In my role working with cancer survivors, one of the most common complaints I hear about is a change in sexual function.Sexuality during and after treatment is a topic that both survivors and their partners may struggle with, and if both parties are not on the same page, it can cause disconnect and worry. I experienced this in my own cancer journey.
Within days after returning home from my mastectomy, I attempted to be intimate with my husband. I thought this would be good idea, but my husband briskly pushed me away.This was yet another blow to my already very fragile state. Years later, we talked about that afternoon. My husband explained his fear of hurting me while I was undergoing treatment. Throughout my battle with cancer, my husband said he worried that being intimate would somehow interfere with the therapies I was receiving or take away some of my very limited energy.Conversely, I still needed to feel attractive and loved. Cancer had robbed me of so much at the time; I desperately needed one part of my life to feel “normal.”
There are many reasons why intimacy can change during and after treatment.Some of these reasons include hormonal changes that decrease libido, difficulty reaching climax, inability to achieve and maintain an erection, or reduced vaginal lubrication.Beyond the physical side effects, psychological issues such as feeling unattractive due to scars or hair loss, or increased anxiety and stress, can also drastically impact a survivor’s desire.
I encourage survivors to speak openly about this with their partner as well as their doctor if necessary. In the past, I have heard providers make comments like, “If a patient has an issue he/she will bring it up to me.” This is not the case! With as many as 90% of prostate cancer survivors, 75% of rectal cancer survivors, and 50% of breast and gynecologic cancer survivors experiencing sexual dysfunction, it is important for providers to inquire about it, signaling to their patients that it is an acceptable topic to discuss.
In March, the National Comprehensive Cancer Network (NCCN) came out with their first clinical practice guidelines on cancer survivorship covering eight areas, including sexual function. The guidelines include a symptom checklist about sexual desire, pain, and ability to maintain erection. These questions are intended to be proactive tool used by providers throughout treatment and survivorship.
The discussion of sexuality and intimacy after cancer has changed a great deal since I was a patient eight years ago. It has been my observation that providers are slowly heeding the NCCN recommendations and starting to discuss these issues with their patients. The good news is most patients do report that their sex life eventually return back to normal, if not a new normal.
This is the final post in a nine-part series covering survivorship guidelines released by the National Comprehensive Cancer Network (NCCN) at their annual conference of March 2013. If you need help navigating cancer survivorship, PearlPoint is here to help. Contact our Supportive Services team at 877-467-1936 x 101 or sign up for a profile at My PearlPoint.
Author: Elissa T. Bantug, MHS, CHES
Bio: Elissa T. Bantug, MHS, CHES, is Program Coordinator of the Breast Cancer Survivorship Program at Johns Hopkins Kimmel Comprehensive Cancer Center. A breast cancer survivor with an extensive history of breast cancer advocacy and outreach work with multiple cancer organizations, Elissa administers day-to-day program activities and serves as a liaison between grant projects and with funding agencies. She can be reached at email@example.com.