Chapter 3

will deal with the value of paying attention. Why is it so difficult to address this topic? We’ll look into the underlying taboos among the professionals and the patients. Paying attention is relevant because sexuality and intimacy are so frequently damaged by cancer and its treatment. Since sexuality and intimacy are relevant factors for quality of life, attention for those areas is an integral part of good care. But also because much of the damage is caused by our interventions and treatments, so in some way we are responsible to deal well with those side effects.

This chapter will also give some explanation on why people have sex, highlighting some of the direct benefits of sexual expression that can favour care with even some elements of cure.

Chapter 4

will give in a nutshell information on some relevant aspects of sexuality. It will deal with sexual function (the sexual response with desire, arousal and orgasm) and with some general information on sexual dysfunctions.

It will also address some of the relevant differences between the (average) female and the (average) male. Many of the sexual disturbances between male and female are (at least partly) the result of misunderstanding differences and miscommunication.

Chapter 5

will deal with the relation between on the one hand the cancer and its treatment and on the other hand the impact on sexuality and intimacy. Whereas many professionals have been educated with the principles of a biopsychosocial (or biopsychosociocultural) approach, we here use another paradigm. Sexuality is composed of three important elements: sexual function, sexual identity and sexual relationship. Knowing that cancer and its treatment can cause sexual disturbances, we believe that in proper care we should inquire about the influence on function, identity and relationship. We recommend to do this inquiring proactively, knowing that the patients themselves are scared to bring up the topic.

In the process of sex and lovemaking, it is not only the genitals that have a role. Many other parts of the body are used as ‘sexual equipment’ and can also be damaged. Since that is rarely mentioned, it will get extra attention in this chapter.

Chapter 6

will approach the area from a totally different perspective. In France, they have started to develop a clinical practical guideline completely devoted to sexuality after cancer. This guideline with standards of care describes various practical questions as ‘For whom?’, ‘Which cancers?’, ‘Who should speak about it?’ and ‘When and how to speak about it? and also about the role of oncosexology. This chapter has extra value for health-care managers who have to think about and deal with the structure of care.

Chapter 7

is about training. In the context of this book, training is in particular intended for the professionals who are not rooted in sexology and who don’t feel at ease in discussing sexual function or who don’t feel at ease in dealing with intimacy.

Whereas teaching can be seen as lecturing on knowledge, training is much more.Good training offers a mixture of teaching knowledge, allowing space for necessary attitudinal change, improving practical skills (here especially to proactively discuss sexuality) and building competence (incorporating the newly learned capacities with the right attitude in daily practice).