Your Cancer, Your Sexuality, Your Partner
Over the past few years a growing body of research has finally focused on the impact that cancer can have on sexual relationships. As most "cancer couples" already know, sexual desire can wane at various times during treatment due to fatigue, vaginal dryness, hot flashes, and other side effects. Certain surgical procedures can have long-lasting impacts on both sexual desire and the physical act of sex itself. Other stresses on a relationship can include worries about changes in appearance, or anxiety about health, family or finances.
A partner's simple lack of understanding can also affect the sexual relationship. Some may worry that physical intimacy will harm the person who has cancer. Others may fear they might "catch" the cancer, be affected by the drugs, or be exposed to radiation. (All are unfounded.)
Complicating this, many couples are hesitant to talk about sex-even when they are healthy. Yet a crucial part of resuming sexual activity after treatment is honest communication with your partner. Both men and women often react to cancer by withdrawing into themselves. The result is that each partner is left to cope alone, and misunderstandings due to lack of communication can often flare up into major difficulties in the relationship.
No couple gets through a cancer diagnosis and treatment without some anxiety, including sexual frustration. Such issues should be-need to be-talked about openly and regularly.
Some partners may fear that showing sexual interest is selfish, or they may worry that touching the cancer site can bring about a recurrence of the disease. (Not true.) They may simply be nervous about seeing the scar from the surgery, or worry how their facial reaction upon seeing it will be perceived. (It is important to realize that any and all reactions are normal and to be expected.)
After mastectomy, some women fear that their partner will be offended at the sight of an absent breast. Recent studies indicate, however, more openness among couples and greater acceptance of the surgical site by partners than previously thought. In fact, it appears that most men "tune out" their partner's missing breast during lovemaking and focus on the pleasures of the experience.
Sexual problems frequently arise not so much from changes caused by medical conditions or their treatment per se, but from how we feel about and deal with those changes.
Practical considerations like medical bills, home finances, and balancing additional home responsibilities with occupational pressures can drain the energy of spouses. These stresses can lead to feelings of powerlessness that may disrupt the frequency, pleasure and importance of sexual activity for the partner of a person with cancer.
In fact, any number of issues-anxiety regarding the prognosis, fear of causing pain, the stresses of altered roles, the burden of medical expenses-can alter a partner's willingness to initiate sexual contact. Partners may withdraw sexual energy from the relationship as a form of self-protection.
If you were comfortable with and enjoyed sexual relations before starting cancer treatment, chances are you will still find pleasure in physical intimacy. You may discover, however, that intimacy changes during treatment.
For some people being treated for cancer, intercourse may now be difficult. Others may feel weak or tired and want their partner to take a more active role in touching or stimulating them. New ways of sexual stimulation may also be necessary to create the most pleasure and avoid pain.
There is no single "right" way to express sexuality, and sexual desires, needs and abilities will change often during the course of treatment. Therefore, couples need to talk honestly with each other to learn what is best and when.
If talking to each other about sex is difficult, you may want to speak to a counselor who can help you talk more openly. And talk to your doctor about any sexual concerns you or your partner may have, including how various treatments may affect your sexuality, or when you can resume sex after surgery or other treatments.
The good news is that one of the least likely causes of sexual difficulties in cancer survivors is rejection by their partners. In fact, most partners are not put off by the physical changes that accompany cancer and are as attracted to their partners as they ever were. Some couples even find that the intimate bonds forged in battling cancer together actually enhance their sexual relationship.
Most loving couples are able to regain a healthy sex life despite the changes brought on by the disease. But it will take time, patience, understanding, and communication. Here are some suggestions that may help:
The National Cancer Institute (http://www.nci.nih.gov)
Abstracts from the Annual Meeting of the American Society for Therapeutic Radiology and Oncology, 1997, Orlando, Florida
The American Cancer Society (http://www.cancer.org)
10th European Cancer Conference (ECCO); Sept. 12-16, 1999, Vienna, Austria
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