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Possible Effects Of Cancer On A Person’s Sexuality
(05/04/2004) by Annette Owens
by Annette Fuglsang Owens, MD PhD
Reprinted with Permission
The diagnosis "cancer" has a tremendous impact on any
person’s existence. Once the initial shock has subsided, the
affected individual may begin to focus on resuming life
under changed circumstances. Often, trying to maintain
sexual wellness has a low priority in this effort, even though
it is a basic human need which significantly affects quality of
life.
Sexual wellness in the cancer survivor is not only affected
by the psychological impact of the diagnosis and the
disease itself, but often also by the treatment necessary to
fight the disease. Ask your oncologist what impact the
cancer may have on your sexuality. It is important to
discuss your concerns and the possible relief of sexual
problems with the health professionals around you. If you
have a partner, include him or her in these discussions.
Three facts are important to emphasize:
- Cancer is not contagious.
- Receiving radiation therapy does not harm others.
- Undergoing chemotherapy does not put your partner
at risk.
These are all potential misconceptions that can affect
intimacy between cancer survivors and their partners.
Management of sexual problems
Not only pelvic, gynecological, and breast cancer but
any cancer can affect your feelings of attractiveness
and your sexual wellness.
Anxiety, depression, grief, emotional stress or fatigue
may reduce your desire for sexual activity.
Try to fill your need for emotional support and physical
contact by a partner, family member or a friend.
If you have a partner, hug, kiss, embrace each other.
Do not hold back these gestures in fear of triggering
sexual feelings.
Try to be open with each other about how your life is
affected by your disease.
Talk about problems as they appear.
Go to the doctor together. It will be easier to absorb
all information, and you can give each other support.
Side effects of current medications can affect sexual
function, including erection, vaginal lubrication, and the
ability to achieve orgasm. Ask your doctor for
information about your medicines.
Women who experience pain during intercourse should
address this problem with their oncologist or
gynecologist and ensure that the pain is not due to a
malignancy. Pain during intercourse can sometimes be
relieved if the female is on top, controlling the level of
penetration and the amount of thrusting.
Dry orgasms (retrograde ejaculation) happen in some
men after pelvic surgery. Usually this is due to the
ejaculate not flowing out through the urethra, but
rather being emptied (flowing "backwards") into the
bladder. This condition is not dangerous. Most men
with dry orgasm claim that the sensation during
orgasm is unchanged.
If erectile function is severely affected there are
several treatment methods available, including
medications, vacuum pumps, sexual counseling or sex
therapy, etc.
Remember that erectile dysfunction does not prevent
you from being sexually active and giving towards the
one you love. This may be a good time to explore
alternative ways of being intimate with your partner.
Fertility & pregnancy
If you are in the reproductive age, fertility may be a
concern for you.
Consider getting genetic counseling.
Women with cancer who wish to become pregnant in
the future should discuss this concern with their
oncologist. Possibly, the treatment plan can be
adjusted accordingly.
Men with cancer concerned about their reproductive
potential should discuss this topic with their
oncologist. Sometimes, it is appropriate to consider
the freezing of sperm for future use in artificial
insemination before cancer treatment begins. The
testicles can be shielded from radiation delivered to
the pelvic area.
Different treatment options for
cancer and their possible impact
on sexuality
The following information summarizes a wide spectrum of
factors that may or may not affect sexual wellness. The
information should not alarm you but rather be seen as a
tool for those people afflicted with cancer who do
experience and wish to understand sexual problems.
Oncologists will recommend the best treatment option for
cancer on an individual basis. Different treatments include:
- Surgery
- Radiation therapy
- Hormonal therapy
- Chemotherapy
Some of the treatment-related affects on sexuality are:
1) Following surgery:
Some types of pelvic surgery (removal of the prostate,
uterus, ovaries, bladder, colon, or rectum) can damage
nerves important for sexual function. Erectile difficulty in
men and incontinence in both sexes may follow a radical
pelvic operation. If a woman has had her ovaries removed
due to cancer, menopause immediately sets in, often
causing hot flashes and mood-swings. Pain during
intercourse may sometimes be due to adhesions following
surgery or inadequate lubrication.
2) Following radiation therapy:
Radiation administered to the pelvic area can affect
hormone levels and fertility if testicles or ovaries are within
the target area of the radiation. If possible, sex organs will
be shielded from radiation. The techniques for administering
radiation therapy are constantly being improved, reducing
the size of the areas receiving radiation and therefore the
amount of negative side effects.
3) Following hormonal therapy:
Hormonal therapy is usually directed against cancer cells
that are sensitive to or depend on certain hormones
(androgens, estrogens) for growth. Side effects of
hormonal therapies include decreased sexual desire, hot
flashes, cessation of menstruation in premenopausal
women, urinary and/or erectile dysfunction, edema,
vomiting, and nausea.
4) Following chemotherapy:
Chemotherapy may trigger menopause in women, causing
vaginal discomfort (including soreness and dryness), hot
flashes, mood-swings and decreased libido. Application of
estrogen cream may reduce or relieve some of these side
effects. Other side effects of chemotherapy include hair
loss, weight loss, fatigue, anorexia (decreased appetite for
food), nausea, vomiting, and bone marrow depression.
Many of these side effects will cease over time following the
completion of chemotherapy treatment. This article appears in the following topics:
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