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When undergoing treatment for cancer, sexual function and well-being may not be top-of-mind issues for most individuals.
But Lori Seaborne, a physician assistant with the UW Carbone Cancer Center, has seen the lasting impact that sexual dysfunction issues can have – especially for women – when they go unaddressed.
“When people are actively on chemotherapy, they experience things like nausea, fatigue, and hair loss,” she said. “But most of these issues resolve over time, usually once they’re done with their therapy. Sexual dysfunction, however, can persist well after cancer treatment ends, and in some cases, sexual function may be permanently altered.”
That’s where the Women's Integrative Sexual Health (WISH) program comes in. For nearly eight years, the program has been giving women, and their sexual partners, the support they need to thrive in survivorship.
“We really try and give people some interventions that help to manage or improve these issues in survivorship,” Seaborne said. “That’s what our goal is.”
The WISH team – which also includes nurse practitioner Megan Peterson and physician assistant Joanne Rash – saw their first patient in November of 2013. Since then, the team has seen over 300 women, and after a few months of shutdown during COVID-19, is once again seeing patients. Housed at UW Carbone, WISH is available to all women, regardless of their type of cancer and where they received their cancer care.
The need for WISH’s services is clear, even if it’s not always talked about. Sexual dysfunction is one of the most common side effects of cancer treatment, and for women, that can mean painful sex, vaginal dryness or a loss of desire. Having a cancer surgery may also limit a woman’s physical ability to have intercourse, or change her body’s appearance in a potentially unexpected way.
Despite all this, many patients are afraid to bring the topic up with their oncologist, and oncologists may not always ask.
“It’s kind of a sensitive topic and these providers may not know what to do for people,” Seaborne said. “We’re hoping that by just knowing about the WISH program and knowing that we have this available to any survivor, it might encourage more providers to bring it up to their patients because they have somewhere to send them.”
While WISH primarily serves patients who have already received treatment, their services are also available to women who have elected to have surgery, or take a medication like Tamoxifen, to reduce their risk of cancer.
“A woman in that situation would have the same sexual side effects as a woman who has had cancer and takes the medication for that purpose,” Seaborne said. “Or consider that a woman with an increased risk of ovarian cancer might decide to have her fallopian tubes and ovaries removed, which puts her into surgical menopause. These are all situations we can help with.”
Working with WISH typically involves two visits. The first involves an extensive interview with one of the WISH team members. This visit normally takes place in-person, but patients may now opt to do this consultation as a video visit, if they are more comfortable with that option.
The second visit involves a physical exam and must be done in person. “There are a lot of physical findings that can help give us clues about how to do interventions, and if pain is an issue, it helps for us to know where and under what circumstances the pain is occurring.” Seaborne said. “However, there are some individuals who get the vast majority of what they need through that one single consultation. So we have a handful of people who don’t end up coming in for their exam.”
However, just like all clinics across UW Health, WISH is taking extra precautions to keep patients safe, including increased sanitation measures and mask usage.
With the information gained from the two visits, WISH can provide appropriate counseling, suggest ways to improve or minimize discomfort, and even discuss alternative ways to share intimacy with a partner.
Since 2019, patients have also received an online survey about their experience. The response from cancer survivors has been positive. As outlined in a recent article in the Journal of the Advanced Practitioner in Oncology, the survey results show that that most women had a positive experience, with 88 percent of respondents reporting that WISH was at least somewhat helpful, and 95 percent saying they would recommend the program to other women.
“Clearly, the suggestions, recommendations, information, and education we’ve been able to offer have been helpful,” Seaborne said. “We want to keep that going for as many people as possible.”
Want to learn more? Visit the WISH website or call 608-265-1700
