Once I've been treated for my cancer, will I be able to enjoy sex again? Why do I feel less desire while on this medication, and what can be done about it? Can our having sex give my partner cancer? Can I still have children after my treatment?

These are just a few of the questions Leslie R. Schover, PhD, has helped cancer survivors answer in her 20-plus years as a counseling psychologist focusing on the unique needs of cancer patients and survivors.

Schover is associate professor of behavioral science at the University of Texas M.D. Anderson Cancer Center in Houston.

Now, those many patients' questions — and her years of teaching and counseling — are the basis of a book Schover has written. Sexuality and Fertility After Cancer, written for survivors, was praised in a recent New York Times book review as a valuable and informative resource.

Schover says her goal was to provide both medical details — the "why's" of drug and hormone interactions that influence desire, for example — and the even more important "how's" — how survivors with specific problems can successfully deal with them and in many cases, move beyond them.

Long-term sexual difficulties are experienced by at least half of all women with breast cancer, about 75% of men with prostate cancer, and around 25% of those with other kinds of cancer, Schover tells ACS News Today.

She notes that women who have gone through premature menopause as a result of treatment may experience pain during intercourse because the ovaries are no longer producing the estrogen that normally leads to lubrication of the vagina during intercourse.

And some men treated for prostate cancer may have difficulty with erections because surgery has severed nerves important for erections, or because surgery or medication has lowered levels of testosterone to prevent the hormone from fueling prostate cancer growth.

Schover says some patients may feel a lessened desire for sex that, in some cases, can be traced to lowered hormone levels caused by pain medications, anti-depressants, or even anti-nausea drugs that interfere with hormone production.

But lubricating creams, some with estrogen and some without, can help eliminate pain during intercourse for a woman experiencing premature menopause. Medications and sexual aids can help the prostate cancer patient achieve an erection, Schover notes.

A change in doses or in drugs can help in some cases where medications are lowering desire, she points out. In other cases, additional medications can be given to offset those undesirable effects.

Schover's book also deals in detail with questions about fertility after cancer treatment.

Schover says that ideally doctors could help patients with these topics. She says they are overwhelmed with the amount of medical information they need to present to patients and are under increasing pressure to see more patients, thus they have little time to address these topics.

Schover says she hopes the book gives patients a place to start to get good basic information. If it isn't enough to completely solve their problems, it can steer them to health professionals in their own communities who can help.

What's important is for patients to get the help they need to address their problems, says Schover. "Unlike anxiety or mild depression or incontinence, which tend to get better with time, a lot of these sexuality problems tend to stick around in the long term," she says. "And if they don't get treated, they don't get better."