1020 - Developing Patient-Facing Guidelines for Navigating Anal Sexual Health during and after Anal or Rectal Cancer Treatment

Purpose/Objective(s):

Sexual health is an important yet often overlooked aspect of quality of life, with oncologists providing limited counseling on the topic. This study aimed to develop practical guidelines to mitigate treatment-related sexual dysfunction, promote healing, and support individuals in safely resuming anal sexual activity after treatment for anal or rectal cancers.

Materials/Methods:

A comprehensive review of the literature on the effects of radiation and chemotherapy on the pelvic organs and sexual function was conducted. Within a single institution, a multidisciplinary approach, integrating expertise from oncology, urology, and patient advocacy groups informed guideline development. Additionally, input from patients who have undergone pelvic radiation informed the recommendations. Key focus areas included the impact of radiation on tissue integrity, psychological considerations, pain management, and strategies for safely resuming receptive anal sex.

Results:

Although the literature on anal sexual health in cancer treatment is limited, existing literature on sexual health in prostate cancer and insights from vaginal health practices post-pelvic radiotherapy informed our guidelines. Our resulting guidelines provide detailed recommendations for patients and healthcare providers to navigate anal sexual health challenges related to anal and rectal cancer treatment. Key recommendations include: informational characterization of the effects of chemotherapy/radiation on pelvic organs; avoidance of receptive anal sex during and immediately after radiation therapy to prevent pain, bleeding, and infection; use of anal dilators, pelvic floor therapy, and NSAIDs to improve tissue flexibility and reduce discomfort post-treatment; psychological support, including sex therapy and couples counseling, to address changes in sexual desire and intimacy; practical strategies such as lubrication, lidocaine cream, warm baths, and dietary adjustments to ease the transition back to sexual activity; emergency guidance for managing complications such as excessive bleeding.

Conclusion:

These guidelines provide a structured, multidisciplinary, evidence-based approach to addressing anal sexual health concerns for individuals undergoing and recovering from anal or rectal cancer treatment. They aim to support patients in maintaining intimacy and sexual wellness while ensuring safe and gradual recovery. Enhancing provider engagement and patient education is essential for improving sexual health outcomes and overall quality of life for cancer survivors. Future efforts will focus on patient feedback, validation, and dissemination within the oncological community.