Sexuality in Adult Patients with Cancer in the Era of Precision Oncology

The aim of this chapter is to complement the information included in chapters that are focused on the particularities of patients with breast, prostate, and colorectal cancer and patients who have undergone bone marrow transplantation. This chapter covers a general overview about the impact of cancer itself and anticancer therapies in the sexual health of adult cancer survivors in the era of precision oncology. Current multimodality anticancer treatment may include surgery and/or radiation therapy directed towards the pelvis as well as hormonal therapies, chemotherapy, targeted therapies, and/or immunotherapy that can result in adverse short- and long-term physical and psychosocial impact on the sexual function of men and women. Sexual issues during and after anticancer treatment often remain unexplored and under-addressed in daily clinical practice due to several barriers, such as a lack of training and communication skills by the healthcare providers or lack of time. In turn, patients with cancer rarely volunteer information on their sexual health. Healthcare providers, including physicians and nurses, should regularly inquire about signs of hypogonadism, erectile dysfunction, decreased libido, menstrual irregularities, or vaginal dryness in order to detect patients at risk of sexual dysfunction and in order to provide optimal multidisciplinary management. Here, the authors review the current general recommendations for the assessment and management of sexual dysfunction and identify the areas that warrant further research and development regarding the incorporation of sexual health-related measures in the evaluation of novel anticancer therapies and the development of models of supportive care for cancer survivors taking into account the diversity of patients with a multidimensional bio-psycho-social perspective.