Cancer and its treatment can have a range of effects on sexuality, according to the Cancer Council Victoria.
The most obvious effects are physical. Some types of cancer require treatment that can directly affect the physical ability to have sex or to enjoy it. More generally, many cancer treatments have side-effects that may interfere with sexual pleasure.
Roles within relationships often change during cancer treatment. Sometimes it happens gradually, almost without noticing, and sometimes it is more sudden and obvious.
You can develop strategies to manage sexuality and intimacy that take the changes into account.
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With many people “suffering in silence” about these issues, one UK charity wants to help break the taboo and encourage more open conversation.
“We know that for many, sex and intimacy following a diagnosis is a huge concern and thousands of people with cancer are suffering in silence, causing a huge amount of stress and anxiety,” said Tracey Palmer, Macmillan information and support manager at Whittington Health NHS Trust.
“We need to start talking more about sex and the very real impact cancer can have on people’s sexual wellbeing and relationships. We know that many people find it hard to raise these issues with their partner or people close to them, and that’s where we can come in.”
The data showed that only 39 per cent of people who actually want support around sex, intimacy and fertility concerns have actually been supported, which leaves thousands trying to navigate these issues on their own.
So, how can cancer affect intimacy and sexual wellness, and why is it important to get support?
Cancer can have a huge impact
According to Dr Hannah Tharmalingam, national clinical adviser at Macmillan, cancer and cancer treatment can have a huge impact on sexual wellbeing.
“It can affect confidence and body image, cause changes to how the body works or looks, and have a knock-on effect on fertility and personal relationships,” said Dr Tharmalingam.
“Many changes caused by cancer treatment are temporary, and some people will find their sex life goes back to the way it was before they were diagnosed. For others, these issues can last a long time after they are treated, or perhaps even be permanent.”
Treatment side-effects can vary
The impact on individuals may also vary depending on the type of cancer and treatment they have.
“Hormonal changes are particularly common for people who experience breast cancer, prostate cancer and gynaecological cancers. Side-effects can include being put into medical menopause, which can lead to changes in sexual function, including vaginal dryness,” Dr Tharmalingam added.
“Surgical treatment can significantly impact your sex life. This can include surgery to the vagina, anus or head and neck, mastectomies, stomas and nerve damage, and radiotherapy to the pelvic area can affect the tissue in the sexual organs.
“If you are having treatment for gynaecological, bowel, or bladder cancers, you may have late effects. These are side-effects that sometimes occur years/decades after treatment – so much so that people don’t realise the sexual issues they have can be related to their previous cancer.”
Body image can play a big part
Dr Tharmalingam says cancer can also affect appearance for some people, from body parts being surgically removed to hair loss and skin changes, all of which can impact how someone feels about intimacy.
“Cancer often puts a huge amount of stress on the person diagnosed and those around them. It can impact mental health and fundamentally change relationship dynamics,” she explained.
Breaking the silence
Raising awareness and opening up the conversation and avenues to support are key.
Dr Tharmalingam said: “We know that issues around sex, relationships and cancer are major concerns for many people with cancer and their partners, with many struggling with issues like hugely reduced self-confidence and serious worries about romantic relationships – but these issues aren’t being spoken about enough, or people aren’t being offered enough support.
“Through this campaign, we want to encourage more people to get talking about these issues to break down the taboos, so more people with cancer feel empowered to open up about concerns they have and access the support they need.
“We also want cancer professionals to feel well-equipped and confident to answer questions and broach the topic of sex and relationships with their patients, as we know this can sometimes be overlooked when focusing on other parts of a patient’s diagnosis and treatment.”
Asking for support
Dr Tharmalingam understands it can be difficult for some people to start a conversation about sex with their healthcare team.
“People may feel uncomfortable talking about something so personal. But it is important to get the right information when you need it. You can ask your healthcare team about anything before, during or after cancer treatment,” Dr Tharmalingam said.
“If your sexual wellbeing has been affected by your cancer diagnosis or treatment, talk to your GP, cancer doctor or specialist nurse, or your local sexual health service.”
Have you encountered any of these issues? Why not share how you coped in the comments section below?
Also read: What happens when you stop having sex?
– With Yolanthe Fawehinmi
Had the prostate removed 12 months ago and the erectile nerves were damaged in the process. Subsequent PSA blood tests indicated that there were some cancer cells remaining.
Had a full body scan that didn’t detect anything, so had nearly 7 weeks of radiation targeting the prostate bed and up to the pelvis.
This now means that any chance of ever having a natural erection again is probably over. Blue or yellow pills won’t work without the erectile nerves, so the only two possibilities are a vacuum pump or penile injections. Neither of which have much appeal to me. So I now feel like any sexual love life is in the rear view mirror.
Am I saddened by that? Yes, very much so, as I have always had an enjoyable sex life with previous partners.
Would I like to have a partner again? I am very hesitant to try, as I would not be happy having a forced celebrate life due to my inability to perform. More importantly, I don’t think it would be fair for a partner, especially if they are able to be fully active sexually.
I am coping fine, apart from recovering from a groin hernia operation at the moment. But apart from that I am well and looking forward to recovering from that, playing golf again in May, going overseas in June to get away from Adelaide’s winter for 3 months and more.
I really appreciate that the medical profession has extended my life so far and am looking forward to catching up with friends and family a lot more, after so much time out the last year or so.
So with a sad smile one part of life is gone, but life is for living and that is what I will do.