Cancer is a disease that risks taking away many things: in addition to sleep, serenity and health, it also obscures one’s own identity – hence the need for a law that establishes the right to oncological oblivionthat is, not to mention the illness as part of the personal journey, after a suitable period has elapsed from the end of the therapies, if the patient returns to feeling well and being a “normal” person – and the sexuality.
A patient affected by a tumor still remains a person, who has the right to live his sexuality peacefully, but who often find themselves unable to do so due to treatment or the cancer itself. In oncology still today talking about sexual well-being is taboo: patients don’t talk about it, as if it were a less influential aspect to deal with, but the tumor itself and the therapies related to it can have a devastating impact, compromising the quality of life.
It’s a problem that it mainly concerns women: over 6 out of 10, after a neoplasm, they undergo some form of «sexual dysfunction», as reported by the research Prevalence of sexual dysfunction in women with cancer: A systematic review and meta-analysis. To this, we add the criticality of one lack of guidelines, that guide clinicians in the management of treatment-related toxicity.
To address the issue and raise public awareness on this delicate topic, the National Center for Oncological Hadrontherapy (CNAO), the IRCCS Policlinico San Matteo Foundation and the Maugeri IRCCS Scientific Clinical Institutes of Pavia promote for the September 25th the conference Cancer and sexual well-being at the CNAO Foundation in Via Borloni in Pavia, a day in which the scientific managers of the aforementioned healthcare entities will provide all healthcare professionals involved in the diagnosis, treatment and follow-up process and patients with suitable tools to identify and successfully deal with possible sexual problems induced by oncological treatments.
After the diagnosis of cancer, the body changes and we no longer recognize ourselves
The diagnosis of cancer already has a prevalent impact on the patient’s psyche, but no one ever focuses on the physical changes she must undergo: «Following oncological therapies, the patient finds herself relating to the image of a body that visually changes: surgical scars, weight changes, hair loss, radiotherapy rashes – he explains Amelia Barcelliniradiation oncologist at the CNAO and among the speakers at the conference – There are, however, also others invisible side effects: premature menopause, infertility, osteoporosis and even genitourinary syndrome, alteration of vaginal elasticity, the latter heavily influencing sexual life”.
The repercussions of these side effects it affects not only the patient, but also those around her: «All this inevitably not only has repercussions on the patient’s psyche, but also on the life of a couple and relationships, often altering the balance. Even though there are tools that allow us to counteract some of these symptoms, today sexual health, especially female health, is still neglected in the oncology field. This is why it is important to talk about it: to offer healthcare personnel the right tools to recognize and manage sexual toxicity and to overcome the embarrassment of talking about it with patients.”
Talking about the right to sexuality is important, so that it is recognized in the LEAs
«We need to break down the wall of silence. Managing the problem through interdisciplinary teams dedicated is the key to find customized solutions for the individual patient – illustrates Chiara Cassanigynecologist oncologist at the IRCCS Policlinico San Matteo – For example, today it is almost always possible preserve fertility before starting treatmentsadminister drugs that protect the ovaries from the negative effects of chemotherapy, offer rehabilitation programs before and after surgical and radiation treatments, use local or systemic therapies to counteract the symptoms related to vaginal atrophy and menopause and support patients with the help of specialized psychologists and sex therapists. However, not everything is always easily accessible or foreseen by the LEAs (Essential Levels of Assistance) and it is essential that scientific research works to find increasingly effective solutions.”
An important focus that calls ATS into question: «Spread the culture of prevention it is a fundamental tool in the fight against tumors – he declares Silvia DeandreaHead of SS Oncology Screening of the ATS – Participate in free screening programs it means promoting the early diagnosis of tumors, when they have not yet shown signs of appearing, and consequently increasing the chances of recovery. Many tumors, in fact, grow for months or even years, without causing any disturbance: these tests can help identify them in time to proceed with the correct therapy.”
«There is still little talk in our clinics about sexual toxicity and how much oncological treatments interfere with our patients’ life as a couple – he adds Laura Locati, Associate Professor of Medical Oncology at the University of Pavia and Director of Medical Oncology at the Maugeri Scientific Clinical Institutes – The survival of cancer patients has improved over the years: for breast cancerfor example, we have a 88% of 5 year survivors from the diagnosis (AIRTUM 2022 data) and, if we add to this that 41% of new cases of breast cancer occur in young women under the age of 50, the need for multidisciplinary and holistic management that accompanies patients during treatment and at the end of treatment is evident. Sexual toxicity linked to oncological therapies can have an explosive impact on the couple, so it is important to begin to identify the phenomenon, prevent it and actively deal with it from the beginning of the treatment process.”
Focus also on the transgender community, often not covered by screening
The conference will address the topic of prevention and sexual health also from a “rainbow” perspective: «From recent literature data we know that patients from the LGBTQIA+ community complain of discomfort during clinical visits, not feeling adequately welcomed and welcomed by healthcare personnel – explains Barcellini – Therefore, they do not often access screening programs. This can result late cancer diagnoses. Furthermore, there is an even more deafening silence regarding sexual health after cancer treatment in the LGBTQIA+ community.”
Right to sexuality: here is the listening point
Also among the speakers, in the session dedicated to patient associations Amalia Vetromile, founder of the APS Mamanonmama and the movement “Sex and the Cancer. What women do not say”, who fights for women’s right to find satisfying sexuality after cancer. «Almost 2 million Italians live with a cancer diagnosis and are embarrassed to talk about their intimate problems with the doctor, convinced that nothing can be done – says Vetromile – Instead, solutions exist. That’s why we created one listening desk which, through a telemedicine platform, offers a free online consultancy service throughout Italy, with the volunteer specialists of our team, including doctors Barcellini and Cassani. To access it, just connect to the site https://www.sexandthecancer.it/sportello-editore-sexandthecancer/».
Right to sexuality: initiatives aimed at everyone
The. will be held on September 24th CorriPavia: on this occasion, CNAO, San Matteo and Maugeri, under the aegis of ATS Pavia and in collaboration with the APS Amiche per mano, will join efforts for the awareness walk Running towards well-being. Cancer and the Right to Sexuality. The race is non-competitive and open to all and by registering, you will support pelvic floor rehabilitation projects for the oncology patients of the three Pavia facilities. Furthermore, at the ATS Pavia stand, it will be possible to book to join the oncological screening programs (cervix, colon, rectum, breast).
The September 30thinstead, on the occasion of European Researchers’ Night, it will be possible to visit the exhibition at the CNAO Sexandthecancer® – Sensual Ballad, an artistic event that brings art, poetry, acting and music into dialogue with the aim of informing and raising public awareness on a topic that women struggle to share. In the video of the Sensual Ballad, 32 photographs from the Alinari Foundation for Photography archive alternate: fragments of reality and invention, sometimes extrapolated from their original context, which, as in a collage, come to compose the four “stanzas” of the ballad by assonance : The assault – The Beast, Inside the Trauma – The nightmare, Different Beauty – The Beauty of the Offended Body, Joyful Sensuality – Venus’ Revenge.
Source: Vanity Fair
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