Recent research and expert statements have highlighted an often silent struggle faced by cancer patients worldwide—including here in Thailand: the significant unmet need for sexual health support during and after cancer treatment. As treatments improve and survival rates rise, the quality of life, especially intimate wellbeing, has emerged as an urgent concern for many survivors and their families. Medical professionals from the Cleveland Clinic and Thai academic circles now urge healthcare providers, patients, and policy-makers to recognize sexual health as an integral part of cancer care—one that is too often neglected, misunderstood, or left unaddressed (Cleveland Clinic, 2024; J Med Assoc Thai PDF).
Cancer affects virtually every aspect of a person’s life, with sexual health being especially vulnerable to disruption. According to Dr. Theresa Callard-Moore, psychotherapist at the Cleveland Clinic, “Sexual well-being affects so many systems when you’re going through a diagnosis, treatment and recovery. Emotionally and physically, the cancer experience has an impact on sexual health.” Yet, conversations about these challenges are rarely initiated by physicians—even though an increasing body of international and Thai studies suggests that nearly all cancer patients, regardless of gender, experience some form of sexual health concern during their journey.
Culturally, cancer care in Thailand has made great strides in extending life. However, many Thai patients report feeling alone when it comes to questions of sexual function and intimacy after diagnosis. Several recent studies conducted locally and internationally reveal the overlapping reasons behind this silence: time constraints in the clinic, discomfort among physicians, a lack of training in sexual health, and the societal taboo surrounding discussions of sex—especially for women and older adults (King Chulalongkorn Memorial Hospital research, J Med Assoc Thai).
A 2025 study of Thai women with cervical cancer found that sexual dissatisfaction is common after treatment and is strongly linked to negative body image and emotional distress—a pattern echoed in studies of breast, prostate, and colorectal cancer survivors both in Thailand and globally ([PubMed: Factors Predicting Sexual Satisfaction of Thai Women with Cervical Cancer After Complete Treatment at Least One Year and Their Spouses, 2025]; EMJ Reviews, 2025). Women often cite pain from surgery, fatigue, and loss of desire from anxiety as persistent problems, while changes in body image—such as from mastectomy, hair loss, or use of medical devices—frequently interrupt feelings of comfort, self-esteem, and relationship intimacy. “Their body is changing in some way, whether it’s losing a breast due to mastectomy, having radiation to the vulva or dealing with a colostomy bag. These things interrupt someone’s feeling of comfort. And in order to feel pleasure, we need to feel comfortable and relaxed,” Dr. Callard-Moore notes.
For men, especially those with prostate or colorectal cancer, erectile dysfunction and loss of libido are common but underreported, often due to cultural expectations of masculinity and reluctance to appear vulnerable (J Med Assoc Thai). In both men and women, anxieties about relationships, the burden on spouses, and feelings of isolation compound the physical effects.
When care teams do not address these issues, patients may experience long-term declines in emotional wellbeing, self-esteem, and relationship satisfaction. The silence can be particularly difficult for younger patients and couples who hesitate to ask for help. Cancer survivors in Thai society often feel pressure to “move on” after treatment and not burden their family or physician with private concerns. Yet, as a survivor in Bangkok shared anonymously, “I could talk about pain, even depression, but asking about sex felt selfish. I was grateful to be alive. But in my heart, I needed to feel whole again—for myself, and for my partner.”
There are promising models to break this silence. One is the PLISSIT model, used by Dr. Callard-Moore to help physicians and therapists discuss sexual health in a stepwise, sensitive way. The approach encourages healthcare providers to at least ask patients if they have any sexual health concerns—opening a door for further conversation, personalized advice, and referral to specialists where needed (Cleveland Clinic). Interdisciplinary support involving oncologists, psychologists, sex therapists, and nurses trained in sexual health is linked to better outcomes, both physically and psychologically. In Thailand, integrating sexual health questions into routine follow-ups for cancer survivors could empower more patients to speak up and seek help (TGCS article).
Thai researchers also stress the importance of culturally sensitive education for families and health workers. For example, targeted workshops at major hospitals and community health campaigns can reduce stigma and normalize discussions about sexuality as part of “overall health”—a concept deeply connected to traditional Thai ideas of wellness, or สุขภาพดี (sukkhapap dii). Research indicates that when couples are included in counseling and communication, both patient and partner benefit, rediscovering intimacy and rebuilding trust after the trauma of cancer (PubMed systematic review).
Expert voices worldwide are sounding an urgent call. A recent commentary in Lancet Oncology described the “sexual toxicity” of many cancer drugs and urged oncologists to see sexual health as a “vital sign,” to be assessed and managed as routinely as pain or fatigue (MedPage Today, 2025). Dr. Callard-Moore agrees: “Physicians don’t need to know all the answers, but being willing to talk about it and bridge the sexual knowledge gap benefits patients. This may simply involve referring the patient to a licensed mental health therapist who specializes in sexual health.”
A lesson for Thailand’s health system lies in the need for integration. Although sexual and reproductive health services are widely emphasized in public health campaigns, explicit support for cancer survivors’ sexual wellbeing remains rare outside specialist centers. The Thai Cancer Society and major cancer institutes are beginning to develop dedicated sexual health clinics, but these are still few and typically located in Bangkok and other big cities, leaving patients in rural provinces underserved (TGCS). Universal health coverage (UHC) in Thailand includes many preventive and screening services, but post-treatment sexual health counseling is not yet standard (PMC). Advocates urge that more funding, staff training, and patient education are urgently needed if support is to reach all segments of Thai society—including transgender and LGBTQ+ patients, who face additional barriers.
In the context of traditional Thai values, where family harmony and self-sacrifice are prized, professionals emphasize that the promotion of sexual wellbeing should embrace compassion, mutual support, and openness. Programs that include Buddhist principles of mindfulness and body acceptance have shown promise in helping survivors deal with pain, body image changes, and emotional upheaval. Such culturally adapted interventions could help Thai patients feel less isolated and reduce stigma around these sensitive topics.
Looking ahead, the field is evolving rapidly. Ongoing studies are testing new ways to deliver support, including mobile apps for remote counseling, peer support groups on social media, and hospital workshops for both patients and spouses ([PubMed: Solution-focused therapy in cancer-related symptom management, 2024]). There are also moves to update medical curricula in Thai universities, ensuring that tomorrow’s doctors are better equipped to address sexual health holistically.
For Thai readers, the takeaway is both practical and hopeful. If you or a loved one is facing cancer, remember: your sexual health is as important as any other part of your recovery. Do not hesitate to raise your concerns with your doctor, nurse, or therapist—even if they do not bring it up first. Patients have the right to access information and counseling, and support networks now exist, both in major hospitals and online. If you struggle to find help, ask your care team for a referral to a licensed mental health therapist with experience in sexual health. Support can be found through organizations such as the American Association of Sex Educators, Counselors and Therapists or directory services at major Thai public hospitals. For couples, open communication, patience, and seeking professional guidance together can help rebuild intimacy and trust.
As Thailand continues its journey towards better cancer care, integrating sexual health support into every stage of the journey will help more patients and families rediscover wholeness, happiness, and dignity. As Dr. Callard-Moore puts it: “Sexual health is a part of overall health.” The call to action is clear—let us bring this vital conversation into the light, for the benefit of survivors across the kingdom.
Sources: Cleveland Clinic | J Med Assoc Thai PDF | King Chulalongkorn Memorial Hospital | PubMed: Factors Predicting Sexual Satisfaction of Thai Women with Cervical Cancer After Complete Treatment at Least One Year and Their Spouses | EMJ Reviews: Breast cancer survivors and intimacy | TGCS | PMC Universal access to SRHS | MedPage Today: Sexual toxicity of cancer drugs