Sexuality and intimacy

Cancer and cancer treatment can change your body and how you feel about yourself and this can affect your sexuality, sex life and relationships. There are ways to adapt to any physical and emotional changes you experience.

What are sexuality and intimacy?

Sexuality is about how you express yourself sexually, and your sexual feelings for others. This can be expressed in the way you dress, the way you move, the way you have sex and who you have sex with. Sexuality is different from sexual orientation, which is the attraction a person feels towards another person. A person can be heterosexual (“straight”), homosexual (“gay” or “lesbian”), bisexual or asexual.

Sex is often defined as intercourse with penetration but it can also include kissing and touching; it is a way to express intimacy although intimacy is not necessarily about sex. Intimacy means being physically and emotionally close to someone else. It is about loving and being loved; showing you value another person and feel valued in return; and demonstrating mutual concern and care.

How does cancer and cancer treatment affect sexuality?

Cancer and cancer treatment can change your body and how you feel about yourself and this can affect your sexuality.

Treatment for some specific cancers can directly affect your physical ability to have or enjoy sex. More generally, many cancer treatments may affect your desire or ability to be intimate with other people.

A cancer diagnosis may influence your body image, relationships and emotions, which can also change how you feel about sex. Existing stresses my become more intense with a cancer diagnosis and treatment.

Many people who have had cancer treatment say they have experienced issues with intimacy and sexuality. Any changes in sexuality may be temporary but some people may have to adapt to long-term changes which they may find to be one of the most difficult aspects of life after cancer. However, the changes may also strengthen a relationship, improve the ways you communicate and lead to new ways to express intimacy and sexuality.

Will my doctor want to talk about sexuality?

Many people, including health professionals, may feel uncomfortable talking about sexual concerns. You may assume that your doctor will bring up the subject, but this doesn’t always happen. You may also think there is no point in talking about sexuality because you don’t realise that there are treatment options available.

If you share your concerns with your health care team, there are ways to improve sex and sexuality. While some health professionals may not know the answer they can direct you to other health professionals who can help. If you are same-sex attracted or transgender, you can also ask for a referral to someone else if you feel that your health professional is uncomfortable talking about your sexual practices.

Who else can I talk to?

You can talk with your GP about your concerns or someone on your health care team you feel comfortable with. Health professionals who can help may include:

Nurses
Cancer care coordinator
Occupational therapist
Physiotherapist
Psychologist or counsellor
Social worker
Sexual health physician or sex therapist.

Can sex make the cancer worse?

Sexual activity will not make the cancer worse or make it come back (recur). The emotional benefits of physical affection may actually help you cope with your treatment and recovery.

In addition, your partner cannot “catch” cancer from you. However, your doctor may recommend that you protect your partner after some types of treatment such as chemotherapy and radiation therapy, by using barrier contraception, such as condoms.

How soon can I have sex?

How soon you can have sex will depend on the treatment you have and the speed of your recovery. Your doctor will tell you how long you have to wait before resuming certain sexual practices such as penetrative intercourse. The waiting period is for medical reasons such as preventing infection or injury after surgery.

Will I ever enjoy sex again?

While most people can have a fulfilling sex life after cancer, you may need to learn different methods to give and receive sexual pleasure. This will take time and practice. Some people have said that their sex lives actually improve after cancer because they try new things.

How can we feel like sexual partners again?

Relationships will often change during cancer treatment and this may happen gradually or may be more sudden and obvious. While it can feel awkward discussing any changes with you partner, it is an opportunity to develop ways to manage intimacy and sexuality.

What if I don’t have a partner?

You may not think about raising sexual issues with your doctor if you don’t have a partner. However, your sexuality is just as important as anyone else’s. You should feel free to openly discuss any concerns you have with your treatment team.

If you are worried about finding a new partner after cancer treatment and telling them about the effects from cancer, you can ask for a referral to a sex therapist – this can help you build your sexual confidence for any future relationship.