{"entity":{"id":"idea-moon-sexual-health-as-toxicity-domain","kind":"idea","name":"Sexual health assessed and treated as a standard toxicity domain","aka":[],"tldr":"Cancer treatment often damages sexual function and intimacy, and almost nobody asks. Make it a routine question with a clinic to refer to.","summary":"Sexual dysfunction after pelvic surgery, radiotherapy, endocrine therapy and stem cell transplant is very common and is among the least discussed toxicities. The proposal is routine screening with a brief validated item set at treatment milestones, a referral pathway to sexual health services (pelvic floor physiotherapy, vaginal and erectile therapies, counselling), and inclusion of sexual function as a PRO domain in trials of pelvic and endocrine treatments.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Toxicity and quality of life are undervalued): Di Maio et al., Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting (JCO 2015)","url":"https://doi.org/10.1200/JCO.2014.57.9334"}],"tags":[],"related":[],"cancers":["prostate","cervical","colorectal","breast-hr-positive"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol","b-survivorship"],"keyPapers":["paper-di-maio-j-clin-oncol"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Routine screening and referral increases treatment of sexual dysfunction severalfold and improves patient-reported quality of life and adherence to endocrine therapy.","rationale":"Under-treatment is driven by embarrassment and absent pathways, not absent treatments; adherence to endocrine therapy is known to fall with sexual side-effects.","test":"Implementation trial in prostate, cervical, rectal and breast cancer clinics with screening rates, referral, and quality of life at 12 months as endpoints.","maturity":"early-clinical","actor":"clinic","cost":"small","horizonYears":2},"route":"/ideas/idea-moon-sexual-health-as-toxicity-domain/","neighbours":{"cancer":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"bottleneck":[{"id":"b-survivorship","kind":"bottleneck","name":"Survivorship and late effects are neglected","route":"/bottlenecks/b-survivorship/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-di-maio-j-clin-oncol","kind":"paper","name":"Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials","route":"/key-papers/paper-di-maio-j-clin-oncol/"}],"technology":[{"id":"rejuv-mind-visible-difference-head-and-neck","kind":"technology","name":"A changed face and voice: body image after head and neck cancer treatment","route":"/technologies/rejuv-mind-visible-difference-head-and-neck/"},{"id":"rejuv-mind-body-image-after-cancer","kind":"technology","name":"Body image after cancer treatment: how it is measured, what drives it, and what helps","route":"/technologies/rejuv-mind-body-image-after-cancer/"},{"id":"rejuv-life-partners-and-intimacy","kind":"technology","name":"Partners and relationships after cancer: what the divorce data actually show","route":"/technologies/rejuv-life-partners-and-intimacy/"},{"id":"sexual-function-after-cancer","kind":"technology","name":"Sexual function and intimacy after cancer, for both sexes","route":"/technologies/sexual-function-after-cancer/"},{"id":"vaginal-oestrogen-after-breast-cancer","kind":"technology","name":"Vaginal oestrogen after breast cancer: what the evidence says, and where it disagrees","route":"/technologies/vaginal-oestrogen-after-breast-cancer/"}]}}