Side Effects How to Cope - Survivor Let’s Talk about Sex after Cancer

couple with heads togetherSex is a normal human behavior. However, it can be an intimidating topic to discuss, especially with your doctor. 

It’s important to keep in mind that the goal of cancer treatment is to treat the whole person, and sexuality is an integral part of your whole person. We are all sexual beings, whether we are with a partner or alone. If cancer or its treatment has affected your sexual function, you should talk about it with your doctor.

Very often, at the start of cancer treatment, fertility is the only sexuality-related concern that is addressed. But there are so many other layers to sexuality that need to be considered. Sexuality is not just about fertility or even the physical act of intercourse; it also involves body image, intimacy, and desire. 

Body Image  Many survivors find that during or after treatment they are mourning the loss of their previous physical appearance – their hair is different, their weight may have changed, they have new scars and changes to their skin. These things are all normal during treatment for cancer, but they can negatively affect a person’s body image, leaving them feeling less attractive or even concerned about how others may see them.

Here are some simple suggestions to help you deal with some of these physical changes:
• Alter the lighting in the bedroom or where you undress; pink light bulbs are more forgiving.
• Find a clothing item that makes you feel attractive – it can be a scarf, a pair of earrings, or a new hat.
• Attend a makeup program through the American Cancer Society or at a local department store to learn how to apply makeup to your post-cancer skin.
• Remember that your partner is not with you just for your looks.
Sexual side effects are just as important as any other cancer-related side effect you may experience.Intimacy  Emotional intimacy can sometimes forge a stronger bond than the physical act of sex. This connection starts with our feelings about ourselves, our partners, and the love we have between us. Finding ways to build upon that intimacy may bring you back to how you felt in the days when you first started dating. Sharing feelings, goals, dreams, and fears will help spark that connection you once had. Holding hands, cuddling, and engaging in activities you both enjoy are simple ways to strengthen your bond and increase the intimacy between you. 

Desire  Cancer survivors often find that the fatigue associated with cancer treatment leaves little energy for everyday tasks, let alone sexual activity. Many cancer survivors experience a loss of desire during cancer treatment. However, after treatment ends and your stamina returns, your fatigue will decrease and your desire may return. Additionally, taking advantage of the times during the day when you have more energy or having a special night out may help create a better setting for desire. 

Talking with Your Doctor  Not many people address their concerns about sexuality at the beginning of treatment. Rather, most newly diagnosed cancer survivors are understandably focused solely on treating the cancer. Moreover, the act of sex is sometimes viewed as an activity for healthy people, so when you’re sick, it can be a low priority. Therefore, when people do mention their sexual health concerns, it is generally after treatment. 

While it’s a good idea to talk to your doctor early on about how cancer treatment may affect your sexual function, these concerns can be addressed at any time during and after cancer treatment. You should never feel that it is too late to address your sexual health concerns. When you’re ready, here are some tips to help you approach the issue with your doctor:
• Bring up the topic, even if your doctor doesn’t. Sexual side effects are just as important as any other cancer-related side effect you may experience.
• Don’t feel embarrassed for yourself or your doctor. It is the doctor’s job to address any concerns you have, including how cancer may affect your sexuality.
• Tell your doctor what your desired outcome is. It may be an easier fix than you think.

Not every oncology professional is well trained in dealing with sexual health issues. If your doctor isn’t able to address your concerns, ask to speak with an oncology social worker or get a referral to someone who can help. 


Melissa DonahueMelissa Donahue is a certified sex therapist at MD Counseling in Ridgewood, NJ, and New Jersey Center for Sexual Wellness in Bedminster and Morristown, NJ. 

You can find a trained medical health professional to help you address your concerns about sexuality after cancer at the American Association of Sexuality Educators, Counselors and Therapists website:
aasect.org.

This article was published in Coping® with Cancer magazine, March/April 2019.