Cancer and sexuality: The couple, a decisive factor, too often neglected

SummaryThe couple, main way of life of cancer patients, is an important parameter for both sexual life and cancer that changes the home private life. To integrate the oncosexual couple problem is an adequate response to many priorities of the 3rd Cancer Plan as to personalize the treatment, to improve the inequality of healthcare, to reduce or to prevent the acute or chronic medical, psychosocial and couple negative impacts. In spite of its cancer protective proved effect, the couple dimension is too often underestimated. If separations are rare, too many couples silently suffer because they feel themselves insufficiently prepared to the real or supposed intimate life changes owing to the information lack by healthcare professionals concerning the sexual morbidity and the available solutions. In spite of both strong demand and treatment efficacy, the healthcare and institutional responses remain very insufficient. This represents an unconscious inequality of care that is no more acceptable as the cancer treatment may be impaired. Whatever the age, to council both healthcare and life pathways is often possible at the condition to: (a) to be sensitized to oncosexual and psychosocial dimensions, (b) to take care soon, (c) to favour a multidisciplinary approach, (d) to know the cancer couple particularities: brutality, major iatrogenic component, partner helping role, complexity to be the sick-person or the partner, revealing role for the relationship quality, (e) to screen the often masked vulnerability factors linked to cancer, gender and couple. Although, the sexual priorities and impacts largely change according to cancers and couples, any sexual insecurity may change the dialogue then the couple dynamic, impairing both distress and suffering in the absence of screening/treatment of the most vulnerable couples.