First nurse-led sexual health clinic for cancer patients in Northern Ontario

A specialized, nurse-led sexual health clinic for cancer patients is up and running at Regional Cancer Care Northwest. It is called the BLISS Clinic, which stands for “Balancing Life, Intimacy, Sexuality and Survivorship,” and it’s the first oncology nurse-led clinic of its kind in the region. Nurses at the clinic offer practical medical advice and encourage couples to communicate about cancer’s impact on sexual health.

“Many patients experience various side-effects when they are being treated for cancer,” explains Angela Saunders, the lead nurse at the BLISS Clinic. “We address their sexual health and give them practical tools to consider. We’re here to help the cancer patients with all of the issues related to survivorship.”

Although the clinic is only offered one afternoon per month, Saunders says it has “met and surpassed expectations.” Over 60 patients have visited, and the clinic has received more than 87 referrals from primary health care providers in the region. Self-referrals are also being accepted.

“We have a large age range of patients, from ages 30 up to 80. The majority of patients have been women, but we’ve also had some men,” she says. “The most common symptom is vaginal dryness as a result of chemotherapy and anti-estrogen medications as well as pelvic radiation … There are some very simple non-hormone based treatments that we recommend, and patients in follow-up appointments have reported improvement in their symptoms.” Another common symptom is erectile dysfunction as a result of cancer and treatment.

Saunders says the need for the BLISS Clinic is more relevant than ever before with the increasing number of cancer survivors. She says primary care providers in Northwestern Ontario seem to be more comfortable talking to cancer patients about their sexual health, thanks to the BLISS Clinic which acts as a resource and a place to refer patients.

“Advances in cancer treatment have increased the likelihood of people surviving after a cancer diagnosis. So we’ve expanded our role in dealing with the impact of a cancer diagnosis and the impact of treatment on the patient’s quality of life,” Saunders explains. “It’s not adequate for us to focus only on treating the disease, it’s vital for us to take an active role in managing long term side effects.” Saunders adds that nurses at the clinic also make referrals to Regional Cancer Care Northwest’s Supportive Care Department when necessary.

Although it is the first of its kind in the Northwest, it is a model that is well established at the Odette Cancer Centre at Sunnybrook Health Sciences Centre in Toronto. The Odette Cancer Centre offers a specialized clinic for women with breast and gynecological cancers who have sexual health concerns. Saunders says the BLISS Clinic was based on the Sunnybrook model.

“We know that treatment for cancer has a profound effect on patient’s relationships and families. We’re used to treating symptoms, like fatigue and depression but until now, we had not directly addressed people’s sexual health,” Saunders says. “It shouldn’t be a taboo subject. We’re here to help with cancer patients.”

Dawn Aho says she would have welcomed the additional support of the BLISS Clinic if it had been up and running when she was facing her diagnosis of cervical cancer back in 2009. Aho is a 37-year-old mother from Lac de Mille Lacs First Nation living in Thunder Bay. She was told she had irregular cells after a routine follow-up visit, following the birth of her first baby. She explains how devastating it was to later receive her diagnosis of cervical cancer. At the time, she was 36. She underwent chemotherapy and daily radiation treatments for six weeks. Aho says the treatment had a long-lasting impact on her sexual health.

“It was a very difficult time for me emotionally. When you’re undergoing treatment you have regular doctor appointments to monitor your symptoms. I was asked about my medical symptoms all the time, but I found it very difficult to discuss the specific intimate changes I was dealing with,” explains Aho. “When you’re being treated for cancer, there is so much going on internally that you don’t feel it is appropriate to talk to a doctor about intimacy. And you question whether these internal conflicts are worth mentioning. Instead, I felt like I had to solve it myself but I really needed support and reassurance.”
Aho says her husband was extremely supportive and their long-term relationship was well established, however when her sexual health abruptly changed she was the one who needed help adjusting. “As a younger cancer patient, I had a really difficult time. I had menopausal symptoms because of treatment, even though it felt like I was too young to be going through menopause. I would have appreciated speaking to a health care professional. I probably would have felt reassured and had been guided in the right direction on my journey of recovery,” she says. “I probably would’ve started to recover a little sooner and felt less alone in my struggles.”

She encourages other cancer patients to take advantage of the BLISS Clinic; “Don’t let this part of your life get brushed aside, be brave, speak up and be open about what you’re experiencing. It’s very personal and private, but it has to be addressed,” she says. “It might not seem important to you immediately but it will play a role in your life later. It is part of the journey to recovery.”
To learn more about the dynamic programs and services offered at Thunder Bay Regional Health Sciences Centre and Regional Cancer Care Northwest visit