Charting Your Course : Seminar I - Taking Your Bearings : Sexuality

Cancer and its treatment can induce significant changes in body image, self-esteem, and sexual desire. Changes occur in most cancer patients and can greatly impact their quality of life. It's not uncommon for patients to experience partial or total lack of interest in sex while undergoing treatment and for some time afterwards. Anxiety, depression, nausea, pain and other symptoms may result in a loss of sexual desire. Both men and women may be profoundly affected by hair loss during chemotherapy. Surgery and chemotherapy can have an impact on sexual functioning. Cancer treatment that interferes with the normal hormone balance can lessen desire.

People are often embarrassed to talk about sex. They are hesitant to bring up the topic with their doctors, and even with their partners. As a result, questions go unanswered and relationships can suffer. Ask your doctor or nurse about the effects of cancer treatment on your sex life. Give yourself permission to express your sexual concerns. Keep an open mind about ways to feel sexual pleasure.

There are a variety of medical and psychological treatments now available to help you continue to have a satisfying sex life after cancer.

With time and information you can often resolve sexual problems caused by your cancer or its treatment. There are some excellent written resources and you may find a support group helpful.

You will need professional help to get medical treatment for a sexual problem. Your oncologist may refer you to a medical specialist, like a gynecologist or urologist, to evaluate and treat any physical dysfunctioning related to your cancer. If you choose to see a sex therapist, be certain to find someone who is certified in sex therapy. Ask your doctor, oncology nurse, or social worker to provide you with a list of reputable specialists. Check your health care policy to see whether sex therapy is covered.

Here are some questions you might discuss with your doctor or nurse:

Do I need to refrain from sexual intercourse for a certain length of time? If so, when can I be sexually active again?
Will my cancer and/or treatment interfere with my sexual functioning? What changes should I expect? Will these changes be temporary or permanent?
Is there a sex therapist I might see if I need some counseling or assistance during my cancer treatment?
Does my health insurance cover sex therapy related to cancer?

If you have an ostomy (a colostomy or ileostomy) you should ask for a referral to an enterostomal therapist--a nurse who specializes in helping people adjust to ostomies. Some things you might find helpful:

obtain a copy of the American Cancer Society's "Sexuality and Cancer" booklet. It is available for both the man who has cancer and the woman who has cancer. The American Cancer Society can be reached at 1-800-227-2345 or online at www.cancer.org
educate yourself and your partner about the physical changes you might experience
prepare yourself to accept these changes
consider joining a peer support group and encourage your partner to do likewise
consider sex therapy or counseling for anxiety
for hair loss, many types of wigs, scarves and other head coverings are available. An oncology nurse can help you find a good source. Low income is not a barrier.
ask your oncology nurse about the American Cancer Society's "Look Good, Feel Better" program, or get information on other support programs through your hospital's Social Services department.

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This content is derived from the "Charting Your Course Seminars: A Whole Person Approach To Living With Cancer", provided by Norris Cotton Cancer Center.