Sexuality after a cancer diagnosis

Read the the answers to the questions below to learn more about the impacts a cancer diagnosis may have on your sexuality.

Learn the answers to these questions:

• How does cancer affect sexuality?
• Do people really think about sex when they have cancer?
• Will my doctor want to talk about sexuality?
• Who else can I talk to?
• How soon can I have sex?
• Can sex make the cancer worse?
• Will I ever enjoy sex again?
• Are there dangers for my partner?
• How can we feel like sexual partners again?
• What if I don’t have a partner?

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Listen to our podcast on Sex and Cancer

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How does cancer affect sexuality?

Cancer and its treatment can change your body and how you feel about yourself, which can affect your sexuality. The most obvious impacts are physical. Treatment for some types of cancer can directly affect your physical ability to have sex or to enjoy it. More generally, many cancer treatments can affect your ability or desire to be intimate with others.

A cancer diagnosis can also influence your body image, emotions and relationships, all of which can change how you feel about sex. Cancer and its treatment can often make existing stresses more intense. If there have been issues in your sexual relationship (or in your relationship more generally) before the diagnosis, these may get worse, and it becomes all the more important to deal with them.

Most people who have had cancer treatment say they have experienced issues with sexuality and intimacy. Some find that any change in their sexuality is temporary. Others have to adapt to long-term changes, and may find this to be the most difficult aspect of life after cancer. It is possible, however, for the changes to strengthen a relationship, improve how you communicate, and lead to new ways to express sexuality and intimacy.

   — Pat

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Do people really think about sex when they have cancer?

Research shows that people who have cancer think about their sexuality, even when cancer is advanced. During the initial shock of diagnosis, sex might be the furthest thing from your mind.

Over time, however, you may have questions about the likely impact of treatments and when you can resume sexual activity. Maintaining or regaining a fulfilling sexual and intimate life after a cancer diagnosis can allow people to feel normal.

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Will my doctor want to talk about sexuality?

Sex is a private matter and many people, including health professionals, may feel uncomfortable discussing sexual concerns. You might assume that the doctor will bring up the subject, but this doesn’t always happen. Or you might think there is no point because you don’t realise that there are treatment options available. Sometimes your doctor may not be able to offer you the time and privacy needed for a sensitive discussion. These reasons may mean that the topic is overlooked.

There are ways to improve sex and sexuality if you share your concerns with your health care team. Some health professionals may not know the answer but can direct you to other health professionals who can help. You can also ask for a referral to someone else if you are same-sex attracted or transgender and feel that your health professional is uncomfortable talking about your sexual practices.

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Who else can I talk to?

You can talk about your concerns with your GP or someone on your health care team you feel comfortable with.

Health professionals who can help

nurse	administers drugs and provides care, information and support throughout treatment
cancer care coordinator	coordinates your care, and supports you and your family throughout treatment; care may also be coordinated by a clinical nurse consultant (CNC) or clinical nurse specialist (CNS)
continence physiotherapist	provides exercises to help strengthen your pelvic floor muscles and improve incontinence and pelvic health
occupational therapist	assists in adapting your working and living environment to help you resume usual activities, including sex after treatment
physiotherapist	helps with restoring movement and mobility after treatment, strengthening pelvic floor, and recommending aids and equipment
psychologist, counsellor	help you manage your emotional response to diagnosis and treatment; provide support and advice about sexuality and intimacy
sexual health physician, sex therapist	can help you and your partner with sexuality issues before and after treatment
social worker	links you to support services and helps you with emotional, practical and financial issues

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How soon can I have sex?

This will vary depending on the treatment you have had and the speed of your recovery – both physically and emotionally. Your doctor will tell you how long you need to wait before resuming particular sexual practices, such as penetrative intercourse. This waiting period is for medical reasons, such as preventing injury or infection after surgery. It can be considered the minimum period. It’s normal to feel hesitant or nervous about resuming sexual activity after cancer treatment.

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Can sex make the cancer worse?

Sexual activity will not make the cancer worse or make it come back. In fact, the emotional benefits of physical affection may help you cope with treatment and recovery.

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Will I ever enjoy sex again?

Most people can have a fulfilling sex life after cancer, but you may need to learn different ways to give and receive sexual pleasure. Like any new skill this will take time and practice. Some people say that because they try new things, their sex lives actually end up being much better after cancer.

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Are there dangers for my partner?

Your partner cannot “catch” cancer from you. After some types of treatment, such as chemotherapy and radiation therapy, your doctor may advise you to protect your partner by using barrier contraception, such as condoms, for a short time. See Safety concerns for partners.

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How can we feel like sexual partners again?

Relationships often change during cancer treatment. Sometimes this happens gradually almost without noticing, and sometimes it is more sudden and obvious. Discussing the changes with your partner can feel awkward, but it’s an opportunity to develop ways to manage sexuality and intimacy. Spending time together as a couple can help build closeness.

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What if I don’t have a partner?

If you don’t have a partner, you may not think about raising sexual issues with your treatment team. However, your sexuality is as important as anyone else’s and your treatment team should openly discuss any concerns you have.

You may be worried about finding a new partner after cancer treatment and how you will tell them about the effects of the cancer. See What words should I use for ways to talk to a potential partner. You can also ask for a referral to a sex therapist if you want to build up your sexual confidence for a future relationship.

For more tips from health professional and personal insights about sexuality, listen to our Sex and Cancer podcast.

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