Wellness & Fitness

How cancer affects your sex life

cancer

Prostate cancer is one of the top killers of Kenyan men. FILE PHOTO | NMG

Cancer changes every aspect of your life. One of the least spoken about issues related to cancer is how it affects one’s sexual intimacy.

Most cancer patients suffer in silence (often due to embarrassment) and most medical personnel do not consider it a ‘vital thing’ to discuss with their patients.

Common problems caused by cancer and its treatment
• Constantly ‘feeling sick’
• Persistent fatigue/tiredness and lack of energy
• Long term pain
• Depression, anger and sadness
• Loss of confidence and self esteem
• Mood swings and irritability
• Physical problems such as redness, sores and scars on the skin, mouth problems such as oral sores, bladder problems such as incontinence and bowel issues such as diarrhoea
• Hormonal imbalance which may affect your sex hormones
• Weight gain or loss

Can having sex make my cancer worse?

No, it can’t. A healthy sex life can in fact improve the quality of life of a cancer patient. Most feel depressed and unloved when they discover that they have cancer and the affection and acceptance from a partner can make a big difference in their lives.

How chemotherapy and hormonal therapy affects your sex life

Chemotherapy may cause reduced sexual desire and overwhelming fatigue in some cancer patients.

Chemotherapy and in women hormonal therapy targeting the reproductive hormones can also cause menopausal symptoms in women. These include vaginal dryness and tightness, irregular or absent menses and even hot flashes.

Cancer and your fertility

Cancer therapy such as chemotherapy and radiotherapy can damage your ova or sperm and result in reduced fertility. Cancer of the testicles, ovaries and womb will directly affect your fertility as often, these organs need to be removed to successfully treat the cancer.

If your doctor is worried that you may not be able to conceive because of your cancer and its treatment, he/she will recommend harvesting your ova or sperm prior to treatment and storing them for future use.

This will ensure that you can still become a parent once you are done with your treatment.

Cancer and pregnancy

Some of the medication used in the treatment of cancer can harm an unborn child and cause him/her to be born with birth defects.

For this reason, most doctors discourage patients from getting pregnant whilst on cancer therapy. Women who need to start on contraception during cancer treatment, should ideally opt for non-hormonal options.

If you are already pregnant when you get your cancer diagnosis, the fate of your baby often depends on how far along the pregnancy is.

If you are in your first trimester, your medical team may have to terminate your pregnancy to prevent delays in your cancer treatment. If you are almost due, you can often safely carry the pregnancy to term.

Most cancer surgery can safely be carried out in the second trimester of pregnancy (fourth to sixth month).

How surgery affects your sex life

Surgery to remove cancerous growths can leave scars which can cause poor body image. In addition, surgery to remove parts such as breasts, testes, ovaries, prostates, wombs and parts of the external genitalia can cause low self-esteem and ‘mechanical problems’ such as erectile dysfunction, ejaculation problems, urinary incontinence, vaginal dryness and premature menopause.

Sex after a colostomy or urostomy

Patients who have had surgery for cancer of their intestines may have part of their intestine pulled up to the abdominal wall to allow for stool to exit through there as opposed to the anus (colostomy).

A similar procedure can be done for cancers affecting the bladder (urostomy). In these cases, the waste material is collected in bags attached to the abdominal wall. If you are very self-conscious about this, it may be a good idea to empty your bag just before intimacy. If the seal is properly re-attached after emptying, the bag will not leak and you can have a comfortable sexual experience.

You can also put a soft pillow over your abdomen to prevent your partner lying or rubbing directly on your stoma bag.

Penetration may not always be possible

Penetrative sex can be exhausting and, often, cancer patients struggle with chronic fatigue (usually due to their treatment). If the cancer involves the reproductive system, the nerves or bone, penetrative sex may also become a very painful experience.

It is important to note, however, that penetrative sex is not necessary for sexual satisfaction given that both men and women can achieve orgasm without penetration.

Both oral and hand stimulation of erogenous zones can give immense pleasure and may be a more acceptable option for couples dealing with cancer.

Be flexible

Be flexible about the time of day you have sex. Having sex last thing at night is often difficult for cancer patients due to fatigue. For this reason, try having sex in the morning when you feel refreshed after a night’s rest. Sex sessions can also be shorter and try to experiment with less demanding sexual positions.

Alternatives to sex

Most cancer patients want to enjoy intimacy with their partners even if sexual intercourse is not possible. Possible ways of maintaining intimacy include couple massages, cuddling, kissing, holding hands and taking time away from work and family responsibilities just to be together.

Pain management

If you are struggling with a lot of pain because of your cancer, it may help to take painkillers 30 to 60 minutes before sexual intimacy. If you have a painful scar because of your cancer or its treatment, select sexual positions that prevents you (or your partner) from putting pressure on the affected area.

When to avoid sex

• After surgery: Often your doctor will give you a designated period of time to abstain from sexual activity after surgery. This is meant to allow for your wound to heal
• When your immunity is very low: Sometimes the cancer or its therapy can result in a markedly weakened immunity. This means you are more susceptible to infections.
• If you notice an unusual genital discharge or warts in either you or your partner: You must get the problem treated first before engaging in intimacy again.

Do not take sex supplements and ‘boosters’

There is an influx of sex supplements in our market. The effectiveness and safety of most of them has not been tested. You should never use these supplements and ‘boosters’ without consulting your doctor. They may interfere with your cancer therapy with devastating effects.

Spousal rejection and insecurities

Cancer can make the spouse of the afflicted person very insecure. Most are worried that their partners will die and leave them. They also feel that their partners are very ‘fragile’ and vigorous activities like sex may ‘hurt’ them.

There are also a few with a misguided notion that cancer is contagious and they, therefore, avoid intimacy with their partners for fear of getting the disease. This wreaks havoc on their sex life.

Sadly, it is also not unusual to have spouses neglect and disown their partners after a cancer diagnosis because they claim that they no longer find them ‘attractive’.

Couple counselling

Couples dealing with cancer should not go it alone. They should seek help from marriage counsellors and other couples who have gone through a similar journey.