Addressing Sexual Health in Breast Cancer Survivors

November 2019 Vol 10, No 11
Judy Horton, RN, BSN, OCN, ONN-CG
Medical University of South Carolina
Georgia Southern University

Many breast cancer survivors experience changes in their sexual health related to cancer treatment. Oncology nurse navigators are in a position to assess and address sexual health in cancer survivors.1 This abstract discusses an innovative way that sexual health was addressed in the survivorship care plans of breast cancer survivors.

Background: Not only do breast cancer survivors endure life-altering surgeries and treatments, they are faced with alterations in their health. Sexual dysfunction is one such health alteration. In fact, 78% of breast cancer survivors report decreased frequency of sexual encounters, and 64% report a decline in sexual pleasure.2 This change in sexual health can negatively impact quality of life.

The National Comprehensive Cancer Network recommends that sexual activity, impact of cancer treatment, and sexual concerns should be considered at survivorship care visits.3 Often, oncology care providers fail to address sexual health.4 Moreover, women feel that it is the healthcare provider’s responsibility to initiate conversations about sexuality and sexual dysfunction.5

Objectives: This abstract discusses one way sexual health of breast cancer survivors was included in survivorship. Secondary objectives included the provision of a sexual health resource to breast cancer survivors and to facilitate communication/referrals to other healthcare providers.

Method: In a surgical oncology practice, the nurse navigator met with the surgical oncologist and patient to discuss the patient’s treatment plan and survivorship care shortly after the diagnosis of breast cancer. The nurse navigator’s presence from the outset of cancer care helped facilitate rapport with the patient. Approximately 6 months after diagnosis, the nurse navigator met with the breast cancer survivor to review the survivorship care plan. Because the nurse navigator had a rapport with the survivor, the survivor was encouraged to share concerns regarding sexual health at this visit. The nurse navigator then provided a resource book on sexual health. If indicated, the nurse navigator would then refer the patient to a gynecologist or other healthcare providers for sexual health concerns.

Results: In 2018, the nurse navigator facilitated 126 survivorship care plans, and in approximately 89% of these care plans, sexual health was discussed. The resource book was provided to the breast cancer survivor.

Conclusions: This successful implementation of sexual health assessment and resource provision was predicated on the rapport built with the survivor so that the patient felt comfortable sharing concerns about a sensitive and personal topic. The survivorship care plan offered a dedicated time to discuss the survivor’s health concerns, including sexual dysfunction. Additionally, a copy of the survivorship care plan, which addressed sexual health, was communicated to other pertinent healthcare providers.

With over 3 million breast cancer survivors in the United States, it is important to assess and address health alterations that result from breast cancer.4 Including sexual health as part of the survivorship care plan is an opportunity to address common concerns that are often overlooked by oncology healthcare providers.


  1. Anderson JL. Acknowledging female sexual dysfunction in women with cancer. Clin J Oncol Nurs. 2013;17:233-235.
  2. Ussher JM, Perz J, Gilbert E. Changes to sexual well-being and intimacy after breast cancer. Cancer Nurs. 2012;35:456-465.
  3. Ligibel JA, Denlinger CS. New NCCN guidelines for survivorship care. J Natl Compr Canc Netw. 2013;11(5 Suppl):640-644.
  4. Dow J, Kennedy Sheldon L. Breast cancer survivors and sexuality: a review of the literature concerning sexual functioning, assessment tools, and evidence-based interventions. Clin J Oncol Nurs. 2015;19:456-461.
  5. Wilmoth MC, Hatmaker-Flanigan E, LaLoggia V, Nixon T. Ovarian cancer survivors: qualitative analysis of the symptom of sexuality. Oncol Nurs Forum. 2011;38:699-708.
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