Skip to main content
SpringerLink
Log in

Psychosocial Issues, Sexuality, and Cancer

  • Published:
Sexuality and Disability Aims and scope Submit manuscript

Abstract

It is well-documented in the literature that psychosocial factors play a significant role in the development and progress of, adaptation to, and survival from cancer. Cancer and its treatment often lead to psychiatric co-morbidity, precipitate spiritual crisis, compel lifestyle changes, and disrupt family and social relationships. One area most affected by cancer is quality of life, including sexual functioning. Cancer treatment may increase risk of infertility, difficulty with intimacy and sexuality, employment discrimination, increased general distress, and fear of recurrence. In addition to describing the psychosocial impact of cancer and its treatment, and discussing how psychosocial factors affect sexuality and sexual functioning, this paper concludes with options available to manage the sexual problems and related psychosocial issues in order to restore optimal sexual functioning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Block KI: Psychooncology and total survivorship. Advances in Mind-Body Medicine 15(4): 244-51, 1999.

    Google Scholar 

  2. Garssen B, Goodkin K: On the role of immunological factors as mediators between psychosocial factors and cancer. Advances in Mind-Body Medicine 16(4): 262, 2000.

    Google Scholar 

  3. Postone N: Psychotherapy with cancer patients. American Journal of Psychotherapy 52(4): 412-25, 1998.

    Google Scholar 

  4. Jacobs, LA, Hobbie W, Meadows, A: Summary of issues identified by cancer survivors. On-colink, The University of Pennsylvania Cancer Center. Retrieved 11/15/2001 from the World Wide Web: http://www.oncolink.com.

  5. Giordano JL: Intimacy issue management in the post-surgical experience of breast cancer patients: A sexuality education program. Dissertation Abstracts International, Humanities & Social Sciences 62(3-A): 929, 2001.

    Google Scholar 

  6. Spencer SM, Carver CS, Price AA: Psychological and social factors in adaptation. In: Holland JC, Breitbart W, Jacobson PB, et al., eds.: Psychooncology, New York, NY: Oxford University Press, 1998, pp. 211-222.

    Google Scholar 

  7. Hallas CN, Patel N, Oo A, Jackson M, Murphy P, Drakeley MJ, Soorae A, Page RD: Five-year survival following oesohageal cancer reaction: Psychosocial functioning and quality of life. Psychology, Health & Medicine 6(1): 85-95, 2001.

    Google Scholar 

  8. Block KI: The role of self in healthy cancer survivorship: A view from the front lines of treating cancer. Advances in Mind-Body Medicine 13(1): 6-27, 1997.

    Google Scholar 

  9. Mackie E, Hill J, Kondryn H, McNally R: Adult psychosocial outcomes in long-term survivors of acute lymphoblastic leukemia and Wilms' tumor: a controlled study. Lancet 355(9210): 1310, 2000.

    Google Scholar 

  10. Block SD, for the ACP-ASIM End-of-Life Care Consensus Panel: Assessing and managing depression in the terminally ill patient. Annals of Internal Medicine 132(3): 209-218, 2000.

    Google Scholar 

  11. Razavi D, Stiefel F: Common psychiatric disorders in cancer patients: I. Adjustment disorders and depressive disorders. Supportive Care in Cancer 2 (4): 223-232, 1994.

    Google Scholar 

  12. Massie MJ: Anxiety, panic, and phobias. In: Holland JC, Rowland JH, eds: Handbook of Psychooncology: Psychological care of the patient with cancer. New York, NY: Oxford University Press, 1989, pp 300-309.

    Google Scholar 

  13. Hendrickson MM, Isometsa ET, Hietanen PS, et al.: Mental disorders in cancer suicides. Journal of Affective Disorders 36(1-2): 11-20, 1995.

    Google Scholar 

  14. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, American Psychiatric Association, 1994.

  15. Schag CA, Heinrich RL: Anxiety in medical situations: adult cancer patients. Journal of Clinical Psychology 45(1): 20-27, 1989.

    Google Scholar 

  16. Friedman LC, Lehane D, Webb JA, et al.: Anxiety in medical situations and chemotherapy-related problems among cancer patients. Journal of Cancer Education 9(1): 37-41, 1994.

    Google Scholar 

  17. Peleg-Oren N, Sherer M: Cancer patients and their spouses: gender and its effect on psychological and social adjustment. Journal of Health Psychology 60(3): 329, 2001.

    Google Scholar 

  18. Alter CL, Pelcovitz D, Axelrod A, et al.: Identification of PTSD in cancer survivors. Psychosomatics 37(2): 137-143, 1996.

    Google Scholar 

  19. Nordin K, Gilmelius B: Predicting delayed anxiety and depression in patients with gastrointestinal cancer. British Journal of Cancer 79(3/4): 525-529, 1999.

    Google Scholar 

  20. Ciaramella A, Poli P: Assessment of depression among cancer patients: the role of pain, cancer type and treatment. Psychooncology 10(2): 156-165, 2001.

    Google Scholar 

  21. Register C: Living with Chronic Illness: Days of Patience and Passion. New York, NY: Bantam Books, 1987.

    Google Scholar 

  22. Boland C: Suicide and cancer: I. Demographic and social characteristics of cancer patients who committed suicide in Sweden, 1973-1976. Journal of Psychosocial Oncology 3(1): 17-30, 1985.

    Google Scholar 

  23. Ofman US: Psychosocial and sexual implications of genitourinary cancers. Semin Oncol Nurs 9(4): 412-25.

  24. Luckmann J: Caring for people with cancer. In: Luckmann J. Saunders Manual of Nursing Care, Philadelphia, Pennsylvania: W.B. Saunders Company, 1997, pp 589-650.

    Google Scholar 

  25. Weisman DE, Haddox JD: Opiod pseudoaddiction-an iatrogenic syndrome. Pain 36(3): 363-366, 1989.

    Google Scholar 

  26. Bruera E, Moyano J, Seifert L, et al.: The frequency of alcoholism among patients with pain due to terminal cancer. Journal of Pain and Symptom Management 10(8): 599-603, 1995.

    Google Scholar 

  27. Horton, DA: Adolescent daughters and the impact and meaning of the loss of their mothers to breast cancer. Dissertation Abstracts International 59(5-B): 2455, 1998.

    Google Scholar 

  28. McNeff, EA: Issues for the partner of the person with a disability. In Sipski ML, Alexander CJ, eds.: Sexual Function in People in People with Disability and Chronic Illness. Gaithersburg, MD: Aspen Publishers, Inc., 1997.

    Google Scholar 

  29. Ben-Zur H: Your coping strategy and my distress: Inter-spouse perceptions of coping and adjustment among breast cancer patients and their spouses. Families, systems & health. The Journal of Collaborative Family Health Care 19(1): 83-95, 2001.

    Google Scholar 

  30. Hong L, Shenghan L, Krongrad A, Trapido E, Page JB, McCoy, C: The effect of marital status on survival in late-stage cancer patients: An analysis based on surveillance, epidemiology, and end results (SEER) data, in the United States. International Journal of Behavioral Medicine 6(2): 150-157, 1999.

    Google Scholar 

  31. Nicholas DR: Men, masculinity, and cancer: Risk-factor behaviors, early detection, and psychosocial adaptation. Journal of American College Health 49(1): 27-43, 2000.

    Google Scholar 

  32. Lansky SB, List MA, Ritter-Sterr C. Psychosocial consequences of cure. Cancer 58(2 Suppl): 529-33, 1986.

    Google Scholar 

  33. Zebrack B, Chesler M: Health-related worries, self-image, and life outlooks of long-term sur-vivors of childhood cancer. Health & Social Work 26(4): 245-257, 2001.

    Google Scholar 

  34. Yellen SB, Cella DF, Bonomi A: Quality of life in people with Hodgkin's disease. Oncology (Huntingt) 7(8): 41-5, 1993.

    Google Scholar 

  35. Kaplan HS. The Sexual Desire Disorders. New York, NY: Brunner/Mazel, Inc., 1995.

    Google Scholar 

  36. Rosen RC, Lane RM, Menza M: Effects of SSRIs on sexual function: a critical review. Journal of Clinical Psychopharmacology 19(1): 67-85, 1999.

    Google Scholar 

  37. Zatzariny K: Meeting the challenges of cancer survivorship. Oncolink, University of Pennsylvania Cancer Center, 1-10, 1999.

    Google Scholar 

  38. Sherman RS: Sexual and psychological functioning of bone marrow transplant survivors. Dissertation Abstracts International, Sciences & Engineering 57(9-B): 5931, 1997.

    Google Scholar 

  39. Heiman, JR: Medical advances and human sexuality: Introduction and comment. Journal of Sex Research 37(3), 193-94, 2000.

    Google Scholar 

  40. Griffith ER, Trieschmann R: Sexual dysfunction in the physically ill and disabled. In Nadelson C & Marcott D (eds): Treatment Interventions in Human Sexuality. Plenum Press, NY and London, p. 241, 1983.

    Google Scholar 

  41. Syrjala KL, Schroeder TC, Abrams JR, Atkins TZ, Brown WS, Sanders JE, Schubert MA, Heiman JR: Sexual function measurement and outcomes in cancer survivors and matched controls. Journal of Sex Research 37(3): 213-226, 2000.

    Google Scholar 

  42. Derogatis LR, Kourlesis SM: An approach to evaluation of sexual problems in the cancer patient. CA: A Cancer Journal for Clinicians 31(1): 46-50, 1981.

    Google Scholar 

  43. Ganz PA, Rowland JH, Desmond K, et al.: Life after breast cancer: understanding women's health-related quality of life and sexual functioning. Journal of Clinical Oncology 16(2): 501-514, 1998.

    Google Scholar 

  44. Anderson BL: Quality of life for women with gynecologic cancer. Current Opinion in Obstetrics and Gynecology 7(1): 69-76, 1995.

    Google Scholar 

  45. Talcott JA, Rieker P, Clark JA, et al.: Patient-reported symptoms after primary therapy for early prostate cancer: results of a prospective cohort study. Journal of Clinical Oncology 16(1): 275-283, 1998.

    Google Scholar 

  46. Arai Y, Kawakita M, Okada Y, et al.: Sexuality and fertility in long term survivors of testicular cancer. Journal of Clinical Oncology 15(4): 1444-1448, 1997.

    Google Scholar 

  47. Bourgeois-Law G, Lotocki R: Sexuality and gynaecological cancer: A needs assessment. Canadian Journal of Human Sexuality 8(4): 231-241, 1999.

    Google Scholar 

  48. Robinson JW, Dufour MS, Fung TS: Erectile functioning of men treated for prostate carcinoma. Cancer 79(3): 538-544, 1997.

    Google Scholar 

  49. Anllo LM: Sexual life after breast cancer. Journal of Sex & Marital Therapy 26(3): 241-248, 2000.

    Google Scholar 

  50. Roemer LS: The experience of chronic illness and its relationship to sexuality. Dissertation Abstracts International, Science & Engineering 60(8-B): 4294, 2000.

    Google Scholar 

  51. Peleg-Oren N, Sherer M: Cancer patients and their spouses: gender and its effect on psychological and social adjustment. Journal of Health Psychology 60(3): 329, 2001.

    Google Scholar 

  52. Weijmar Schultz HBM, Van de Wiel HBM, Hahn DEE, Van Drief MF: Sexuality and cancer in women. Annual Review of Sex Research 3, 151-199, 1992.

    Google Scholar 

  53. Robson M: Body image as perceived by women treated for breast cancer. Dissertation Abstracts International, Sciences & Engieering 62(5-B): 2499, 2001.

    Google Scholar 

  54. Paek JE: Female breast cancer patients' attitudes towards mastectomy and sleepwear design preferences. Dissertation Abstracts International, Humanities & Social Sciences 62(4-A): 1251, 2001.

    Google Scholar 

  55. Hammond LC: A qualitative study of treatment issues of eight women with breast cancer. Dissertation Abstracts International, Sciences & Engineering 62(4-B): 2058, 2001.

    Google Scholar 

  56. Front CJ: Body image, sexual functioning and mood disturbance among three early breast cancer treatment groups. Dissertation Abstracts International, The Sciences & Engineering 60(5-B): 2338, 1999.

    Google Scholar 

  57. Gluhoski VL, Siegel K, Gorey E: Unique stressors experienced by unmarried women with breast cancer. Journal of Psychosocial Oncology 15(3-4): 173-183, 1997.

    Google Scholar 

  58. Spencer SM, Lehman JM, Wynings C, Arena P, Carver CS, Antoni MH, Derhagopian RP, Oronson G, Love N: Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients. Health Psychology 18(2): 159-168, 1999.

    Google Scholar 

  59. Westgate B: Sexual and personal relationships of the mastectomee. Sexuality and Disability 3(1): 0146, 1980.

    Google Scholar 

  60. Parle M, Gallagher J, Gray C, Akers G, Liebert B: From evidence to practice: factors affecting the specialist breast nurse's detection of psychosocial morbidity in women with breast cancer. Psycho-Oncology 10(6): 503-510, 2001.

    Google Scholar 

  61. Astin JA, Anton-Culver H, Schwartz CE, Shapiro Jr DH, McQuad, J, Breuer AM, Taylor TH, Lee H, Kurosak, T: Sense of control and adjustment to breast cancer: The importance of balancing control coping style. Behavioral Medicine 25(3): 101-110, 1999.

    Google Scholar 

  62. Frost MH, Schald DJ, Sellers TA, et al: Long-term satisfaction and psychological and social function following bilateral prophylactic mastectomy. Journal of the American Medical Association 248(3): 319-324, 2000.

    Google Scholar 

  63. Turner LJ: Sexuality for breast cancer survivors: Reconstructing sexual self-images. Dissertation Abstracts International, Sciences and Engineering 68(8-B): 4257, 2000.

    Google Scholar 

  64. Anderson BL, Woods XA, Copeland LJ: Sexual self-schema and sexual morbidity among gyne-cologic cancer survivors. Journal of Consulting & Clinical Psychology 65(2): 221-229, 1997.

    Google Scholar 

  65. Steginga SK, Dunn J. Women's experiences following treatment for gynecologic cancer. Oncology Nursing Forum 24: 1403-1408, 1997.

    Google Scholar 

  66. Yurek DL: Surgical treatment of breast cancer: Sexual self-schema, stress reductions, and sexuality outcomes. Dissertation Abstracts International 59(1B): 0432, 1998.

    Google Scholar 

  67. Meyerowitz BE, Desmond KA, Rowland JH, Wyatt, GE, Ganz, PA. Sexuality following breast cancer. Journal of Sex & Marital Therapy 25(3): 237-251, 1999.

    Google Scholar 

  68. Cyranowski JM, Aarestad SL, Andersen BL: The role of sexual self-schema in a diathesis-stress model of sexual dysfunction. Applied & Preventive Psychology 8(3): 217-228, 1999.

    Google Scholar 

  69. Sevin B-U: Social implications of sexually transmitted cancer. Journal of Women's Health & Gender-Based Medicine 8(6): 759-767, 1999.

    Google Scholar 

  70. Gray R, Fitch M, Davis C, et al: Breast cancer and prostate cancer self-help groups: Reflections on differences. Psycho-Oncology 5(2): 137-142, 1996.

    Google Scholar 

  71. Steginga SK, Occhipinti S, Dunn J, Gardiner RA, Heathcote P, Yaxley J: The supportive care needs of men with prostate cancer. Psycho-Oncology 10(1): 66-75, 2001.

    Google Scholar 

  72. Jones H: Sexual function after permanent prostate brachytherapy. Oncolink, The University of Pennsylvania Cancer Center Retrieved 11/7/01 from the Wolrd Wide Web: http://www. oncolink.com.

  73. Wise TN: Psychosocial side effects of sildenafil therapy for erectile dysfunction. Journal of Sex & Marital Therapy 25(2): 145-150, 1999.

    Google Scholar 

  74. Sheppard C, Wylie K: An assessment of sexual difficulties in men after treatment for testicular cancer. Sexual & Relationship Therapy 16(1): 2001.

  75. Arrington ML: Sexuality, society, and senior citizens: an analysis of sex talk among prostate cancer support group members. Sexuality & Culture: An Interdisciplinary Quarterly 4(4): 45-74, 2000.

    Google Scholar 

  76. Benerjee AK: Sexual dysfunction after surgery for rectal cancer. Lancet 353(9168): 1900-1903, 1999.

    Google Scholar 

  77. Snow B: The ostomist-self-image and sexual problems. Sexuality and Disability 3(3): 0146, 1980.

    Google Scholar 

  78. Greenberg DB, Goorin A, Gebhardt MC, et al.: Quality of life in osteosarcoma survivors. Oncology (Huntington, NY) 8(11): 19-25, 1994.

    Google Scholar 

  79. Schover LR, montaque DK, Lakin MM: Sexual problems. In Devita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. Philadelphia, Pa: Lippincott-Raven Publishers, 5th ed., 1867-2871, 1997.

    Google Scholar 

  80. Schover LR, Jensen SB. Sexuality and chronic illness: a comprehensive approach. New York: Guilford Press, 1988.

    Google Scholar 

  81. Thaler-DeMers D: Sexuality, fertility issues, and cancer. Illness Crisis & Loss 10(1): 27-41, 2002.

    Google Scholar 

  82. Kaplan HS. The Evaluation of Sexual Disorders: Psychological and Medical Aspects. New York: Brunner/Mazel, 1983.

    Google Scholar 

  83. Lamb MA, Woods NF: Sexuality and the cancer patient. Cancer Nursing 4(2): 137-144, 1981.

    Google Scholar 

  84. Auchincloss S: Sexual dysfunction after cancer treatment. Journal of Psychosocial Oncology 9(1): 23-42, 1991.

    Google Scholar 

  85. Annon JS: The behavioral treatment of sexual dysfunction. Vol 1. Honolulu, Hawaii: Enabling Systems, Inc, 1975.

    Google Scholar 

  86. Creti L, Fichten CS, Brender W, et al. Global sexual functioning: a score for Nowinski and LoPicccolo's Sexual History Form (SHF). In Davis CM, Yarber WH, Bauserman R, Schreer G, Davis SL, eds: Sexuality-related measures: a compendium (2nd edition). New York: Sage Publication, 2001.

    Google Scholar 

  87. Schover LR, Evans RB, von Eschenbach AC. Sexual rehabilitation in a cancer center: diagnosis and outcome in 384 consultations, Arch Sex Behavior 16:445,1987.

    Google Scholar 

  88. Masters WH, Johnson VE. Human Sexual Response. Boston, Mass: Little, Brown and Company, 1966.

    Google Scholar 

  89. Rivas DA, Chancellor MB. Management of erectile dysfunction. In: Sipski ML. Alexander CJ, eds: Sexual Function in People With Disability and Chronic Illness, Gaithersburg, Md: Aspen Publisher, 429-464, 1997.

    Google Scholar 

  90. Lue TF. Contemporary Diagnosis and Management of Male Erectile Dysfunction. Newton, Pa: Handbook in Health Care, 1999.

    Google Scholar 

  91. Whipple B, McGreer KB. Management of female sexual dysfunction. In: Sipske ML, Alexander CJ, eds.: Sexual Function in People With Disability and Chronic Illness. Gaithersburg, Md: Aspen Publishers, 511-536, 1997.

    Google Scholar 

  92. Kaplan HS, Owett T. The female androgen deficiency syndrome. Journal of Sex Therapy 19(1): 3-24, 1993.

    Google Scholar 

  93. Bloom L. Meeting sexuality needs of women with breast cancer. Innovations in Oncology Nursing 10(2), 29, 46-51, 1994.

    Google Scholar 

  94. Schover LR. Sexuality and Fertility after Cancer. New York: John Wiley and Sons, 1997.

    Google Scholar 

  95. Schover LR. Sexuality and Cancer: For the Man Who Has Cancer, and His Partner. Atlanta, Ga: American Cancer Society. 1999.

    Google Scholar 

  96. Schover LR. Sexuality and Cancer: For the Woman Who Has Cancer, and Her Partner. Atlanta, Ga: American Cancer Society. 1999.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Houston VA Medical Center. Department of Anesthesiology, Baylor College of Medicine, 2002 Holcombe Blvd., Houston, TX, 77030

    Gabriel Tan

  2. Mental Health Care Line, Houston VA Medical Center, Houston, TX

    Karen Waldman

  3. Baylor College of Medicine, Houston, TX

    Rose Bostick

Authors
  1. Gabriel Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karen Waldman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rose Bostick
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tan, G., Waldman, K. & Bostick, R. Psychosocial Issues, Sexuality, and Cancer. Sexuality and Disability 20, 297–318 (2002). https://doi.org/10.1023/A:1021661614318

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1021661614318

Search

Navigation