative systematic review. Intensive and Critical CareNursing 58: 102802.

² Collier, T., Smith, S., Greenwood, M. and Ng,K. (2020) Living with Advanced Hormone-Sensitive Prostate Cancer and Treatment with Abiraterone and Androgen Deprivation Therapy: The Patient, Nursing andPhysician Perspective. (2020) Oncology and Therapy. Available online at: https://www.bing.com/search?q=Collier%2C+T.%2C+Smith%2C+S.%2C+Greenwood%2C+M.+and+Ng%2C+K.+(2020)+Living+with+Advanced+Hormone-Sensitive+Prostate+Cancer+and+Treatment+with+Abiraterone+and+Androgen+Deprivation+Therapy%3A+The+Patient%2C+Nursing+and+Physician+Perspective.+(2020)+Oncology+and+Therapy.&cvid=10039f9f2852435b81c7c1f0a0a88714&pglt=547&FORM=ANNTA1&PC=HCTS

³ Dahlen, H. (2019) Female Sexual Dysfunction: Assessment and Treatment. Urologic Nursing 39 (1):39-46.

⁴ Heyworth, B., Gilliver, A., Ralph, S., Hewitt,P. and Mackereth, P. (2016) Prostate cancer awareness survey to proud postcards. Sexual and Relationship Therapy. 31 (4): 462-472.

Please see #UKONS study day (sexual health and cancer for further patient experiences.

Proposed Questions 

Question 1: Do you feel confident to discuss sexual function?

Question 2: Did you have training at nursing school to discuss sexual function?

Question 3: Do you feel you need more training to discuss sexual function?

Question 4: Do you feel able to discuss concerns with LGBTQ patients?

Question 5: Have you had LGBTQ training?

Question 6: What do you think would help you to be confident to discuss sexual health?

Uro-onc Clinical Nurse Specialist (CNS) team

Michelle Greenwood graduated from City University in 2008and worked on a solid oncology ward at St Bart’s until 2010, moving into district nursing for 6 months after that. Then Michelle moved into a research sister role for urology oncology for 3 years followed by 7 months working in anOcular Melanoma CNS role. In 2014 Michelle moved into the Uro-Onc CNS role taking over from Wendy Ansell, the first Macmillan Uro-Onc CNS in England. Within this role is an attached lead cancer Teenage, Young Adult (TYA) CNS role, as the germ cell practice incorporates 19 to 25 year olds, who may have additional care needs. Holds numerous courses including Physical Assessment and Clinical Reasoning and is due to start her MSc.

Shievon Smith graduated from London Southbank University 2002. Worked 6/12 on infection control ward at Whipps Cross Hospital then moved to Accident and Emergency on a staff nurse development programme late 2002.Gained her ‘E’ grade, then spent 2 years working for the Royal College ofNursing as an Assistant Officer at London region, then went back to A&E. In2013 changed career to Urology then Uro-oncology in 2014. Graduated from The Royal Marsden school (UEA) in 2017 with a BSc (Hons) in Cancer Care. Joined StBart’s to care of metastatic Uro-Onc patients later that same year.

Daniel Richardson graduated from University of Hertfordshire with a Psychology BSc in 2013. Then changed direction into nursing graduating from City University in 2017. Began his career at The Royal Marsden on a private male ward caring for surgical patients for urology and GI, caring for patients post bladder and prostate surgery, including pelvic exenterations. June 2020 joined the St Bart’s team to transition from surgical to metastatic Uro-Onc patient centred care, in a CNS training post.