Oncology

The diagnosis of cancer and receiving corresponding treatments often including surgeries, radiotherapy and chemotherapy will affect profoundly one’s sexuality, sexual identity and sexual behaviour. Surgeries such as mastectomy (removal of breast), oopherectomy (removal of ovary or ovaries), vulvectomy (removal of vulva), hysterectomy (removal of the uterus) and orchidectomy (removal of one testicle or both) may have a significant impact on the person in ways such as loosing interest in sex, feel less sexually aroused, difficulties with having/ keeping erections and having orgasms and experience pain during sex.

 

With chemotherapy the effects are often both physical and psychological. Women of a child bearing age should be advised to prevent pregnancies as chemotherapy has a detrimental effect on the embryo’s development. For men the preservation of sperm and testicular tissue may be advised. The medical team will discuss these options in more details. Chemotherapy often brings about lack of sex drive, reduced vaginal lubrication thus leading to pain during intercourse. Also patients on chemotherapy should be advised to protect themselves against sexually acquired infections especially when their white cell count is low with the constant use of condoms. Hair loss, weight gain or loss, feeling sick, having dryness of the mouth, diarrhoea, constipation, tiredness and loss of appetite have a detrimental effect on the sexual lifestyle of the persons involved. With radiotherapy there is often localised damage to nerves, muscles, veins and arteries which often affects the person’s abilities to express their sexuality. Radiation often gives rise to erectile difficulties, vaginal dryness leading to painful intercourse, weight gain or weight loss, nausea, vomiting, constipation, diarrhoea, radiation burns and extreme tiredness which all are deterrents to a healthy sexual lifestyle. With hormone therapy there could be a decreased interest in sex, in ability to achieve an erection, mood changes, tiredness and hot flushes in men. In women vaginal dryness, mood changes, lack of interest in sex and hot flushes are also experienced.

 

Fortunately with the right advice and guidance from the oncology team many people and partners adjust and feel satisfied with the kind of sexual relationships they have. This may mean adjusting to changes in one’s old ways of being sexual with one’s partner. This may take time and some experimentation. It is very helpful to talk to one’s partner and share feelings, fears and wishes. In addition coming to a consensus together, on what can be done at the time to be able to relax and express one’s feelings without fear is important. Erections, penetration and orgasm may become secondary to mutual intimacy and emotional bonding.  Cancer care often leads to a change in body image so one has to get to know one's body again and to accept one's self as it is. Self-exploration such as touching areas (such as the eyelids, ears and back) which before where not considered sexy may help. The sooner the altered body is confronted the easier self-confidence and sexuality becomes. One’s body could be appreciated in several non-sexual ways such as mutual massage, having showers/baths together and carrying out some sort of physical activity such as a walk near the sea or at the country side. Exercise increase blood flow to the body including sexual organs. Wearing sexy underwear and clothes that deflect the attention from the affected body areas will aid in feeling wanted again. Discovering new ways to feel sexually satisfied can become a more satisfying exercise in itself rather than the usual sexual routine. Communication with one’s partner is crucial in adjusting to one’s body changes. It is also important to accept positive compliments from one’s partner in order to feel attractive again. Wearing wigs, having breast reconstruction, using vaginal lubrication and having oral sex are ways to deal with one’s altered sexuality. If one feel exhausted one should try less energetic and more fulfilling sexual activities.

 

Enjoying one’s sexuality does not interfere with treatment or make the cancer worse or increase the risk of recurrance. It is important to increase one’s opportunities for physical contact and closeness for a better well being.