CECOS

Psycho-sexual counceling of adolescents
diagnosed with cancer:
The experience of a French sperm-bank
(CECOS)
Dr Myriam DAUDIN
Cecos Midi-Pyrénées, EA 3694
Groupe d’Activité de Biologie de la Reproduction
Fédération Française des Cecos
CHU Toulouse
France
3rd symposium cancer & sexuality, october 19th 2012 , Lyon
1
The Cecos
Annual contact/cryopreservation?
Fertility
preservation
Before
Cancer
diagnosis
Treatments
Sperm analysis controls
After
(1 year
post
treatment)
Stopping ?
More or less long after
A baby ?
2
Sperme
Sexuality
Masturbation
3
Getting sperm

Feasibility of masturbation

If masturbation possible, assistance
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Erotical : magazines, films
Mechanical : Vibrator
Medicinal : Inhibitor of Phosphodiesterase 5
4
Psycho-sexology consultation

Adolescent

Parents

Relationship
5
Specificity of the consultation

Management with care, attention and respect in the field of intimacy
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To be recognized the adolescent as a whole person

Well lead management : confidence in himself, in adults

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Father rather mother.
Consultation with him alone

Words must be perceived positively by the adolescent

Act with parents can prove complicated
Not destabilizing the parent-child relationship

Oppenheim D, GOF, 2005
6
Integrative sexual approach
Physiological
AYA
at the Cecos
Intrapsychic
Interpersonal
Bonal M, Andrologie,1995
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Evaluation
Physiological
Pubertal development
Erection
Ejaculation
Nocturnal emission
Pain
Fever
Fatigue
Medication (morphine)
Intrapsychic
Motivation
Knowledge
Belief
Anxiety
Negative thoughts
Self esteem
Infantile regression
Interpersonal
Parental relationship
Sex education
Medical relationship
Partners relationship
Sexual experience
Cultural values
Social norms
Religious belief
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Action
Behavior of the physician, of the staff
Physiological
Intrapsychic
Interpersonal
Explanation
Calm pain
Drugs
IPDE5
Explanation
Self-esteem
Advices
Taboo
Separate from his
parents
But include them in the
management
Support from the
parents
9
During his last consultation

Biological data : projection in the future and
erases embarassment about masturbation

Re-evaluation of the relational quality between the
adolescent and his parents

More adult relationship
10
Conclusion :
The Cecos is a place of anchoring

Matters of fertility and sexuality/intimacy

Emotions will be expressed

Management is flexible

Strong confidence bond with the adolescent

Patient returns without resentment
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Recommendations/follow-up care

Multidisciplinary management
Cooke L and coll, J Psychosoc Oncol, 2001
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Reinforce self-esteem

Avoid isolation
Evan and coll, Cancer Supp, 2006
Treadgold and Kuperberg, JCO 2010
D’Agostino and coll, Cancer, 2011

Assessment of sexual dysfunction
Canada AL and coll, Pediatr blood Cancer, 2007

Integrative sexual treatment model
Bober and Varela, JCO, 2012
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Acknowledgements
« Thanks you for your attention! »
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Dr Michèle Bonal
Dr Eric Huyghe
Pr Louis Bujan
Dr Nathalie Moinard
Dr Roger Mieusset
Dr François Isus
Dr Roger Léandri
Pr Jean Parinaud
Dr Florence Lesourd
Dr Carole Fajau
Ms Marie Walschaerts
Mrs Camille Esquerré
Mrs Michele Hall
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