Sexuality for the Man With Cancer

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Frequently asked questions

Can sex cause cancer?

For most cancers, there’s no link between a person’s sex life and the risk of cancer. Nor does having sex after cancer treatment increase the chances of cancer coming back or getting out of control. But viruses passed from one person to another through sexual contact have been linked to some cancers, including squamous cell carcinoma of the cervix, vulva, vagina, penis, mouth and throat, rectum or anus, and Kaposi sarcoma. Hepatitis B and hepatitis C viruses, which can be passed from one person to another during sex, can increase the risk for liver cancer. Epstein-Barr virus, which causes mononucleosis (also called mono or the “kissing disease”), seems to increase the risk of certain other types of cancer, too.

These cancers are not caused by having sex itself, but by viruses that can be picked up during sexual activity with someone who already has the virus. News stories about viruses and cancer can be confusing. The roles of these viruses are not fully understood, but some can cause changes in the DNA of the cell. Keep in mind that most people who get these viruses never develop cancer. You can get more information about viruses and cancer in our document called Infections That Can Lead to Cancer. (See the “To learn more” section.)

Human papilloma virus

Nearly all women with cervical cancer have been infected with human papilloma virus (HPV), which is recognized as the main cause of cervical cancer. HPV can also cause cancers of the mouth and throat, anus, penis, vulva, and vagina. HPV is the most common sexually transmitted infection in the United States. HPV is passed from one person to another during skin-to-skin contact. It can be spread during sex – including vaginal sex, anal sex (entering or being entered through the anus), and even during oral (mouth) sex. Most adults who have had sex will at some point get HPV. But HPV does not cause cancer in most people who get it. Some people with HPV may be more at risk of getting cancer because of their age, poor health, family history, or past experience with other cancer-causing agents. For example, women who smoke cigarettes have an increased risk of cervical cancer. Men who are not circumcised are more likely to develop cancer of the penis.

Many patients and their partners worry that cancer is contagious – that cancer itself can be passed from one person to another during sex. Despite this myth, a cancer cell from one person’s body simply can’t be transmitted to another during sex, then take root and grow in their body. Cancer is not contagious.

Can AIDS be picked up from sex?

The virus that causes AIDS is called the human immunodeficiency virus (HIV). It can be passed to someone else when blood, semen, or vaginal fluids from an infected person get into the body of an uninfected person. This can happen during oral (mouth), vaginal, and anal sex (entering or being entered through the anus). Nearly everyone with HIV got it in 1 of 3 ways:

  • Unprotected sex with an infected person
  • Sharing an infected person’s needle or equipment during drug or steroid use
  • From a mother to her baby during pregnancy or breast-feeding

Most people with HIV don’t look sick until they have had the virus for many years. During that time, the only way to find out whether a person has the virus is to take an HIV test. Unless you know for sure that neither you nor your partner has the virus, and that both of you are careful to avoid infection, you should practice safer sex. If you are in a trusting relationship, and both of you have been tested and don’t have the virus, unprotected sex may be safe. But both partners must stay faithful in order to protect themselves from HIV.

Examples of safer sex include:

  • Touching each other’s genitals with the hands.
  • Oral sex with a woman if a “dental dam” is used. A dental dam is a rubber sheet that is used to cover the woman’s vulva during oral sex. Or a sheet of plastic kitchen wrap that keeps the woman’s sexual fluids contained can be used instead. Do not taste vaginal secretions without knowing the woman’s HIV status first.
  • Oral sex with a man if he wears a latex or plastic condom from start to finish. Never taste or swallow a man’s semen if you suspect he might have HIV.
  • Vaginal or anal sex using a latex or plastic condom. Condoms only work if they are used correctly, every time, from start to finish. Lots of water-based lubricant can help reduce the risk of the condom breaking. Never use lotion, oils, or petroleum jelly, which weakens latex condoms.

Spermicides (sperm-killing chemicals often used to prevent pregnancy) are not a good idea if you are trying to protect yourself from HIV. The sperm-killing chemicals in contraceptives were once thought helpful in fighting bacteria and some viruses. But some studies have suggested a higher risk of getting HIV infection in people who used nonoxynol-9 (N-9), a popular ingredient in foam, film, and gel contraceptives. N-9 can harm both vaginal and rectal tissues. Some lubricated condoms also have N-9, so you may want to check the label before you use them. Talk with your doctor about what methods might best meet your needs for preventing sexually transmitted infections or pregnancy.

Talk to an HIV counselor at your local health department if you have questions about HIV transmission, or see the “To learn more” section for more information.

What if I already have HIV?

If you have HIV, safer sex is important to avoid sexually transmitted infections. You will also want to protect your sex partner from HIV. Even if your partner has HIV too, either of you could become infected with a second strain of the virus. Researchers have discovered, for example, that people who were first infected with a type of HIV that could be treated with anti-viral drugs have gotten drug-resistant HIV through unprotected sex. If properly used, latex condoms can keep HIV from being transmitted through sex. (See our document called HIV Infection, AIDS, and Cancer for more information.)

Can sex during treatment be harmful to a patient or partner?

A few chemo drugs can be present in small amounts in semen. You may want to use condoms while you are getting chemo and for about 2 weeks afterward. Some types of radiation treatment require special precautions for a certain amount of time, too. For instance, a man who is having “seed implants” (brachytherapy) for prostate cancer should check with his doctor about safety precautions, like using condoms, because sometimes the seeds can move.

Men who are getting chemo also should avoid causing pregnancy during and for some time after treatment because chemo may damage the DNA in sperm cells. This could lead to birth defects. Ask your doctor about birth control if your partner might get pregnant. You will also want to know when you can stop using birth control for this reason.

Although sexual activity is usually safe for your partner during your cancer treatment, some couples just stop having sex, without checking out their fears with the health care team. If you have been cleared medically to resume sex, but are still unsure, you may just need more time. Think about your feelings. Are there times when you feel a stirring of sexual desire?

Be sure to let your partner know that you’ll want to have sex as soon as you feel better. Give your partner some ideas on helping you feel more sexual again, such as, “Let’s try being affectionate in a relaxed way,” or “I’d like to know that you still find me attractive.”

You may also need to reassure your partner that your cancer treatment does not make sex dangerous. Cancer can’t be caught from another person. If you have external radiation treatments, having sex with you does not expose your partner to radiation.

When should a person with cancer not have sex?

Ask your doctor if sex may be a problem at any time during or after your treatment. Here are some general guidelines to think about:

  • When recovering from surgery, sex can cause bleeding or strain the incision (cut). Sex may also increase your chance of an infection. The time between surgery and when it’s safe to have sex varies. It depends on the type of operation and how well you are healing. Your surgeon can tell you when it’s safe to try sex again.
  • Some types of cancer, like cancer of the bladder, may cause bleeding in the genital area or urinary tract. If this bleeding is worse after sex, talk with your doctor about it. You may need to stop having sex until the bleeding has stopped and the area has healed.
  • During chemo, a person with an infusion catheter sometimes worries that sexual activity will harm it. As long as you take care not to rub against it, sex should not cause any problems.
  • When you’re being treated for cancer, there are often times when your immune system isn’t working as well as it should. This may happen during radiation or chemo. At such times, it may be easier for you to get all kinds of infections. Again, ask your doctor if sexual contact puts you at too much risk for infection. Most doctors say that if you’re well enough to be out in public, you’re well enough to have sex. If you’re in the hospital because of weak immunity, ask your doctor’s advice on kissing, cuddling, or sexual touching.
  • There are things you can do to try to prevent urinary tract infections. Some of the bacteria that can start infections in the urinary tract or genital area may wash away if you urinate a few minutes after sex. You might even want to drink a glass of water before you make love, so it will be easier to urinate afterward.
  • If you notice any sores, bumps, or warts on your partner’s genitals, or any unusual fluids or discharge, you should ask for an explanation of the symptom and decide whether it’s safe to have sex. But you should not expect to be able to screen your partner for sexually transmitted infections (STIs) before having sex. Remember that most STIs never cause signs or symptoms you can see. The only way to detect most of them is to go to the doctor and ask to be tested for them. And often the person with an STI doesn’t even know they have it. You can reduce your chances of getting an STI if you wear a latex or plastic condom for oral, vaginal, or anal sex.

Do other people with cancer feel shame or guilt?

Even if a cancer treatment hasn’t left obvious scars, many people still feel ashamed of having cancer. Some people feel that the person with cancer may be unclean or somehow to blame for the disease. These ideas are not true. Feelings of guilt or blame can only take away from the efforts you make toward solving sexual problems.

My partner is acting different since we talked about my cancer. How do I handle that?

Many people think that cancer is always fatal. But in a nation where 1 out of every 2 to 3 people will have cancer in their lifetime, and where survival rates are steadily going up for those with cancer, this belief is unfounded and harmful. Still, it can affect the way others relate to you.

Talking to your partner about your diagnosis and treatment as it unfolds may help both of you. Fear of the unknown can interfere with intimacy. Your partner may be afraid of losing you but afraid to say so, and sometimes it helps if you can bring that up. You may have some other concerns you would like to share, too.

Sit down in a quiet, private place. Offer a chance to talk, but don’t force the issue if your partner is unable to open up with you at first. Try to be available if your partner wants to talk later. If that doesn’t happen, you may want to try again. If it continues to be a problem, you may want to think about counseling. If your partner doesn’t want to seek help, it’s OK to go by yourself. (See the “Professional help” section.)

What about sex and advanced cancer or at the end of life?

A very ill person is not often seen as a sexual person, but sexual feelings exist in everyone, even in times of very poor health. Touching, caressing, sharing, and emotional intimacy are always important – even at the end of life.

When cancer is far advanced, a person’s needs for affection, sharing of feelings, and touch may become even stronger. Partners of patients can help by remembering how important physical closeness is, even when sex might be too much for the person with cancer.

Other questions

You probably have many other questions that haven’t been addressed here. Don’t be afraid or embarrassed to discuss them with your doctor or other members of your health care team. Write them down now so you’ll remember to ask them at your next visit.

Last Medical Review: 08/19/2013
Last Revised: 08/19/2013