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A Resource Guide for Continuing Intimacy and Pleasure
Nearly everyone treated for cancer can continue to enjoy physical intimacy, according to oncology professionals at the American Cancer Society – and many people report their emotional and sexual relationships take on new meaning when one partner faces cancer. However, problems ranging from a poor body image to impotence can appear and harm a couple's sex life if they are not actively addressed.
In general, couples can save their love lives by heeding the words of prostate cancer survivor and author Keith Laken: "Keep touching, keep being intimate, keep making love, in whatever form love-making takes," he advised. Laken's personal story of renewed intimacy is recounted in a separate article on cancer.org.
Intimacy During Treatment: What's Happening…or Not Happening?
For both men and women, radiation and chemotherapy can each cause specific, temporary sexual problems during the course of treatment, in addition to making the person with cancer too tired to even think about sex. So it's important to ask your health care team what sexual effects to expect and how long they will last. Find a full discussion of sexuality during cancer treatment on the following pages:
Despite the side effects of treatment, people who were comfortable with and enjoyed sexual relations before starting therapy will most likely continue to find pleasure in physical intimacy during and after treatment. Priorities may change; for instance, hugging, touching, holding, and cuddling may become more important than sexual intercourse for some. Regardless, good communication between partners is the most important way to maintain or resume sexual activity -- even for those who have been too shy to talk much about sex in the past.
That was certainly the case for breast cancer survivor Lillie Shockney, who began to talk more openly with her husband about their sex life after her surgery. "It forced me to talk about what I liked and didn't like. I had been giving signals by grunting," she explained with a laugh. "We ended up with our sex life being better than before. How do you like that?"
Carefully, Lovingly Getting Back in the Game
When cancer has brought a couple's sex life to a halt for weeks or months, it's a good idea to resume intimacy slowly and to have some limits for the first few encounters. A session of all-over touching is a loving, sensual way to start.
In brief, couples pick an occasion offering plenty of time and privacy. They set a relaxing scene with candles or soft music and then take turns touching and being touched all over. Partners can try many types of touch, from light stroking to a firmer touch, as in a massage. For the first session, they should avoid the breast and genital area. The goal is to feel relaxed and to feel sensual pleasure – and to take the nervousness and pressure out of being close again.
Over time, couples can include more sexual touching and develop a sexual intimacy they both enjoy.
Love is the Answer, but Stress Can Ruin Everything
Facing cancer as a couple can strengthen a relationship and help people realize what is truly important to them in life. As love deepens, it may also improve or sustain a sexual relationship through the difficulties of cancer.
"It brought our relationship to a new level that I didn't know existed," said Shockney, recalling how breast cancer improved her marriage and made her husband more demonstrative. "When you realize that you could lose somebody, you want to show them how much you love them," she explained.
In some cases, however, the stress and emotional turmoil of cancer can cause people with the disease and their partners to withdraw emotionally. And this can weaken the bonds holding the couple together.
Patients may avoid intimacy because they feel their partners no longer find them attractive due to hair loss, a pale complexion, or other side effects of treatment. Either partner may not want to burden the other person by sharing feelings of sadness or fear, and the result is that each person suffers in silence. Misunderstandings can develop and cracks can open in the love underlying a couple's relationship.
Protect Love and Keep Your Sex Life Going, too.
Again, good communication will help protect a couple's relationship from the stresses of cancer. It's important that the person with cancer talk about changes in sexual feelings, body image, and self image.
Treatments that affect the shape or look of a person's body, such as a mastectomy for breast cancer, may require action, as well as talk, to rebuild a positive self-image. The article Keeping Your Sex Life Going outlines steps women can take to polish their appearance, change negative thoughts, and use mental exercises to once again feel like an attractive, sexual being. There are also suggestions to rekindle desire, conquer anxiety, and resume sexual activity with your partner.
Women can check out the following articles for more online information about sexuality and cancer:
For men, the article Ways of Dealing With Sexual Problems covers changes in appearance, reduced desire, and erection problems as well as medications, surgeries and devices that may aid sexual function. There are also suggestions to help rebuild self-esteem, which can sink under the stress of prostate cancer, its treatment choices and side-effects.
The following web pages provide more online information for men about sexuality and cancer:
Special Approaches for Some Cancer Treatments explains how to feel confident and comfortable with sexual intimacy after a mastectomy, colonoscopy, laryngectomy, and certain other treatments.
Sexual Healing
Sex is a form of communication for many couples, as well as one aspect of the human need for closeness, touch, playfulness, caring, and pleasure. For those reasons, continuing sexual activities can help couples facing cancer stay close.
Keith Laken and his wife Virginia never realized how important their sexual activities were within their relationship until Keith's prostate cancer put their familiar sexual routine on hold for a while.
"Four months without sex made me begin to appreciate the integral role sex played in our marriage," said Virginia. "Making love was what we did to reconnect when things weren't going well and how we celebrated when they were. Without sex, we had felt isolated from each other."
The old, familiar sexual routine was never quite the same again for the Lakens, but by seeking alternatives and focusing on pleasure, rather than intercourse, they report finding a deeper, more intimate relationship than they ever imagined before cancer.
Human Sexuality: What You May Not Know
- Many sexual problems that men have after cancer treatment will not last long. Pain after pelvic surgery or radiation will probably disappear. The stress of treatment can cause hormone levels to dip, causing reduced desire or problems with erections that often resolve in a few weeks.
- Most men who cannot have erections or produce semen can still have the feeling of orgasm with the right kind of touching. This survival of the orgasm makes it worthwhile for people with cancer to try sexual touching. Pleasure and satisfaction are possible, even if some aspects of sexuality have changed.
- Estrogen and progesterone, the female hormones made by a woman's ovaries, do not create her sexual desire, and a lack of these hormones from menopause or cancer treatment does not decrease a woman's sexual desire.
- It is normal to have an interest in sex throughout your life. Many people, however, believe the myth that sex is only for the young. Men and women can remain sexually active until the end of life. No one should ever have to apologize for still having an interest in sex "at my age."
- Sexuality is an important part of everyday life. Feelings about sexuality affect our zest for living, our self-image, and our relationships with others.
Additional Resources
Couples Confronting Cancer: Keeping Your Relationship Strong
Expert Answers for Prostate Cancer Message Board
Feeling Good About Your Appearance
A Breast Cancer Journey
Long-Term Breast Cancer Survivors Do Well
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