title: Sexual Concerns after (Pelvic) Radiotherapy: Is There Any Role for the Radiation Oncologist?
abstract: BACKGROUND
  Sexual function is an important aspect of quality of life, and may be impaired after (pelvic) radiation.
  
  
  OBJECTIVE
  The aim of this study was to identify practice, responsibility attitudes, knowledge, and barriers of Dutch radiation oncologists regarding sexual counseling.
  
  
  METHODS
  A cross-sectional survey was performed using a 28-item questionnaire sent to all members of the Dutch Society for Radiotherapy and Oncology.
  
  
  METHODS
  Self-reported practice, knowledge, barriers, need for training and responsibility attitudes in regard to demographic characteristics.
  
  
  RESULTS
  Of the surveyed sample, 54.6% of the radiation oncologists completed the instrument (n = 119). Frequency of discussing sexual function was fluctuating, depending on the type of tumor. The majority of the responding radiation oncologists (75%) agreed that discussing sexual function is their responsibility, about one-third (33.6%) pointed at the involved specialist (surgeon, urologist, gynecologist, or oncologist), a fifth also considered the general practitioner responsible (21%). Additional training about discussing sexuality was required according to 44.4%, the majority agreed that sexual counseling should be a regular component of radiation oncology residency (n = 110, 94%). Barriers most mentioned included patient is too ill (36.2%), no angle or reason for asking (32.4%), advanced age of the patient (27%) and culture/religion (26.1%). For prostate cancer patients, phosphodiesterase 5 inhibitor information was supplied regularly (49.2%) and often (40.7%).
  
  
  CONCLUSIONS
  Radiation oncologists generally perform sexual counseling in case of pelvic radiation therapy, but not consistently in case of gastrointestinal, breast, and other cancers. The majority of radiation oncologists considered counseling on sexual functioning as a part of their job, some also pointed at the referring specialist or general practitioner. The findings suggest that awareness about sexual dysfunction is present among radiation oncologists, but responsibility for active counseling is uncertain. Results emphasize the need for providing educational and practical training, as well as a list for specialized referral.
authors.affiliation: Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Esmée M
authors.identifier: http://orcid.org/0000-0003-2727-7539
authors.initials: EM
authors.lastname: Krouwel
authors.affiliation: Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Melianthe P
authors.initials: MP
authors.lastname: Nicolai
authors.affiliation: Department of Urology, Bronovo Hospital, The Hague, The Netherlands.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: van der Wielen
authors.affiliation: Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.affiliation: Department of Radiation Oncology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Augustinus D G
authors.initials: AD
authors.lastname: Krol
authors.affiliation: Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Rob C M
authors.initials: RC
authors.lastname: Pelger
authors.affiliation: Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Luca
authors.initials: L
authors.lastname: Incrocci
authors.affiliation: Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Henk Willem
authors.initials: HW
authors.lastname: Elzevier
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D003075:Coitus / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010348:Patient Care Team; D010386:Pelvic Neoplasms / Q000532:radiotherapy*; D010818:Practice Patterns, Physicians'; D011788:Quality of Life / Q000523:psychology; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D018787:Radiation Oncology / Q000193:education*; D012731:Sex Counseling / Q000379:methods*; D011795:Surveys and Questionnaires
keywords: Cancer; Cross-Sectional Survey; Oncology; Physician Practice Patterns; Quality of Life; Radiotherapy; Sexual Dysfunction