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Nurses urged to 'normalise' conversations about sex with young cancer patients

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A paediatric nurse has said young cancer patients are missing out on vital sexual health information due to embarrassment among care professionals. 

Beth McCann wants to see nurses and other health staff given more targeted training on how to broach conversations around sexuality and intimacy with young people having cancer treatment.

”I think nurses need to have more training in that area because at the moment the research is telling us people aren’t having those conversations because nurses don’t feel comfortable”

Beth McCann

She is also hoping to develop an online resource for these patients where they can privately find information on how cancer diagnosis and treatment may affect their sexual health and personal relationships.

Ms McCann gave a presentation on the subject during a conference for nurses and allied health professionals hosted by The Brain Tumour Charity at the University of Birmingham on Wednesday.

Addressing delegates, Ms McCann, a clinical nurse specialist at a young people’s cancer unit, stressed the importance of “normalising” the conversation.

She explained how a cancer diagnosis can make it difficult for young people to form intimate relationships, raise body image issues and prevent them getting sexual health education through traditional routes such as school.

Treatments given for the disease can also impact sexual function and can heighten risks during sex, she added.

However, Ms McCann said there was limited research in this area and a lack of essential information being passed to young people during the care pathway due to reluctance among health professionals to raise the conversation.

In an interview with Nursing Times after her presentation, Ms McCann said: “I think it’s important to have the conversations that patients need to have around their sexual health after a diagnosis of cancer. There are certain things the patients need to be made aware of. On a practical level, is it safe to have sex when they are on chemo?

“Someone needs to have that conversation and it usually does fall to nurses but I think nurses need to have more training in that area because at the moment the research is telling us that people aren’t having those conversations and a lot of when it’s been explored it’s because nurses don’t feel comfortable in having those discussions.”

”The message that we are trying to give is if you are having sex we just want you to have it in a safe way”

Beth McCann

Demonstrating why informing patients on the risks is so important, Ms McCann explained how she had met a young male cancer patient who ended up in A&E with severe anal bleeding after having sex with his boyfriend because he was not told that chemotherapy can lower the platelet count.

Ms McCann patients should be advised against having anal sex if their platelet count falls below 50.

She added: “He said if someone would have just had that conversation with me all of that horribleness for him could have been prevented.”

Ms McCann said cancer patients should also be warned against having oral sex for five days after their last chemotherapy session as traces of the drug can pass through bodily fluids.

Other topics that Ms McCann said should be discussed with these patients include the importance of using contraception to avoid getting pregnant during treatment.

Passionate about the subject, Ms McCann personally provides training to all new healthcare professionals starting at the hospital where she works.

Ms McCann has been pushing for wider progress on this matter for many years but has come up against barriers due to the sensitive nature of the subject.

She said in 2014 a charity agreed to work with her to publish a booklet on young cancer patients and sexual health, but it pulled out last minute.

“I couldn’t tell you how disappointed I was, not only for the fact I put so much work into it but all of the people who had contributed to it had put so much work into it,” Ms McCann said. “It had gone through 10 revisions, there was a lot of work.

“When I tried to get to the bottom of why they wouldn’t do it I was basically told that it was a sensitive subject because you have got parents that might not be happy that you’re talking about that sort of thing, and it discusses anal sex and they didn’t like that but I wasn’t willing to take that out because it’s part of it.”

She also explained how she recently had to take down posters in her young people’s cancer department about practising safe sex due to complaints from parents.

“It’s just really frustrating because the message that we are trying to give is if you are having sex we just want you to have it in a safe way, we are not encouraging people to go out and have sex if that’s not what they are doing already,” Ms McCann added.

Ms McCann was more recently able to utilise her passion and knowledge when she was involved in a study looking into the sexual health information and support needs of adolescents and young adults facing cancer.

The findings were published in the Journal of Adolescent and Young Adult Oncology this year and one of recommendations was to develop training for health professionals to help them feel comfortable talking about sex with these patients.

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