Developing age appropriate psychosexual support for adolescent cancer survivors: A discussion paper

Introduction: Cancer in adolescence raises unique challenges for all involved. In healthy populations, the transition from childhood to adulthood is seen as a normal phase of the human life course focused primarily on the process of identity formation. For young people diagnosed with cancer, there are specific, negative impacts to consider. In this paper, the impact on intimacy, body image, and sexuality are discussed and the need for innovative supportive solutions highlighted. Aim: Based on a presentation given at the ISSM conference in Washington, DC, the paper describes the challenges in providing effective supportive care in relation to sexuality in young people surviving cancer. Main Outcome Measures: Discussion of key issues involved when developing psychosexual interventions for this age group. Methods: A scan of available evidence was combined with examples of recent service and research developments. Results: The limited amount of available research belies the complexity of providing effective supportive care in relation to sexuality for young people both during and after cancer. As the number of long-term survivors of cancer during childhood and adolescence increases, there will be increasing demand for attention to be paid to the supportive care needs of this population; including issues of relationships and sexuality. Two examples of novel interventions are presented. Conclusions: Services provided for cancer survivors must consider the unique challenges facing different age groups. For young people diagnosed during adolescence and young adulthood there is a need to enhance the evidence base, and to apply this evidence in practice contexts. Locating the need for further developments within a Complex Intervention Framework may assist in the development of interventions that can be developed and tested in a logical, step-wise fashion