Sex and cancer

Reviewed by Christine Webber, psychotherapist and lifecoach and Dr David Delvin, GP and family planning specialist

Does cancer cause sexual problems?
Yes, very frequently. You see, it is always a shock for people to be told that they have cancer or any other serious illness. Their lives are suddenly dominated by medical examinations and treatment and quite naturally all of their attention is focused on the disease.

In this frightening situation, it's not unusual for sex to take a back seat for a time. But after a while, when the patient has gathered enough strength to look forward and to take an interest in good health and a normal life once again, he or she will almost certainly rediscover an interest in sex. But it may be difficult to resume sexual relations - particularly if you are tired or in pain.

Does cancer cause problems in a relationship?
In most relationships, serious illness can result in anxiety and uncertainty. Furthermore, the patient may be afraid that sex could cause physical injuries.

Even after patients recover, they may worry that having sex will cause the illness to break out again. People may also have irrational fears that the illness may be contagious or sexually transmitted.

These kinds of thoughts and misconceptions can make a relationship come to a standstill. It's vital for couples in this situation to talk to each other - and to a doctor - to dispel any fears or uncertainties.

They may also benefit greatly from being referred to a medical expert specialising in psychosexual medicine, or from getting some counselling with a sex or relationship therapist.

Can it be dangerous to have sex when you have cancer?
Unless the cancer affects the genital area, there is usually no reason why the patient should not have sex.

It is a good idea for cancer patients to discuss with their doctor whether or not they can have sex. If possible, this question should be raised early in the illness before any potential operation or complicated medical treatment such as chemotherapy has begun.

Unfortunately, it has to be said that - even today - not all doctors are comfortable talking about this subject. Sometimes a nurse, or a counsellor, is a better person to chat to.

It is extremely important that patients are kept well informed about their illness and its immediate consequences in the short term and in the long term.

They will want to know what impact it will have on every aspect of their life - including their sex life. For instance, people need to know whether the treatment will have any effect on their sexual function or fertility.

Are the patient's sexual problems caused by factors other than cancer?
If a patient experiences difficulties with their sex life after cancer or any other serious disease, it may help if they ask themselves the following questions: 'Are their sexual problems a result of the disease itself or are they caused by other things in their relationship?'

If a person is not sure that he or she is capable of functioning sexually it might help to try achieve orgasm by masturbation. If this 'works', then that is a sign that the basic mechanics of the sexual apparatus are functioning properly.

If sexual difficulties arise, it is essential that you ask a GP or specialist whether the problem is due to:

• the cancer
• the treatment of the cancer
• other factors such as psychological causes.

. What can be done if cancer has led to a physical disability that affects the performance of the sex organs?
Remember that loss of sensation does not mean loss of feelings. If the illness has resulted in a male patient becoming impotent he should bear in mind that there are many highly effective treatments for impotence these days.

But he should also realise that he can still be loving towards a partner and help him or her have orgasms by methods other than intercourse. It is very possible for a person to have a sexual relationship even if the function of their genitals has been lost.

Any cancer patient - male or female - who has sex or relationship problems will also probably benefit from being involved in one or other of the excellent cancer patients' support groups. It is very useful to chat to other people who are going through similar problems to your own. This communication will help you feel less hopeless and less isolated.

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