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Coping with sexual concerns after cancer: the use of flexible coping

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Abstract

Introduction

Although cancer treatment commonly has a negative impact on sexual functioning, sexual concerns are still largely undertreated in routine cancer care. The medical model that guides current approaches to sexual care in cancer does not adequately address key patient needs.

Methods

In this paper, we describe a broader approach to understanding and treating sexual concerns in cancer that focuses on the construct of flexibility in behavioral and cognitive coping strategies. We previously presented this model in the context of general medical conditions. We now adapt this model to the context of cancer, focusing on issues related to the benefits of flexible coping, interventions that shift perspectives following cancer, and on coping as a couple.

Results

We argue that coping flexibly with sexual concerns is likely to lead to improvements in mood and sexual and relationship satisfaction. We present clinical applications of the flexible coping model, including suggestions for assessment and sexual concerns and methods of introducing flexible coping into both the content and process of clinical interactions with patients.

Discussion

Finally, we discuss areas for future research, including the development of a validated instrument, the use of electronic methods of assessment, and intervention trials directly addressing flexibility in coping.

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Notes

  1. Please see the initial publication describing this model by Barsky, Friedman & Rosen [11] for a more detailed review of the research informing the construct of flexibility in coping with sexual challenges in the context of medical illness.

  2. Brief sexual counseling in cancer may include: education for the patient and partner about how cancer treatment can affect sexual function; suggestions on methods of comfortably resuming sex; encouragement of more open communication about sex between partners; help in coping with physical changes that cause feelings of unattractiveness and that hinder resumption of sexual activity; and referrals or resources to patients obtain treatment for specific sexual problems.

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Acknowledgements

The writing of this manuscript was supported by National Institute of Mental Health T32 MH 070448 Aging and Mood Disorders grant and by American Cancer Society postdoctoral fellowship PF-09-154-01-CPPB awarded to Jennifer Barsky Reese, Ph.D.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 5510 Nathan Shock Dr., Suite 100, Baltimore, MD, 21224, USA

    Jennifer Barsky Reese

  2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2200 W. Main St., Suite 340, Durham, NC, 27705, USA

    Francis J. Keefe & Tamara J. Somers

  3. Department of Medicine, Division of Medical Oncology, Duke University Medical Center, P.O. Box 3436, Durham, NC, 27710, USA

    Amy P. Abernethy

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  1. Jennifer Barsky Reese
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  2. Francis J. Keefe
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  4. Amy P. Abernethy
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Correspondence to Jennifer Barsky Reese.

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Reese, J.B., Keefe, F.J., Somers, T.J. et al. Coping with sexual concerns after cancer: the use of flexible coping. Support Care Cancer 18, 785–800 (2010). https://doi.org/10.1007/s00520-010-0819-8

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