Treatment side effects and sexuality

When you are first diagnosed with cancer, it’s natural to focus on getting well. As treatment progresses, you may notice the effect on your self-esteem, body image, relationships and sex life. It usually takes time to adjust to these changes.

Max felt he was not the same man after treatment. He would avoid talking and touching. Counselling gave us ways to help express what was really going on.

       — Pat

Learn more about:

• Emotions and sexuality
• How cancer treatment affects sexuality
• Surgery
• Radiation therapy
• Chemotherapy
• Hormone therapy
• Immunotherapy and targeted therapy
• Palliative treatment

Listen to our podcast on Sex and Cancer

Emotions and sexuality

It is normal to experience a range of emotions during and after cancer treatment. Some of the emotions you may feel include:

Anger – You may feel angry about having cancer and about the ways it has affected your life, including your sexuality or your ability to have children (fertility).

Anxiety – The thought of being intimate or having sexual intercourse again after treatment may make you feel anxious. You may be unsure how you’ll perform, dread being touched, or fear that penetrative intercourse will be painful. If you’re single, you may feel anxious about starting a new relationship. Anxiety may affect your self-esteem and your interest in having sex.

Fear – You may worry that others will avoid or reject you when they see how your body has changed. Or you may be afraid that you’re not satisfying your partner sexually, or that your partner no longer finds you sexually attractive. You may not be able to imagine yourself in a sexual situation again.

Guilt – Many people think they should just be grateful to have the cancer treated and feel guilty for thinking about their sexual needs.

Self-consciousness – If the way your body looks has changed after cancer treatment, you may feel self-conscious about being seen naked. Often people find that their partner (or a potential partner) isn’t as concerned about these changes as they are.

Shame – You may feel ashamed by changes to how you look, your sexuality, or the way your body functions.

Depression – Feeling sad after a cancer diagnosis is common. If you have continued feelings of sadness, irritability or anxiety, trouble sleeping, less interest in activities you previously enjoyed, poor appetite and a reduced interest in sex (low libido), you may be experiencing depression.

Grief – You may grieve for the loss of your former body and its functioning, and your sex life if the changes are significant.

These emotions can affect your self-esteem, sexuality and attitude towards intimacy. It can help to talk about how you’re feeling with someone you trust, such as your partner or a health professional, or with another person who has had cancer.

For more on this, see Emotions and cancer.

How cancer treatment affects sexuality

The most common cancer treatments are surgery, radiation therapy, chemotherapy and hormone therapy. Other treatments include immunotherapy and targeted therapy. These treatments, as well as the cancer itself, can have temporary or permanent effects on your sexuality. Some sexual problems are common, but may not be an issue for everyone. For more on ways to manage specific problems, see Overcoming specific challenges.