Guest Editor's Note: Ask and Tell

Abstract

In 1987, the American Cancer Society sponsored the first Workshop on Psychosexual and Reproductive Issues Affecting Patients with Cancer. I was halfway through a joint postdoctoral fellowship in psycho-oncology and human sexuality at the time (at Memorial Sloan-Kettering Cancer Center and New York Hospital/Cornell Medical Center, respectively). Since then, we have become more sophisticated with medical techniques, measurement devices, and medication to treat the psychosexual sequelae of cancer. Not surprisingly, the medical advances precede our ability to handle the subtler emotional repercussions. Sexual problems after cancer, depending on how you measure them, the type and severity of the cancer, its treatment, and the gender of the patient may occur in as few as 10% or as many as 90% of cancer survivors (Syrjala et al., 2000). Patients who talk about their sexual problems are probably treated more appropriately and with more respect than in the past. However, given the extent to which sexual problems are hypothesized to exist among this population, too few patients are being asked or told about sexual side effects. My colleagues in the field and I have continued to see too many patients who mourn the loss of sexual function after cancer treatment, claiming that "no one told me." These patients often feel betrayed by their doctors as well as their own bodies. For most patients, only brief intervention is required to get their sex lives back on track. For example, since the advent of sildenafil (Viagra), somewhere between 40% and 70% of men treated for prostate cancer are getting help from just a little pill (Kaufman, 2001). Knowing this and having an open mind should lead each and every cancer professional to prepare all patients and their partners for the likelihood that cancer will impact their sexual lives, and how and where to get help. My hope in organizing this special issue titled Cancer and Sexuality is to mobilize cancer professionals to