When Cancer Threatens Intimacy

by Jill Kafin

(Editor’s Note: This article is reprinted with permission from the Summer 2010 issue of Cancer Fighters Thrive, www.cfthrive.com. As you work with and minister to cancer patients and their family members, there are information and tips here that will be good for you to remember and also to share with them, if you recognize they’re dealing with these issues or they tell you themselves.)

Cancer can put a strain on intimate relationships. Treatments for cancer and the disease itself can cause changes in sexual desire and function. If your physical appearance has changed, you may feel less attractive or desirable. At the same time, your partner may feel helpless, fearful, or unsure how to support you. All these issues can form barriers to intimacy.

How Cancer Affects Intimacy

The causes of sexual dysfunction are often both physical and psychological. Cancer and its treatments, particularly those involving the genital or reproductive organs, can directly affect sexual functioning and desire. The side effects of cancer treatments, such as fatigue, nausea, vomiting, constipation, and pain, can also decrease sexual feelings. In addition, you may be dealing with anxiety and depression, which may impede sexual desire and functioning. These feelings can become amplified if your physical appearance changes, due to surgical scars, hair loss, or weight loss or gain. These physical changes can make you feel unsexy or insecure.

Balancing Cancer and Intimacy

Intimacy has different meanings and importance for each of us and can be expressed in various ways. When cancer enters your life, roles and relationships change. For many, an intimate connection with a partner is an important part of feeling alive and whole during cancer treatment. And while it may take persistence and teamwork to maintain intimacy in your relationship, it can be done.

Tips for Rebuilding Intimacy During Cancer Care

Give yourself time. You and your partner will need time to adjust to the physical and emotional changes cancer brings to your lives. Be patient with yourself if certain side effects, such as stress, pain, depression, or fatigue, lower your desire for sexual activity. Also give yourself time to come to terms with changes to your body.

• Communicate with your partner. An important tool for building intimacy is communication. You may be anxious about resuming sexual activity after cancer treatment, fearing that sex will hurt, you won’t be able to perform, or your partner will no longer find you attractive. Your partner may be anxious about putting pressure on you by initiating sexual activity. Talk openly about your feelings so that you understand each other’s needs and preferences.
• Make necessary adjustments. After cancer treatment some sexual positions may hurt and certain activities that once gave you pleasure may not anymore. For example, for some women pain during intercourse may be relieved if the woman is on top, controlling the level of penetration. Try to be a guide for your partner and explore your expectations together.
• Plan ahead. Levels of sexual desire vary during cancer treatment. It may help to plan sex for when you have the most energy or for after you take your pain medication. Also, your partner may have moved into a caregiving role, making it difficult to feel sexy around each other. Try to clearly separate time for caregiving and time together as a couple.
• Enhance your self-image. Cancer can affect your body image and feelings of attractiveness and desirability. Simple boosts like a new haircut, wig, makeup, or clothing may help you feel better about yourself. Your doctor may recommend medical options (such as breast reconstruction or devices to improve erectile function). Try to remember that cancer doesn’t make you less of a woman or man.
• Talk with your doctor. Many doctors won’t talk with you about your sex life unless you ask. Although it can be an uncomfortable discussion, it’s an important one to have. Your doctor can clear up any concerns, including the impact of cancer treatment on sexual function. Let your doctor know about any sexual dysfunction you experience throughout treatment.
• Get healthy in other areas. Regular exercise and good nutrition can help stimulate sexual desire by increasing your energy and improving your mood. Ask your doctor what type of exercise is best for you. Also, depression can make you lose interest in sex. If you think you may be depressed, talk with your doctor. Learn relaxation techniques to reduce stress and muscle tension.
• Seek professional help. For some couples, a professional counselor can help facilitate communication. You may also find value in talking with a social worker, nurse, chaplain, or friend. In addition, support groups can give you both a place to voice your fears and concerns. By talking openly about issues, you can come up with new ways to build intimacy in your relationship.
• Work as a team. During cancer treatment it is especially important to work together with your partner. The closeness and the companionship that come from teamwork can help you feel more secure and in control. By communicating effectively and making an effort to maintain intimacy, your relationship can flourish in the face of cancer.
• Validate each other’s feelings. It is likely that you and your partner will have your own questions and concerns. It’s important to listen to each other’s feelings and point of view without interrupting or being dismissive. Empathize with your partner and try not to take things personally. Avoid statements like “Everything is going to be great.” Instead say things like “Although I can’t fix it, I am here for you.”
• Get reacquainted. You and your partner may have disconnected from each other over the course of the cancer journey. Emotional closeness and companionship are important to your relationship and can help rebuild physical intimacy as well. Start out slowly, by cuddling, kissing, and touching. Learn to touch, hold hands, and simply relax together. Each day make a point to say, “I love you,” to your partner.
• Experiment with other forms of intimacy. Even if you can’t have sexual intercourse, you can still maintain intimacy through loving affection and touch. Dim the lights and put on romantic music. If you feel self-conscious, get creative with lingerie. Give your partner a massage. Focus on the sensual, not the sexual. Even going for a walk, watching a movie, swimming, or reading together can create intimacy.