Dr Liz O'Riordan Profile picture
Sep 24, 2020 23 tweets 7 min read Read on X
SEX. That got your attention.
Sadly @OncologyForum have had to cancel today's session due to website issues.
But Sex after cancer is so important so I'm going to share the key points from my talk
Whose job is it to talk about sex?
EVERY HCP looking after cancer patients
If you're not happy giving advice, signpost patients to get the right advice
High quality care is not just about safely doing the right thing to the right person at the right time. It's about the patient experience, both in and out of the hospital. Sex is one of the basic human needs, along with warmth, shelter and food (potatoes)
As a breast surgeon I'm ashamed to admit I never asked my patients about their sex life after treatment, and I never asked around to see if anyone else was talking about it either
It was only when I got breast cancer myself and had an instant menopause thanks to chemo and then hormone blockers that I got just how bad the side effects are. Every woman I spoke to said they wanted their partner to leave them for someone with 2 healthy breasts and a libido.
That made me cry, because I felt the same. A nurse with head and neck cancer told me to took her 5 years to work out the only place she could kiss her husband was in the shower when she didn't need to use the awful fake saliva.
A stoma patient asked her surgeon what to do on a one-night stand. He looked horrified.
dailymail.co.uk/health/article… I wrote this to help #breastcancer patients get their penetrative sex life back - thanks to @SamTalksSex @jodivineuk for letting me spread the word about the great work they do in this space
Using @Theyescompany lubricants (chemical free, oil- and water-based, vaginal and anal, available on prescription), vaginal dilators from @stressnomoreuk stressnomore.co.uk/inspire-silico…
And these amazing silicone rings from @OhnutCo ohnut.co
Vagifem is safe for ER+ patients. Please can EVERY breast surgeon just prescribe it with lubricant at diagnosis instead of making patients go round in circles trying to get someone to give it to them. We give chemo with a 5% chance of it working, knowing some will get mets
The patient should be able to make an informed choice about a tiny tiny bit of increased oestrogen for a better Sex Life. Many women don't take AIs and Tamoxifen because of the side effects. It should be our choice
We also need to follow @TantamKate lead about intimacy after a long hospital stay. It can take years for some ITU patients to be comfortable sharing a bed having been a patient for a long time. Patients and partners need help to become intimate again
Partners may also need help to have sex with a cancer patient. Fear of hurting them or doing the wrong thing make penetrative sex impossible. Again, lubricants, viagara, sex toys may be needed to help get things going again
You may find it very hard to ask patients about sex. I did when I went back after treatment. But the women I did ask were so bloody grateful, tears in their eyes thankful that someone appreciated this was a huge problem. I got better with practice.
I used to say 'Some patients find that these tablets have a huge affect on their sex life. I'm happy to talk about it now, or I can show you where to get help and advice '. If you don't feel comfortable, find out who is and send the patient their way
I didn't realise my own hospital has a sexual counsellor for cancer patients. I only found out when I went back to talk as a patient at a Grand Round. How bad is that?
How can you educate yourself and your patients? Buy the ohnuts and dilators and lubricant and put them in a corner in the quiet room / waiting room so patients can look at them.
Listen to the @ThePleasurePod - I did an episode about sex and cancer. They cover everything. I promise you'll learn something and your patients will thank you
Add some books to the Macmillan leaflets. @trishgreenhalgh and I cover sex and relationships in detail in our book amazon.co.uk/Complete-Guide…
Read Me and My Menopausal Vagina by @MyMenopausalVag
mymenopausalvagina.co.uk
Read Sex and Disability by A Andrews - thanks to @HannahPopsy for the recommendation - because cancer treatment can make some people disabled and disabled people want / need to have sex too simonandschuster.com/books/A-Quick-…
Remember that cancer treatment can have a devastating impact on someone's sex life. There is no point giving them the latest treatment if their quality of life is miserable. Make it your mission - every patient gets offered advice. Every patient. Every time.

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More from @Liz_ORiordan

Jul 20, 2023
🧵Please stop doing this. You're ruining someone's day!

The next time someone pays you a compliment, just say 'Thank You'.

Let me tell you why… twitter.com/i/web/status/1…
🧵Yesterday I told you all that the one thing you should be doing every day is paying someone a compliment.

It was so lovely hearing the feedback from those of you who did, and how it made you smile.

But what if YOU were the person getting the compliment?
🧵What did you say?

'Oh this old thing? I've never really liked it.'
‘Do you think so? It's only from Primark '
‘Don't say that. It's not perfect yet'

How do you think it made them feel?
I know how it makes me feel. Any joy I felt in giving you a compliment has disappeared
Read 5 tweets
Sep 19, 2021
I’m fed up of the media blaming GPs for the spike in late-stage #breastcancer. From my experience GPs refer anyone with a breast symptom to a clinic, no matter the age. They know, as I do, that the only way to exclude a cancer is to be examined and have …
… either an USS, mammogram or both. And even then, a cancer might be missed. Cancers can be sneaky. One month they might be too small to be felt or seen on a scan. Then 4 weeks later, there they are. I should know. I’m a breast surgeon. I have ‘expert hands’. I just thought…
… I had a cyst. Turned out it was a 6cm cancer sitting on top of a 13cm cancer. Yes you will hear about the rare cases when a GP didn’t send a young girl up. But remember - #breastcancer is RARE in women under the age of 40. Less than 4% of all cases. Most young women have …
Read 4 tweets

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