One of the ideas I’ve been developing over the two years is what I call intimacy-informed care.

People often assume that means teaching healthcare professionals how to talk about sex. It certainly includes sexuality, but that is only one part of the picture.

An intimacy-informed approach begins with a different observation. Cancer changes far more than a person’s body. It often changes their relationship with that body. It changes how they experience closeness, touch, communication, identity, partnership, confidence, and sometimes their sense of belonging within their own life. Those experiences are common across diagnoses, yet they rarely become part of routine cancer care in any consistent way.

Most clinicians recognize pieces of this. An oncology social worker may notice that a couple has stopped talking to each other. A nurse may hear a patient quietly admit that they avoid looking in the mirror. A physician may be asked about painful sex, erectile dysfunction, or loss of desire and wish they had somewhere meaningful to send that person. These are not isolated issues. They are different expressions of the same reality. And they happen every day in oncology care spaces around the planet.

When I talk about intimacy-informed care, I’m talking about a way of recognizing those experiences as legitimate parts of cancer care rather than peripheral concerns that belong somewhere else.

In practice, that might mean creating space for conversations that patients have been waiting for someone to start. It might mean helping staff become more comfortable with topics they were never trained to address. It might mean having clear referral pathways, practical resources, and realistic expectations about what each member of a care team can contribute. It might also mean acknowledging that intimacy extends well beyond sexual function and includes our relationships with ourselves, with partners, with family, and with the bodies we are learning to inhabit after cancer.

I don’t think healthcare has been missing compassion. I think it has been missing a coherent framework that helps compassionate people know how to respond.

Over the coming months, I’ll be writing more about what intimacy-informed care is, what it isn’t, and what it can look like in everyday oncology practice. I believe this conversation has become both overdue and increasingly possible. I have lots to say and the start of a robust framework to offer.