When people are diagnosed with cancer or living with cancer, they have many questions regarding sex and sexuality. They often find it difficult to discuss these questions with other people, even their own partners. They become worried, stressed and concerned with many questions, such as the following:
• Can I have sex when I am diagnosed with cancer?
• When is it safe to have sex?
• Will I still be able to have sex?
• Will my partner catch cancer from me?
• Will my partner still love me?
• Will I be able to date again?
• Will I ever be sexually aroused again?
• Will my partner leave me because I have cancer?
• How will I have sex when I have a colostomy or urinary bag?
• Is there anybody with whom I can discuss my sex concerns?
Most of these concerns are either related to being diagnosed with cancer or a result of cancer treatment. Most sexuality issues and problems during cancer treatment are psychological, physical, physiological, or a combination of these. Many of these problems are a direct result of chemotherapy, surgeries, or radiation therapy. Some estimates show that almost all people have some form of sexual dysfunction or sexuality-related problems after cancer treatment. Research suggests that almost 50 per cent of women who have had breast cancer or gynecologic cancer experience long-term sexual dysfunction. For men with prostate cancer, erectile dysfunction and impotence are the main sexual problems. Research also shows that almost 25 per cent of people who have had Hodgkin’s lymphoma or testicular cancer develop long-term sexual problems.
The most common sexual problem for both men and women with cancer is loss of desire for sex, or low libido. ED (impotence) among men and pain during sex among women are as common as the loss of desire for sex. Other problems, such as anxiety, depression, pain, and fatigue, also reduce the patient’s desire for sex. Unfortunately, unlike many other side effects of cancer treatment, sexual problems do not improve early and may even worsen.
Cancer treatment can also affect fertility, which means that women cannot get pregnant and men cannot make women pregnant after cancer treatment. Many sexual and fertility problems are the direct result of radiation therapy to the pelvic area. For women, this includes radiation to the vagina, uterus, or ovaries, and for men this includes radiation to the testicles or prostate. Surgeries such as breast removal, penis amputation, limb amputation, and permanent colostomy bags cause a negative body image and low self-esteem, which directly affect sexuality and sexual activities.
It is very important for patients to very openly discuss their problems with their doctor, because most of these problems can be solved. Patients may be referred to a sexual therapist (a person who deals with sexuality issues), psychologist, counselor, or other professional, as required.
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