Sexual Problems and Cancer: ASCO Clinical Practice Guideline Adaptation of CCO Guideline

As reported in the Journal of Clinical Oncology by Jeanne Carter, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues, ASCO has issued a clinical practice guideline adaptation of the Cancer Care Ontario (CCO) guideline on interventions to address sexual problems in people with cancer. ASCO staff reviewed the CCO 2016 guideline and updated the relevant literature search. An ASCO expert panel reviewed guideline content and recommendations. The panel was co-chaired by Dr. Carter and Julia H. Rowland, PhD, of the National Cancer Institute.

Key Elements of Recommendations

  • It is recommended that there be a discussion with the patient, initiated by a member of the health-care team, regarding sexual health and dysfunction resulting from cancer or its treatment.
  • Psychosocial and/or psychosexual counseling should be offered to all patients with cancer, aiming to improve sexual response, body image, intimacy and relationship issues, and overall sexual functioning and satisfaction.
  • Medical and treatable contributing factors should be identified and addressed first.
  • In women with symptoms of vaginal and/or vulvar atrophy, lubricants in addition to vaginal moisturizers may be tried as a first option. Low-dose vaginal estrogen, lidocaine, and dehydroepiandrosterone may also be considered in some cases.
  • In men, medication such as phosphodiesterase type 5 inhibitors may be beneficial, and surgery remains an option for those with symptoms or treatment complications refractory to medical management.
  • Both women and men experiencing vasomotor symptoms should be offered interventions for symptomatic improvement, including behavioral options such as cognitive behavioral therapy, slow breathing and hypnosis, and medications such as venlafaxine and gabapentin.

Additional information is available at and

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.




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