Cancer is hard. Everybody knows that the journey is long and at times can be treacherous. There are many treatment decisions that are made to help people survive the disease but there are also side effects from the life saving treatment. The list can be long, but one side effect that is sometimes difficult to talk about is sexuality. The reality is that sexuality and intimacy are a part of the human experience and affects our self-image, and our relationships with others.

During the cancer journey, one’s sexuality and sexual desire can be compromised and become yet another struggle. After diagnosis, possible surgery, chemotherapy, and radiation, men and women recovering from cancer face the necessity to seek out information from others about how to be sexual again in ways that are comfortable for them. Sexuality is one aspect of our need for closeness, touch, playfulness, caring and pleasure, and when sex becomes difficult, such as during a severe illness, the physical expression of caring remains an important way of sharing closeness. Unfortunately, surgery and chemotherapy can often bring about a feeling of “don’t touch me.” This can put a huge strain on the relationship. Sometimes the partner that is not sick will become frightened of touching the patient in fear of hurting them or causing them more pain. For some types of cancer, such as breast cancer, there can be parts of the body that are disfigured and an impaired body image can make a huge impact on the comfort level of the couple’s sexual relationship. Finally, for people who are not in a steady relationship, walking into the dating scene can be daunting at best with questions about how much information to pass along about the cancer diagnosis, and at what point in the relationship.

In the middle of all of this, people have a human need to be close, to touch and be touched, and quality of life can be impaired until this issue is resolved. So, what do you do? Where do you begin?

1. Communicate with your partner. Communication is the key to managing the complications incurred from cancer, and is important as a beginning point in an ongoing or new relationship. It is essential to be able to talk about what you want, and what you don’t want in the physical relationship. Be specific with your partner so they understand specifically what you need. For example, “because of my surgery, it hurts when you touch me there, but it feels good when you touch me there.” Or “I am so tired, that I don’t want to be touched very much. However, I love it when we cuddle as we go to bed.” Hopefully, your partner will be open to communication, and appreciative for the information. If talking about your sex life with your partner is not possible, seek help from a professional therapist who specializes in working with couples.

2. Intimacy is more than sexual intercourse. One thing many people learn in high school is that “meaningful sex” must include sexual intercourse. The golden goal seems to be when both partners are able to reach orgasm during penetration, and if they don’t, they feel that they haven’t “performed.” However, sex is much more than the act of intercourse, and there is much pleasure in other forms of sexual expression. This is the time to explore new ways to give and receive pleasure through touch. You can help each other know where to touch that feels good and gives you both a sense of connection. Massage, skin-to-skin contact, and eye-contact can be very rewarding and provide a feeling of pleasure for both of you. It is important not to deny yourself just because your usual routine has been changed. Sometimes this new routine will remain and enhance the sexual relationship even after the cancer treatment is over and both partners feel healthy again.

3. Physical concerns may need medical attention. For some cancer patients, treatment may change the way the body functions, and make sexual intercourse painful. The woman may have vaginal dryness, pain during penetration, and decreased ability to reach orgasm. Men may have trouble getting or maintaining an erection, premature ejaculation, or pain. Both people may experience a lack of desire for sex, which is understandable in the face of a severe disease, particularly when both may be feeling fatigued and crappy. When this happens, there are frequently techniques and treatments that can be helpful to restore sexual function. It is important to gather as many facts as you can about the usual effects that come with your treatment. Talk with your doctor, nurse or someone on your health care team that you feel comfortable with. When you know what to expect, and ways to handle it, you will feel more at ease and increase your ability to talk with your partner about what is going on. If you can, bring your partner with you during the consult.

Sexuality can be a wonderful part of who we are and how we express ourselves, but during a cancer diagnosis, there are many road blocks that we may encounter. Through communication, gathering necessary information and getting the help from health care and mental health professionals, you will be able to ease some of the burden that comes with having cancer in your life. Being a member of the support groups at Cancer Support Community is a great way to find ways to manage and improve quality of life. Also, look for education sessions specifically about sexuality in our monthly calendar which can be found on the website www.cancersupportmontana.org or call 582-1600.