ABSTRACT
The sexual problematic linked to both cancers and their treatments remains underestimated by health carers especially since patients dare not speak about it. The oncosexology is a new offer of health care responding to an epidemiological reality, a strong demand, a care quality process and a societal demand of ethical, technical and humanist medicine. It aims at conciliating the oncological and quality of life objectives because sexual health belongs to oncological care and quality of life belongs to well-being for a majority of people/couple. By comparison to the pain situation of 20 years ago, a proactive politics is necessary to change the individual level to a collective one by modifying the attitudes of patients and health carers, that is, by breaking the silence, by legitimating the demand and by allowing all the actors to be open about it. The optimal strategy for actualizing the "software" of physicians, who are the main factor of resistance, consists in simplifying and professionalizing the oncosexology by responding to the needs for information and offer visibility for all, and training for the most sensitized or involved carers. The term oncosexology should not shock. This new competence in supportive care corrects a real inequality of access to health care and fits in with a medical humanism by promoting a more personalized approach as much initially as in follow-up: a) to inform about sexual risks and sequels is an ethical and legal duty, b) the therapeutic strategy may be influenced by the iatrogenic sexual risk, which is frequently treatment-dependant, c) the impact and demand evolve throughout the health care process, d) multidisciplinary solutions exist according to the demand and its simple or complex nature, e) the impact is often positive for the patient/couple.
