While there's abundant evidence for good living after cancer, it's less clear if that includes good sex. Dry vaginas, limp penises, scarred bodies, perhaps incontinence--not to mention baldness, anxiety, nausea, and fatigue--do not exactly inspire a chorus of "I'm in the Mood for Love." The results of diminished desire can be profound, impairing both the emotional and physical well-being that is so crucial to coping with cancer.
Sexual complaints can be the consequence of the diagnosis, the disease itself, or the treatments. Stress hormones are elevated at the moment of diagnosis and long after, and these biochemicals quash libido. Among breast and prostate cancer survivors, it is estimated that 90 percent have some form of sexual complaint. And the problem rarely gets better by itself. Increasingly cancer centers are including a sex therapist and psychologist in the patient's treatment team.
Teasing out the root cause of sexual dysfunction may be difficult. But there's a lot that can be done, including lubricants and moisturizers for women suffering from vaginal dryness, hormone therapy for low libido, and different sexual positions to compensate for pain or shortness of breath. Sloan-Kettering has a "penile rehab" program, which helps men exercise their erectile tissue with regular erections. Ninety-five percent of men respond to drugs if needed.
The key for couples is to discuss all this early, says Michael Krychman, who is with the sexual health program at Sloan-Kettering. "It's OK to talk about sex. And on the flip side, we have to educate clinicians that it's OK to ask about it."
This story appears in the April 5, 2004 print edition of U.S. News & World Report.