Rediscovering Your Sexuality After Cancer
People—men more so than women, according to certain polls—think about sex a lot, several times a day even. But when you have been diagnosed with cancer, sex is not top of mind. Getting better and surviving is all you can think about.
“You are grateful to be alive; you’re not thinking about sex, you’re thinking about getting rid of the cancer,” says Claire Postl, MA, LPCC, a sexual health therapist with The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) Survivorship Program.
But there may come a time when things start to calm down; treatments have been going well, and you are on the road to recovery. Thoughts of being intimate with your partner start to return, which is not only natural but also healthy.
“Usually, you are impacted for three to 12 months, and then you find that there’s a lack of closeness and intimacy and a need to find balance again,” Postl says.
However, the cancer treatments—surgery, radiation, chemotherapy or a combination of those—have taken a toll. Treatments affect individuals physically, mentally and emotionally. They also affect a person’s partner, who in most instances has taken on a caregiver role throughout the recovery.
“Cancer treatments age our bodies, and they can change our sexual functions. These medications are strong, and they have good and bad effects on our bodies and our ability to function sexually,” Postl says. “This can come as a big shock and cause anxiety or depression.”
“Both the patient and doctor need to talk about the side effects of surviving and the life the patient will lead after treatment,” says Lawrence Jenkins, MD, a urologist who specializes in men’s sexual health at the OSUCCC – James.
Facing Cancer While Pregnant: One Woman’s Story
Maggie, now 34, can relate to these challenges. She was 20 weeks pregnant when an ultrasound intended to reveal the gender of her second child also showed a large tumor on her right ovary. Additional tests confirmed a rare form of advanced sarcoma that's generally seen only in young boys.
Her life changed quickly, taking action to treat her cancer, which was growing quickly and also threatened the healthy growth of her unborn daughter. She has been on continued treatment for more than three years to keep her cancer from progressing.
Dealing with a cancer diagnosis on top of parenting two small children, however, took a toll on other aspects of Maggie’s life, including her marriage. Regaining that part of her life, she says, was not easily done because it involved both mental and physical hurdles.
“Cancer consumes life on top of everything else. We lost sight of being a married couple and all the sexual stuff that comes with that,” recalls Maggie. “My husband and I were both 31 when I was diagnosed. We should be able to still have this part of our lives. It will never be the same as before cancer treatment, but we both want to try and be as ‘normal’ as possible.”
Maggie connected with the OSUCCC – James survivorship program, where Postl began counseling her on how to work through the psychological impact of cancer on her sexual health and then create a plan for moving forward to work through it, along with addressing the physical trauma she experienced as a result of childbirth and cancer treatment.
Maggie says the combination of counseling and physical therapy has made a tremendous difference in regaining her sexuality.
“This is not something you learned about in sex ed,” Maggie jokes. “But things change after cancer treatment and interventions can help restore this area of the body. More woman need to know there is hope and help available.”
Side Effects of Cancer Treatment on Sexuality Vary
Any type of cancer treatment can affect a person’s sexuality, but certain types of cancer and their treatments have an immediate effect.
Men who have prostate or bladder cancer and undergo surgery to remove the organ most likely will experience erectile dysfunction, because the nerves have been damaged. Other side effects include leaking during arousal or no longer being able to ejaculate when they have an orgasm, Jenkins says.
Women who have undergone radiation or chemotherapy experience vaginal dryness and thinning of the tissue as well as tightness in their pelvic floor muscles, which causes a great deal of pain during intercourse. Some women, because of treatments or surgery, are thrown into menopause because they stop producing hormones.
“Some women with pain are white-knuckling it through sex, or feel they have to avoid it altogether,” Postl says.
But there are resources, such as counseling and therapy (physical and psychological), and medical treatments that can help both men and women, ranging from pills to injections to implants.
For men, treatments include pills that help them achieve an erection, injections that do the same, vacuum pumps and penile implants. The only treatment that truly provides sexual spontaneity is the penile implant, Jenkins says.
Perhaps even more important is the mental and emotional aspect that’s involved, Postl says. While sex is an action, people’s sexuality is how they feel about themselves as a sexual person—their self-esteem, confidence, feeling attractive and being attracted to someone else.
Cancer survivors struggle with body image issues because they may lose their hair, gain or lose weight, have less energy and become depressed, Jenkins says, adding that men might become ashamed because they can no longer achieve an erection.
You might have to find other ways of being intimate with your partner, Postl says. “You can always do something. You might have to redefine what that is, but that doesn’t mean it can’t be great again.
“Any change is a loss, and we have to grieve it and cope with it,” she adds.
It’s also important that a patient’s partner be involved in the conversation, because he or she has a stake in it too.
“Don’t stop being your partner’s partner. Cuddle and date. Intimacy needs to be ritualized,” Postl says, noting that there needs to be a consistency in being close to one another no matter what forms it may take.
The OSUCCC – James offers sexual therapy services as part of its Survivorship Program. “People who are going through cancer treatment need to talk to their doctor about the sexual side effects,” Postl says.
“People don’t ask for help nearly as much as they need to because they are uncomfortable talking about sex in general,” she continues. “Women are much less likely to ask for help. But it’s a conversation that definitely needs to be had.”
To learn more about survivorship services at the OSUCCC – James, visit cancer.osu.edu or call 1-800-293-5066.