The Silent Side Effect: Why Oncology Training Fails Patient Intimacy
0.01% = The TOTAL Amount of Time Oncology Fellows Spend Learning to Talk About Sex
A hematology/oncology fellowship is 36 months. Roughly 8,000 hours of training. A 2024 national survey of every fellowship program in the United States found that fewer than half — 49% — offered any formal instruction on patient sexual health. When it existed, it typically amounted to less than an hour.
One hour out of 8,000. That’s 0.01% of a doctor’s training dedicated to a side effect that will affect up to 90% of their female patients and up to 85% of their male patients.
How does that gap not close itself? Why does a medical system that performs nerve-sparing robotic surgery with extraordinary precision not require a single hour of training on what to say to the patient afterward about their sex lives?
The study’s authors, led by Jennifer Barsky Reese at Fox Chase Cancer Center, found that most programs relied on clinical exposure rather than formal instruction — fellows learn by watching practicing oncologists.
But most practicing oncologists don’t raise the subject (sex) either, often because of their own lack of training.
As the researchers noted, fellows whose training consists of watching clinicians who don’t discuss sexual health are essentially learning how not to have the conversation. The silence replicates itself.
And patients feel it. Only 5.4% of cancer patients in a 2024 survey said their healthcare provider initiated a discussion about sexual health before treatment. A separate study found 87% of patients reported treatment changed their sexual function, but only 27.9% were ever formally asked about it.
Three men on this week’s episode of Kicking Cancer’s Ass lived inside that silence — and each one paid for it differently.
