As discussed in the assessment section, part of the process of treatment is recognising whether or not this is an issue of importance or not. For some the need for intimacy and/or sex does not exist and it is crucial that people are not squeezed into a ‘one size fits all’ or algorithmic approach. Equally, for some this may be one of the most significant and vital aspects of their quality of life before, during or after treatment, or living with cancer in any of the stages of their disease.

Accordingly, a conversation – either internal or with partner(s) is the first step in any form of therapy to address intimacy or sex issues. This conversation should be safe, open, inclusive, and above all honest.

Once issues are identified (if they do, in fact, exist) realistic aims can be identified and steps on the road to achieving those aims can be developed. This may be very simple and self-achievable, involve self- or partner-guided basic therapy techniques or those used in formal psychosexual therapy by a trained therapist, trained in working with patients living with and beyond head and neck cancer.

Next section: Treatment