I have been an oncology nurse navigator since 2011. When I worked at the Southern end of our health care system, I worked closely with our oncologists and sat in on consultations. Sometimes I needed to remind them of the patient age and to discuss fertility preservation and other times they did discuss. This is for young adults over the age of 18 diagnosed with cancer. Contraception was discussed briefly.  It was a rather quick conversation. I always advised the patient/partner to reach out to me for any further discussion. It lacked sexual health and reproductive health. Now I work at a different facility as a breast navigator. I work closely with our breast surgeon who does open the conversation of fertility preservation. I read the medical oncology and radiation oncology notes and collaborate with these physicians. In talking with patients/partners, I again advised that they can discuss anything with me about their concerns, fears, etc. I build up a rapport over time and patients generally feel comfortable asking me questions. When I provide the survivorship care plan, I get more detailed in my questions about sexuality and how the diagnosis, treatment may have an impact and the resources to help if experiencing anything. I know that I need to have these conversations more upfront and in more details as the physicians are so busy that they touch on discussions. So for me, becoming more comfortable in initiating conversations, knowing that I do not have all the answers but have resources to refer them too, etc. Women diagnosed with breast cancer may have decreased libido, vaginal dryness, body image, risk of infertility, strain on relationship if involved, psychological-some experience post traumatic stress or are just processing the diagnosis at completion of treatment, etc.

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