Relationships and Sexuality

Relationships and Sexuality

After a Cancer experience, a person needs to reclaim each area of their life, including their sexuality. Once a diagnosis has been made and treatment is underway, it is important to rediscover feelings of sexuality and intimacy. There is great symbolism in illness and you may not feel like the same person you were before. Your sense of self-esteem or your self-image, which is how you see yourself and how you function or act, may also be changed. To rediscover your feelings about being a sexual person, information must be given and questions answered. Sexual problems come up quite often (from 20% to 100% in cancer patients) but frequently do not get addressed by healthcare professionals.27 You need to know whether anything about you as a sexual person will be or has been changed, due to the disease itself or because of treatment, which would affect any of the four phases of sex: desire, excitement, orgasm, and resolution.

Information in this section will speak to many of your personal worries that have to do with an intimacy problem with a specific type of cancer, and will help you realize that there can be feelings of embarrassment. Many of you will feel glad to be able to resume a loving and close relationship with your partner. And if you do not have a partner nor wish to have a partner, it is important to understand that your sense of who you are as a woman or a man may often be shown in other relationships such as being close friends with another person or in a grandparent-grandchild relationship. All deserve to be recognized and help us feel alive.

Talking with others is an important part of coping, not only with the cancer diagnosis, but also with the effects of treatment that may cause a change in how you view yourself as a woman or a man. If you have a partner, it has been noted in cancer books and articles that a relationship or marriage that is strong before diagnosis and treatment usually will remain so afterward. Those with supportive partners who communicate well tend to resume their normal patterns after the first crisis (the new diagnosis of cancer) has passed. What is most important is that you and whomever you are close to communicate wants and needs to each other as you travel this challenging journey together.

Information provides a way to help patients and families gain control of a disease process that often seems to be invading every part of their life. Please supplement this information by asking questions or by talking with your nurse or other healthcare provider to obtain the resources you need to successfully face sexual dysfunction.

Sexual Ability

Our sexuality is physically and emotionally a source of satisfaction and is life affirming, however, the process of becoming ill can create a sense of doubt in who we are sexually and our ability to respond. For men, your sexual response stages (desire, excitement, erection, ejaculation and orgasm) can be affected separately due to separate systems of control in your body. Sexual arousal and orgasm pleasure often are not affected, even though cancer treatment may inhibit the ability to get an erection..

The sexual response in women (desire, excitement, expanding and lubricating of the vagina, and orgasm) is less well understood. If the anatomy or nerve structure of the clitoris or vagina is affected or if other weakness or fatigue occurs due to cancer treatment, you may feel a diminished sexual desire. Sometimes, painful intercourse may be another factor that can decrease or prevent orgasm.

Other added physical or emotional problems can also be involved in your ability to function sexually. Many people suffer other chronic illnesses in which the medication or illness itself prevents adequate sexual function, such as for some people with diabetes or high blood pressure. Alcoholism or drug abuse, past physical and/or sexual abuse, or irresponsible sexual behavior can also prevent proper sexual response.

If you don't feel attractive and desirable because of cancer and its treatment, you may feel that you don't deserve the pleasure of giving and receiving sexual pleasure. However, what often happens instead is that your partner does desire sexual activity but feels guilty about having a sexual interest in you because you are ill. Therefore what can happen is that both of you may avoid any intimate or sexual contact at a time when you may need it the most. Many cancer patients report that they continue to enjoy being close but there is a decrease in the desire for sexual intercourse until they regain strength and begin to feel more "normal". Please give yourself permission to take your time to heal and to simply enjoy a close relationship with your partner, spouse or other family members.

If you are in the age group where fertility is of importance to you, it is important for you to have appropriate information about reproductive risks associated with treatment. There are increased options for men and women to preserve fertility after cancer treatment. It is also essential that you use good birth control because there may be health risks if females become pregnant during treatment and/or the health of the baby may be in jeopardy if pregnancy occurs during treatment.

Site Specific Physiologic & Body Image Alterations

It is particularly devastating and emotionally painful if you experiences cancer in the head and neck region since the disease can be immediately recognizable. You may be feeling rather unattractive if you must have any surgery that changes how your face looks. And, as treatment progresses, there may be problems with your most basic needs such as eating, talking and even perhaps breathing. It is clearly understandable, then, that sexuality issues and the need for closeness and touching may not be the first thing on your mind. However, as you begin to realize that treatment is going well, the need to feel close and intimate with your spouse or partner will return. The suggestions in the Manage section may be helpful and permit you to continue with confidence in your present relationship.

General Information & Suggestions

Promotion of Sexual Function

  • Your sexuality is reflected in touching, smelling, hearing, tasting and visual stimulation and sensations. Use all of these senses when being intimate with your partner.
  • You may not have or even wish to have a partner and/or your partner may not be of the opposite sex. However, we continue to be sexual beings from birth until death, and exhibit our sexuality through many different ways such as how we communicate, how we dress, what we do for recreation, and many other activities.
  • What may be standard sexual expression for some may not be okay for you. But it is certainly permissible for you and your partner to make different choices as suggested in the American Cancer Society's booklets on sexuality (see reference list). Self-stimulation (masturbation) is also a good choice whether or not you have a partner.
  • Signs of affection and sexuality can include hugging, hand holding, fondling, caressing, kissing, and cuddling.
  • It is important for you to recognize when there are few acceptable alternatives for sexual expression in your relationship. Many couples remain intimate with each other simply through good communication and companionship.
  • If you have difficulty finding acceptable alternatives for sexual expression, you may also choose to seek counseling from a sex therapist.

It is vital for you to understand your disease, the treatment options you have and how these will affect your sexuality and ability to act in a sexual manner. Ask many questions of your nurses and doctors. Not only do your healthcare providers expect you to ask questions, but they appreciate knowing what major concerns there may be for you. It may help if you ask them to use models or drawings to explain normal anatomy and how your treatment may affect how your body works. It is important to remember that just because one part of how you act sexually may be changed or damaged does not necessarily remove your entire ability to be sexual with your partner. Ask questions until you understand completely what is going to happen! Knowledge, especially ahead of time, will help you feel in control, and help you begin to think of alternative ways to remain sexually active.

Hair Loss

If you experience hair loss, you may wish to:

  • Shampoo your hair only about every 4 to 7 days.
  • Use a mild, protein-based shampoo and conditioner.
  • After you rinse your hair, pat it dry; DO NOT dry it with too much vigor.
  • Avoid hair dye or bleach and hair spray.
  • If hair loss is expected soon, avoid permanents. However, perms may be used after hair grows back.
  • Avoid electric hair dryers and curling irons or anything that would pull on the hair like barrettes, bobby pins or clips.
  • Buy some kind of cap or other head wrap even if it is summer. Hair keeps the head warm, and air conditioning can be very chilling especially at night.
  • Turbans and other hats are often available at most general goods stores and often very inexpensively.
  • Use sunscreen on the scalp both winter and summer.

Your sexual relationship may not only be influenced by treatment with Chemotherapy and radiation therapy, but also by your age, or smoking and drinking habits. If alcoholism is present, treatment for cancer and rehabilitation will most likely be negatively affected, along with your ability to share in intimacy, trust and open communication with your partner. Since you may already have a low sense of self-esteem if you are an alcoholic, you may need to focus on this issue before sexuality and your sense of femininity and masculinity.

Preserving Intimacy

Today, more patients survive cancer and its treatment than ever before. Survivorship means that you must look to the best Quality of life possible and that includes your sexuality and sexual relationship. Restoring sexual function means restoring your self-image and sense of self-esteem. It promotes the unique person you are and can create for you and your partner your own special intimacy, sense of affection, and physical gratification. Your values and beliefs are important in the success of various alternatives; sometimes all you need is permission to try something different. Go ahead! Be yourselves! Take the risk! Have some fun!

© 2006 Oncology Nursing Society. All rights reserved. All use subject to Terms and Conditions of Use set forth at All materials published on or used on the Site are protected by copyright, and used with permission from The Oncology Nursing Society.

This page was last modified on 20 March 2009 at 21:50.

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