The silent dimension of cancer survivorship: sexual health, body image, and intimacy in oncology care

Abstract

This article examines sexual health as a frequently neglected but clinically relevant dimension of cancer survivorship. Moving beyond a purely functional view of sexuality, it explores how cancer diagnosis and treatment may affect body image, sexual identity, desire, intimacy, self-perception, couple communication, dating confidence, and quality of life. Particular attention is given to the lived experience of the changed body, the relational consequences of illness, the needs of single patients, and the specific vulnerabilities of sexual and gender minority populations in oncology care.The paper argues that sexual health should be recognized as an integral component of patient-centered cancer care rather than as a secondary or optional concern. It highlights the persistence of a “clinical silence” around sexuality in oncology, sustained by patient embarrassment, cultural taboos, lack of professional training, and insufficient referral pathways. To address this gap, the manuscript proposes an integrated stepped-care framework, ranging from proactive communication and normalization to structured assessment, symptom-oriented management, body image support, relational interventions, psychosexual counselling, inclusive care, and continuity throughout survivorship.The article is intended for clinicians, psycho-oncologists, sexologists, oncology nurses, rehabilitation professionals, researchers, and healthcare educators interested in survivorship care, sexual medicine, body image, communication, and quality of life in oncology.