Sexual Wellbeing and Supportive Care Needs After Cancer in a Multiethnic Asian Setting: A Qualitative Study

The physical and emotional impact of cancer and its treatment may be detrimental to the sexual well-being of patients. We aimed to gain an in-depth insight on the impact of cancer on the sexual wellbeing of cancer patients living in a middle-income setting with limited supportive care services. Twenty focus group discussions, stratified by gender, were conducted among 102 patients with breast, cervical, colorectal, or prostate cancer. Participants were recruited from five hospitals in Klang Valley, Malaysia. Discussions were audio recorded and transcribed verbatim. Thematic analysis was performed using NVivo. Three major themes emerged: loss, adjustments, and unmet supportive care needs. Under the main theme of loss, changes in physical appearances and childbearing abilities negatively impacted participants' self-confidence and body image, particularly in the females. Changes in quality of sexual activity were commonly raised, which often brought about conflicts and marital strains. Various methods to cope with the changes were described, including reprioritization of sex, using sexual aids, employing other forms of intimacy, and reframing sex as an obligation. Participants further voiced the unmet need for professional counselling services to enable honest communication between patients and their partners, and also sexual healthcare services, which were all deemed as paramount to address their sexual issues. In the low- and middle-income countries, provision of sexual healthcare services including counselling and clinical management of sexual dysfunction should not be overlooked as an important component of supportive cancer care.