With improved cancer survival rates, it is becoming increasingly important to focus on quality of life issues throughout all stages of cancer treatment. Sexual problems often result from the physical and psychological side effects associated with cancer and cancer treatment regimens, yet few cancer patients recall discussing sexual risks before treatment or treatment options for sexual dysfunction after treatment. This review summarizes the literature, to date, on patient and clinician communication about sexual dysfunction. Patients' views about the importance of these discussions and patient and clinician barriers to sexual dysfunction communication are presented. We adapted a behavioral health counseling model, the 5 A's, and present it as a proposed framework for sexual health communication with cancer patients in a multidisciplinary setting.