Cancer survivors often face fertility and sexual health challenges resulting from their treatment or disease, making reproductive issues a critical yet understudied component of survivorship care. In this interview, we spoke with Sadaf Sedaghatshoar and Karlynn BrintzenhofeSzoc (both University of Louisville, KY, USA) about their work into the sexual and reproductive health variables that impact cancer patients’ quality of life. 

Could you highlight the most commonly addressed health-related quality of life (HRQoL) variables you identified in your research?

In our scoping review (manuscript in progress), which was presented at the AOSW Annual Conference (June 11–13, Atlanta, GA, USA), the most commonly addressed HRQoL variables were those related to sexual health. Interventions frequently focused on sexual function and behavior, such as erectile dysfunction, vaginal dryness and changes in sexual activity, as well as psychosexual and emotional factors including body image, sexual confidence and distress.

Notably, fertility and reproductive health variables were almost entirely absent, as none of the included studies directly measured outcomes such as fertility preservation, hormonal rehabilitation or family-building support, despite their known importance for many survivors.

What specific aspects of fertility preservation do you believe require the most urgent attention from researchers and clinicians?

The most urgent fertility preservation needs relate to early, proactive counseling and decision-making support for patients at risk of infertility. Too often, fertility is overlooked in survivorship interventions, leaving patients without timely information about preservation options before treatment begins.

Researchers and clinicians need to prioritize structured interventions that address both the medical aspects of fertility preservation, such as cryopreservation, hormonal protection and reproductive technologies, and the psychosocial dimensions, including fertility-related distress, uncertainty about future family building, and cultural or financial barriers to fertility preservation care. There is also a need for integrated, multidisciplinary models that connect oncology with reproductive endocrinology, and for long-term follow-up studies that examine how preservation choices affect quality of life, mental health and relationship outcomes.

What are your practical recommendations for healthcare providers who want to better address sexual and reproductive health in their survivorship care programs?

Based on our research, a key recommendation for healthcare providers is to implement proactive and universal screening for sexual and reproductive health concerns as part of survivorship care, rather than waiting for patients to raise these sensitive topics. Even if comprehensive interventions are not available, providers can offer basic education on common side effects such as vaginal dryness, erectile dysfunction, premature menopause and infertility risks, and connect patients with appropriate resources.

Multidisciplinary collaboration is also critical, with clear referral pathways to gynecologists, urologists, reproductive endocrinologists, mental health professionals and social workers. Care should extend beyond physical symptoms to include issues like intimacy, body image, desire and relationship quality, ideally involving partners when appropriate. Finally, providers should adopt culturally sensitive approaches, advocate for equitable access to specialized services, and integrate sexual and reproductive health into long-term follow-up, recognizing that these concerns can persist or emerge years after treatment.

Improving sexual health in breast cancer survivors

In this interview, Maya Franks (Intermountain Health, UT, USA) discusses the complex and often overlooked sexual health concerns experienced by breast cancer survivors.

What policy changes might help improve attention to sexual and reproductive health issues in cancer survivorship care?

There are several important guidelines that address sexual and reproductive health in cancer survivorship. For example, the American Society of Clinical Oncology (VA, USA) and the National Comprehensive Cancer Network (PA, USA) both provide recommendations related to fertility and sexual health. In addition, the American College of Surgeons (IL, USA) Commission on Cancer (CoC) has incorporated language into its survivorship care standards that encourages referrals to fertility and sexual health specialists.

However, these are guidelines rather than mandates. Sexual and reproductive health remains inconsistently addressed in practice. Stronger policy action could build on the existing guidelines and move toward mandated standards to ensure equitable access for all survivors.

The following article by Sadaf Sedaghatshoar and Karlynn BrintzenhofeSzoc is based on a session at the Association of Oncology Social Work (AOSW) Annual Meeting. For more information about AOSW Annual Meeting please go to www.aosw.org

Interviewee profiles:

Sadaf Sedaghatshoar (University of Louisville, KY, USA) is a third-year doctoral student in Social Work with a background in Clinical Psychology and an interest in qualitative research methodology. Her research focuses on HIV care, oncofertility, reproductive health and mental health, with particular attention to the reproductive and psychosocial experiences of individuals affected by cancer. She is working toward developing a research agenda grounded in health equity and person-centered care.

 

Karlynn BrintzenhofeSzoc is a Professor at the Kent School of Social Work and Family Science, at the University of Louisville. With over 30 years of experience as a clinician, researcher, educator, and mentor, BrintzenhofeSzoc applies the BioPsychoSocialSpiritualSexualCultural (BPSSSC) approach to her work. Her research focuses on understanding the experiences of individuals with cancer and other chronic and life-limiting diseases, as well as those of their families and caregivers, from diagnosis through treatment and beyond.

The opinions expressed in this interview are those of the author and do not necessarily reflect the views of Oncology Central or Taylor & Francis Group.

No potential competing interest were reported by the contributors to this feature.