Fred Hutch Breast Sexual Health Clinic supports patients’ intimacy needs

Patients undergoing treatment at Fred Hutch Cancer Center have access to a wide range of supportive care services designed to provide holistic care. The latest of these is the Breast Sexual Health Clinic, which opened earlier this year. 

Breast oncology and sexual health advanced practice provider Kelly A. Nelson, ARNP, DNP, leads the clinic, based on her experience working with breast cancer patients in the Fred Hutch Breast Oncology Clinic. 

“I’ve always loved working with breast cancer patients,” Nelson said. “As the years went on, I found myself increasingly drawn to opportunities for helping our patients find enjoyment in life, even while undergoing treatment. This clinic is a great way to do that.” 

The Breast Sexual Health Clinic is currently open to patients undergoing breast cancer treatment at Fred Hutch, as well as those who have completed treatment with us within the past five years. 

Learn more about the clinic in this Q&A with Nelson. 

What kinds of concerns can this clinic address?

Breast cancer can have far-reaching effects on both physical and mental health. For many patients, treatment can introduce challenges with sexual health and intimacy, in large part caused by the suppression of estrogen. Many patients who visit the Breast Sexual Health Clinic are looking for ways to treat things like low libido, pain with intercourse, vaginal dryness and body image concerns, among other symptoms. 

We offer a wide range of services in the clinic, including education and support on topics like vaginal health, intimacy and effective communication with partners. We can also prescribe hormone replacement therapy creams, gels and suppositories; address dryness with lubricants and moisturizer; recommend treatments to address pain; and refer patients to specialists like pelvic floor physical therapists and sex therapists. 

Relationships are totally impacted by a cancer diagnosis. This clinic can help people figure out how to love their body the way it is now, as a cancer patient or survivor. It’s also about learning how to reconnect with their partner.

What advice do you have for patients with sexual health needs who don’t know where to start?

My recommendation for patients is to bring up concerns related to their sexual health early and often in treatment. It is much easier to treat these concerns earlier in the process. Patients can talk to anyone on their care team they feel comfortable sharing with, be that a nurse, scheduler or provider. 

Patients don’t have to wait until they are experiencing side effects or symptoms. We’ve had so many patients saying, “I just wish I had known about this clinic sooner.” 

What can patients expect from an appointment with you?

Initial appointments are 60 minutes, during which time patients will complete a detailed intake form and discuss their responses, sexual history and symptoms. All questions are welcome, and we promise a judgement-free conversation. 

After talking through their challenges and goals, we can prescribe treatments, make recommendations, share educational resources and connect patients with external physical therapy providers as needed. 

Patients will have follow-up appointments every three to four months, or more often as needed during the course of treatment and as they transition into survivorship. 

What do you enjoy most about working in this clinic? 

I have a deep-rooted interest in women’s health — especially after over five years of work in breast oncology and the Women’s Wellness Clinic. I enjoy having a space to talk to women about living with breast cancer and life after breast cancer.

The sexual side effects of cancer treatment can last a lifetime. Because sexual health has been a taboo subject, people often go years without bringing up their concerns to their health care provider. Patients will find that I create a safe space for them to talk about something incredibly vulnerable and intimate during a challenging time of life. 

I’m excited to see this clinic grow over time, while also building a great referral network of sexual counselors, physical therapists and other providers.