Impact on sexuality and intimacy
Head and neck cancer can affect your sexuality in emotional and physical ways. You may worry that you are less sexually attractive to partners or you may be grieving the loss of your former body. Reduced interest in sex (low libido) is common during cancer treatment. Tiredness, or anxiety about cancer returning, may also affect your sexual wellbeing.
Surgery to the mouth may reduce sensation in the tongue or lips. This can affect the enjoyment and stimulation from kissing, but sensation should return in 12–18 months. Side effects such as dry mouth, bad breath, poor tongue and lip movement, facial palsy, scars, or a stiff neck and jaw can also make kissing and oral sex difficult or less pleasant.
Surgery to your face and mouth may also cause problems with controlling saliva. If you have a dry mouth, kissing and oral sex may be uncomfortable. If your speech is affected, this may affect your self-esteem and ability to express yourself during sex.
You or your partner may be afraid of having sex if the cancer was HPV-related. Research has shown that it is uncommon for long- term partners of people infected with oral HPV to also be infected. New partners may be at risk and may want to use barrier contraception, but in most people the virus is cleared by the immune system.
Some people choose to express their feelings in other ways, such as hugging, holding hands or touching cheek-to-cheek. You may wish to talk to a counsellor or sexual health professional, by yourself or with a partner, to help you find solutions to any sexual changes.
A/Prof David Wiesenfeld, Oral and Maxillofacial Surgeon, Director, Head and Neck Tumour Stream, The Victorian Comprehensive Cancer Centre at Melbourne Health, VIC; Alan Bradbury, Consumer; Dr Ben Britton, Senior Clinical and Health Psychologist, John Hunter Hospital, NSW; Dr Madhavi Chilkuri, Radiation Oncologist, Townsville Cancer Centre, The Townsville Hospital, QLD; Jedda Clune, Senior Dietitian (Head and Neck Cancer), Sir Charles Gairdner Hospital, WA; Dr Fiona Day, Staff Specialist, Medical Oncology, Calvary Mater Newcastle, and Conjoint Senior Lecturer, The University of Newcastle, NSW; Dr Ben Dixon, ENT, Head and Neck Surgeon, Peter MacCallum Cancer Centre and St Vincent’s Hospital Melbourne, VIC; Emma Hair, Senior Social Worker, St George Hospital, NSW; Rosemerry Hodgkin, 13 11 20 Consultant, Cancer Council WA; Kara Hutchinson, Head and Neck Cancer Nurse Coordinator, St Vincent’s Hospital Melbourne, VIC; A/Prof Julia Maclean, Speech Pathologist, St George Hospital, NSW; Prof Jane Ussher, Chair, Women’s Health Psychology, Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, NSW; Andrea Wong, Physiotherapist, St Vincent’s Hospital Melbourne, VIC. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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