Can couples enjoy sex again after cancer?

Sex and cancer. Most people never speak those words in the same sentence. But for cancer patients, survivors, and their partners, the subject comes up all the time.

Cancer and cancer treatment can cause a patient’s self-worth, confidence, body image, and sexual function to diminish. Both the patient and his or her partner are likely to be stressed, depressed, and fatigued, which can further impact their desire for intimacy. Depending on the type of cancer and treatment, these problems may be short-term or long-term.

So how can we help cancer patients return to their normal lives – including their sex lives – after diagnosis and treatment? It takes open discussion about the physical effects of cancer and treatment, as well as frank conversations about their emotions and their partner’s emotions.

Physical effects of cancer

Some cancers directly impact the reproductive organs, and, in some cases, cancer treatments directly affect the hormonal system. For women, this can lead to premature menopause, which can affect intimacy and sexuality. For men, this can lead to a physical inability to have sex and/or hormonal changes that may reduce the desire for sex.

When cancer directly affects the sex organs or hormones, there’s a natural context for discussing intimacy and sexuality during health care appointments. But often it’s the cancer treatment side effects that affect a patient’s sexuality, and it isn’t such an obvious discussion. It’s important that health care providers open the door to discuss these sensitive topics so patients know where to turn when they need assistance.

Barriers to discussing intimacy

The ability to manage intimacy challenges after cancer can depend on many factors:

• Age: Sexual function tends to decrease with age.
  
• Cultural background and religious beliefs: Discussing sex is taboo in some cultures and religions.
  
• Comprehension level: Patients who have a poor understanding of their illness, treatment, and side-effects often struggle discussing sex after cancer. Patients who have a good understanding and are able to follow their physician’s advice can discuss it more easily.
  
• Ability to research the topic: Knowing what questions to ask, who to ask, when to ask, and what to expect during treatment makes talking about intimacy after cancer easier. 
  

It’s so important for health care providers to take time to explain intimacy challenges in a way that’s respectful and appropriate for each patient’s unique situation. We encourage patients and their partners to ask questions when they don’t understand something or when issues arise.

It can be embarrassing to talk about aspects of life that are typically kept private. But intimacy is a big part of healthy relationships, and if it’s missing or radically different after cancer, it can be difficult to navigate the changes without guidance.

Where can people turn for help?

Some people find it helpful to discuss sexuality issues in a cancer-specific support group. Talking with others who have been in their shoes can help them manage the emotional impact of changes in sexuality.

For those who prefer a one-on-one approach, the Cancer Answer Line may be a good fit. It’s a free, confidential, public service provided through our cancer center, which allows callers to connect with an experienced, oncology-certified nurse and gain information, resources, and referrals to achieve the best quality of life throughout cancer treatment and survivorship.

All people who face sex-life challenges during or after treatment are different. But there are three common themes callers often ask about:

• How do I deal with my partner’s diagnosis? A recent caller wanted information to help him sort through his wife’s advanced cervical cancer diagnosis.
  
• How do I deal with my diagnosis? A traumatized breast cancer patient reached out to ask for support in regaining confidence in the bedroom after losing her breast. We spoke with a male patient who wanted to discuss how to increase intimacy for his partner’s sake, even though his ability to engage in sex had changed.
• How can I help my partner deal with my diagnosis? We spoke with a male patient who wanted to discuss how to increase intimacy for his partner’s sake, even though his ability to engage in sex had changed.
  

We often suggest that callers and their partners work with a team of specialists to help with their unique intimacy questions and concerns. That team can include a physician who specializes in cancer rehabilitation medicine, a psychologist, and a social worker – all of whom are focused solely on improving quality of life for cancer patients and their families. These professionals can provide information, techniques, tools, and counseling.

Not all patients turn to us for help with these real, intimate worries, but when they do, we listen respectfully and offer personalized options that can work for their situation. Cancer patients and their loved ones deserve the highest possible quality of life. If they need help with personal concerns, including sexuality and intimacy or family building, we are here to help.

If you’re facing the challenge of resuming intimacy after cancer – even if you aren’t our patient – call us on the Cancer Answer Line. It’s free and anonymous, and it could make a world of difference for you and your partner.