While there are many ways in which cancer can affect your wellbeing, the impact on your sexual health is often neglected during doctors’ conversations. Whether it’s the treatment or the illness itself, a growing number of cancer survivors’ sexual wellness is affected by sexual dysfunction, and yet it is rarely addressed in the overall evaluation of their quality of life. So how exactly does cancer have an impact on your sex life, and what can you do to overcome these effects?
According to Stacy Tessler Lindau, MD, Associate Professor of Obstetrics/Gynecology at the University of Chicago, ‘Sexual function and distress related to sexual problems are increasingly being included in studies looking at quality of life of female cancer survivors. The problem is that, in clinical practice, the topic is often left out of planning for cancer care and preparing for side effects of changes that commonly occur after cancer or cancer treatment.’ Dr. Lindau, director of the Program in Integrative Sexual Medicine for Women and Girls with Cancer –the PRISM Clinic– at the University of Chicago, adds, ‘In general, men are much more likely than women to be counseled by a doctor about sexual matters. Research shows that physician factors, like not enough time or worry that raising the topic of sexuality could be too stressful for women with cancer, are common barriers.’
A spokeperson for Stupid Cancer, the largest support community for young adult cancer survivors, also warns, ‘Sexuality is greatly affected by a cancer diagnosis and treatment, and this is one of many areas in which young adults are underserved with, through and beyond cancer. It’s a serious issue and one that we address every year at our annual OMG! Cancer Summit for Young Adults.’ Dr. Lindau points out, ‘Right now, many of the problems we see […] are heavily alleviated with education and counselling. If we were to raise the issue of sexual function and the impact of cancer on sexual life before cancer treatment, I believe we could prevent or reduce the severity of many problems.’
First and foremost, communication is key. As Dr. Lindau reminds us, ‘One thing is certain, we can do very little to solve sexual problems if we don’t talk about them.’ So seek help from your physician and talk to your partner. Sexual health expert Elena Marquina advises, ‘Keep an open mind and get your partner on board, are experts’ recommendations to cancer survivors who are ready to rekindle their sex life: experiment with caressing and kissing; try different positions to avoid pain and find the most comfortable one; use clothing cover-ups, vibrators and water-based lubricants whenever necessary; and avoid alternative remedies that may interfere with cancer treatment. While spontaneity is likely to suffer, renewed intimacy is the reward at the end of this delicate learning process.’
Depending on your treatment, you should bear certain things in mind before, during or after sex. ‘When surgery is involved, patients need doctor’s clearance before having sex,’ says Marquina. ‘Unlike a radiation implant, which will expose your partner while it’s in place, external radiation does not put them at risk. Chemotherapy will dampen your sex drive, let alone drain your energy with each cycle. Chemo drugs may be excreted in bodily fluids during the first two to three days, posing a risk to your partner. Safe sex is a must for cancer patients with a compromised immune system, when the chances of infection are high. Women need to use some form of birth control to prevent getting pregnant during cancer treatment and for a period of time considered unsafe afterwards.’