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The Scientific Network on Female Sexual Health and Cancer
LETTER FROM THE CHAIR
Greetings and Happy Summer from the Scientific Network!

Having recently started to travel again for in-person academic meetings, I can say that I honestly hadn’t realized how much I missed the richness of being together – in real life – with colleagues and old friends. As much as I thought that I had acclimated to living much of my work life from the vantagepoint of an online box, there is nothing like the energy and excitement of exchanging ideas, sharing experiences, and just hanging out, face-to-face. It is with this heightened appreciation for in-person connection that I am thrilled to share some of the planning for our Scientific Network’s in-person annual conference this November, to be held at Yale University in New Haven, CT.

First, I want to enthusiastically acknowledge the Co-Chairs of our Meeting Planning Committee: Dr. Shari Damast and Dr. Kristen Carpenter. Dr. Damast is a radiation oncologist at the Yale Cancer Center and Dr. Carpenter is a clinical health psychologist at The Ohio State University. The conference title, “Extending Our Reach: Broadening the Boundaries of Oncosexual Health,” reflects an agenda that will allow us to learn from researchers, clinicians and thought leaders who are at the forefront of actively extending the boundaries of care.

Our keynote speakers include Dr. Narjust Florez , a thoracic oncologist and the Associate Director of The Cancer Care Equity Program at the Dana-Farber Cancer Institute, as well as Dr. Hoda Badr, a health psychologist and behavioral scientist at Baylor University who has done ground-breaking work around couples coping after a cancer diagnosis.

We will also highlight innovative clinical and research endeavors in contexts where sexual health is often under-addressed, such as with women living with metastatic disease. And more than anything, we will have lots of opportunities to do what we love to do…exchange ideas, network with colleagues, and learn with and from each other. I warmly invite you to mark your calendar and keep an eye on our website for additional details as the date nears.

Finally, I want to send a big congratulations to members of the Network including Dr. Shari Goldfarb and Dr. Carol Kuhle, who have just returned from a very successful Multinational Association of Supportive Care in Cancer (MASCC) meeting in Toronto where the Network offered a joint symposium on the “Nuts and Bolts of Assessment and Management on Female Sexual Health.” This symposium was received with enormous enthusiasm and was a wonderful example of how the Network builds bridges with other professional organizations working to support people after cancer.

Hoping that you have a summer filled with joyful and relaxing moments and I look forward to seeing you in person this Fall!

Sharon Bober, PhD
Chair
CONFERENCE UPDATE

8th Conference of the Scientific Network
Extending Our Reach: Broadening the Boundaries of Oncosexual Health
November 17-18, 2022
Yale University, New Haven, CT

We are thrilled to announce the 8th Conference of the Scientific Network on Female Sexual Health and Cancer will take place in-person on the campus of Yale University, with support from the Yale Cancer Center/Smilow Cancer Hospital. Our goal with this year’s theme of extending our reach is to shed light on often overlooked aspects of oncosexuality, such as supporting women with advanced disease and centering on populations of women who do not get the attention they need regarding their disease, survivorship, and sexuality. Our invited speakers will be addressing:
  • Health equity
  • Sexual health in metastatic disease
  • Innovations in sex tech and applications to cancer
  • Building a multidisciplinary sexual health clinic
  • Couples’ communication about sexual health
  • Sexuality-specific survivorship issues pertaining to global health
  • And more!
The conference aims to help close a significant gap in care for female cancer survivors by providing clinicians with the knowledge, tools, and training to address the sexual side effects of cancer treatment. CME credits will be available. In addition to your attendance, we encourage the submission of abstracts regarding all aspects of research and clinical care within this area. Research by trainees will be highlighted with an invited talk and award. The Call for Abstracts is open through 8:00am Eastern on Thursday, July 21. Submit today!

We look forward to welcoming you to New Haven!

NETWORK WITH THE NETWORK
On June 8th, the Network came together for another successful Network with the Network event with 65 registrants from all over the United States and even across the globe! In typical fashion, attendees spanned the field with oncologists, nurses, sexual medicine specialists, gynecologists, psychologists and other mental health professionals, and even biomedical device developers.

The clinician-focused breakout was moderated by Carol Kuhle, DO, MPH and Kristen Carpenter, PhD, and focused on how to develop and implement sexual health programs, as well as how to nurture ongoing programs in sexuality and cancer. An important point raised in this discussion was the critical need for prevention of sexual concerns in those who have had a cancer experience. Are we starting too late when we are picking up the sexual function pieces in the wake of cancer treatments?

The researcher’s breakout was moderated by Kelly Shaffer, PhD, and Jennifer Reese, PhD. The conversation included focus on the challenges of sexual health communication in oncology settings, and the research necessary to move the oncology field forward in this regard.

As usual, the Network is expert at bringing clinicians, researchers, and advocates together for intimate and productive conversations. Join us for more of the same at our annual conference in November!
RESEARCH SPOTLIGHT
The safety of vaginal estrogen and other local hormonal therapies for breast cancer survivors remains controversial. Faculty at the University of Barcelona Clinic Institute of Gynecology recently published findings from the VIBRA pilot study in the journal Climacteric, assessing the safety and efficacy of prasterone (DHEA; Intrarosa) in breast cancer survivors with genitourinary syndrome of menopause (GSM) who were also being treated with aromatase inhibitors (AIs). Ten heterosexual, sexually active, postmenopausal women (mean age 56) used the prasterone vaginal ovule (6.5mg/day DHEA) nightly for one month, then every other night thereafter through 6 months of follow-up. Efficacy results were promising, showing that prasterone improved both patient-reported outcomes (dyspareunia as assessed by Visual Analog Scale [VAS], sexual functioning as assessed by Female Sexual Function Index [FSFI]), and clinician-assessed outcomes (decreased vaginal pH, improved Vaginal Health Index [VHI]), without local adverse effects.

Serum estradiol levels were also measured at baseline (pre-treatment), and 15 days, 1 month, 3 months, and 6 months after treatment initiation. Importantly, there was found to be no significant increase in serum estradiol levels through 6 months of follow-up. To the authors’ knowledge, this is the longest follow-up published to date for use of vaginal prasterone in this population. However, greater clarity on what study authors and the oncology community consider normal or acceptable serum estradiol levels for breast cancer survivors on AI therapy is essential for interpreting findings into clinical practice. Further study in larger, more diverse patient populations are also warranted.
Read the Full Article
MEMBER SPOTLIGHT

Lily Gutnik, MD, MPH

Tell us a little bit about yourself and your background.
I am a breast surgeon at the University of Alabama, Birmingham. I am both clinical and research oriented. I am also the Associate Vice Chair of Global Surgery for the Department of Surgery, as well as Assistant Program Director for the General Surgery Residency–Global Surgery.

I was born in the former Soviet Union and moved to New York City at age 3, where I spent most of my life. I went to undergrad at NYU. My medical school was a joint program between Ben Gurion University in Israel and Columbia University in New York. I then completed my general surgery residency at the University of Utah and breast surgical oncology fellowship at Duke University. I also completed a Master’s in Public Health from Harvard University, as well as a research fellowship at the Center for Surgery and Public Health at the Brigham and Women's Hospital. In my free time I love traveling and eating good food.

What is the focus of your research and/or clinical practice?
My research mainly focuses on multilevel interventions and implementation science, with the focus on Sub-Saharan Africa and women of African ancestry. I was previously a Fulbright and Fogerty Fellow in Malawi where we trained lay women to conduct screening clinical breast exams. Since then, I have been involved in various breast cancer projects around Sub-Saharan Africa and globally, particularly focusing on screening and early detection strategies. For the last 2 years I have been supervising a PhD student in Moshi, Tanzania. Her work is a mixed methods approach to understanding advanced stages at time of diagnosis from the perspective of the patient's providers and traditional healers. I am currently mentoring several undergraduate and medical students, as well as general surgery residents. Clinically, I work in all aspects of surgical breast cancer care, as well as in a high-risk screening program.

How long have you been a member of the Network?
I have been a member of The Network for about a year now. During my fellowship, I had the privilege and good fortune to rotate in our sexual health clinic, which is an amazing multidisciplinary clinic staffed by a medical oncologist, sex therapist, and physical therapist. I think that sexual health and sexual side effects are such a critical part to comprehensive cancer care, yet it is a less approached topic with patients. I was really impressed with the services the sexual health clinic was able to provide and gained valuable learning experience which I have incorporated in my practice.

What do you find meaningful and/or how have you benefited from Network membership?
Sexual health is critical to patient-centered comprehensive breast care, yet it is a topic that has not received a lot of attention in research or clinical training. My goal as a breast surgeon is to be able to engage in not only multidisciplinary care with my colleagues, but also to treat the whole patient and address all the concerns they may have on their breast cancer journey. This includes not only physical side effects of treatment but also important emotional, financial, and psychological side effects. This of course also includes very importantly sexual health side effects. This Network gives me the opportunity to learn more about research and practices to address these critical patient needs. The Network has wonderful resources and other opportunities to learn about how to manage this aspect of breast cancer care that is not offered robustly and other forms.

What is an interesting fact about you, or what is your favorite hobby?
I have been to 73 countries and speak 4 languages. Travel is my absolute passion and hobby. It could be exploring my local neighborhood, a day trip, a weekend trip, a domestic adventure, or foreign adventure. I truly value diversity in thought, culture, and food. This is why I love travel and the discovery that it brings.

NEW AND NOTEWORTHY
During the 2022 Annual Meeting of the Society for Sex Therapy and Research, Dr. Kyle Stephenson of Xavier University presented a recently developed online tool called eSense to provide psychological and mindfulness-based treatment for sexual concerns. Dr. Stephenson and Dr. Lori Brotto of the University of British Columbia are in the initial phase of a study to tailor this tool for ovarian cancer survivors.

Dr. Brotto reports that eSense has been found to have excellent feasibility and preliminary efficacy in a broad sample of individuals with sexual dysfunction. Their plan is to use feedback from an ovarian cancer patient advisory group to modify the eSense intervention in a way that makes it more applicable to sexual health needs after ovarian cancer treatment. The researchers hope to recruit a sample of 30 ovarian cancer survivors for a study looking to measure the feasibility, usability, and efficacy of the tailored program, eSense-Cancer, in this population. The long-term plan for the project is to make the tool broadly available to ovarian cancer survivors.
MEMBER RECOGNITION
  • The Scientific Network recently offered a joint symposium at the Multinational Association of Supportive Care in Cancer (MASCC) Annual Meeting in Toronto, Canada, with Scientific Network members, Shari Goldfarb, MD, and Carol Kuhle, DO, MPH presenting “The Nuts and Bolts of Assessment and Management on Female Sexual Health.”
  • Network members Deborah C. Marshall, MD, Ayesha Ali, MD; Jenna Kahn, MD and colleagues published Female Erectile Tissues and Sexual Dysfunction After Pelvic Radiotherapy: A Scoping Review in the journal CA: A Cancer Journal for Clinicians.
  • Network members Kelly M. Shaffer, PhD; Jennifer Barsky Reese, PhD; Ayesha Ali, MD; and Jenna Kahn, MD, with colleagues, published Including Partners in Discussions of Sexual Side Effects from Breast Cancer: A Qualitative Study of Survivors, Partners, and Providers, in the Supportive Care in Cancer.
  • Network member Christina Wilson, PhD, CRNP, WHNP-BC, and colleagues published Clinician and Patient Communication on Body Image, Sexuality, and Sexual Function in Gynecologic Cancer: An Integrative Review in the journal Sexuality and Disability.
  • The Scientific Network's Kristen Carpenter, PhD, spoke on Sexuality and Sexual Health Among Women with Cancer at the 14th Annual Conference of the Oncofertility Consortium, held May 2-4, 2022, in Pittsburgh, PA.
  • Network member Marloe Esch, BSN, RN, OCN, was featured on The Oncology Nursing Podcast, the official podcast of the Oncology Nursing Society, discussing sex as a component of patient-centered care.
  • Network pioneer, Stacy Tessler Lindau, MD, MAPP, has recently been interviewed by two national media publications, discussing topics in sexual health that may be pertinent to oncology patients and your clinical practice. The New York Times features her expertise in two articles addressing sexual desire in women and the impact of cannabis use on sexual functioning. Dr. Lindau also weighed in on the important issue of sexual health for individuals with dementia, published in Slate.
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The Scientific Network is always looking for ways to recognize and celebrate the achievements of our members in the world of women's sexual health and cancer. If you or a member you know recently been published, been in the media spotlight addressing this important topic, or is blazing trails in clinical practice, we want to hear about it! Give us the scoop in a sentence or two, and shout-outs will be included in upcoming newsletters.
OTHER CONFERENCES OF INTEREST
WELCOME NEW MEMBERS
Gina Franco, Director CIOS, Greenville, SC (University of South Carolina Medical School)
Anne Katz, PhD, RN, FAAN, Manitoba, Winnipeg, Canada (Manitoba Prostate Centre CancerCare Manitoba)
Carmen Hancock, MSN, APRN, FNP-C, AOCNP, Greenville SC (Prisma Health Cancer Institute, Center for Integrative Oncology and Survivorship)
Shona Jurak, RN, ACCN, MN, NP, Victoria, British Columbia, Canada (BC Cancer Agency – VIC Radiation Oncology)
Jutta Deininger, NP, Milwaukee, WI (MCW Oncology)
Nicole Dreibelbis, MSN, CRNP, WHNP-BC, Middletown, PA (UPMC of Central PA Women’s Cancer Center Ortenzio and Hillman Cancer Center, Harrisburg)
Nicole Sandilands, DNP, APRN, RNP-BC, RN, Norwalk, CT (Hartford Health Care, St. Vincent’s Cancer Center)
Karen Meltzer, BA, MA, MS, Dallas, TX (Doctoral Candidate at UT Southwestern Medical Center)
Nancy Tray, MD, Pebble Beach, CA (Pacific Cancer Care)
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