Sexuality

As cancer care has improved and survival rates have increased, issues that affect quality of life, such as sexual health, have become increasingly important. Often patients are not sure what to expect from healthcare providers in regard to talking about sexual health during and after cancer treatment.

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Cancer treatment, such as surgery, chemotherapy, hormone therapy, or radiation therapy, can decrease your level of sexual desire by slowing down the production of sex hormones. Side effects of treatment, such as nausea or fatigue, may also decrease your desire. Negative emotions like depression, anger, fear, or guilt may keep you or your partner from wanting to have sex. Medications for pain, nausea, anxiety, or depression, can also decrease desire. If you have experienced changes in your appearance as a result of treatment, you may feel self-conscious. All of these factors affect sexual desire.

Surgery or radiation treatment to the abdomen or pelvis may cause physical changes in blood circulation or nerve supply to the sex organs. Women who experience vaginal dryness as a result of surgery or radiation may use water-soluble lubricants or moisturizing suppositories available at any drugstore without a prescription. Some women may experience some shrinkage of the vagina as a result of radiation or surgery. A combination of learning to relax the vaginal muscles and gentle, gradual stretching of the vagina with dilators can overcome this problem. Finding positions that give the woman control over movement and minimize deep penetration can also help. Your doctor can give you additional advice about sexual activity after radiation treatment or surgery. For more detailed information about positioning and sexual techniques, refer to Sexuality for Women and Their Partners by the American Cancer Society.

If you are having chemotherapy, it is important to know what your platelet count is before engaging in sexual activity. If your platelet count is lower than 50,000 and you engage in sexual activity, you may be at risk for bleeding.

During chemotherapy you are also at greater risk for getting an infection. For this reason, practice good personal hygiene and bathe daily. Wash your hands and genitals before and after sexual activity. If you are not in a monogamous sexual relationship (having only one partner) or you are not sure of your partner's faithfulness, you should practice safer sex, using latex condoms to avoid contact with your partner's body fluids. If you use a lubricant with latex condoms, choose a water-based lubricant, and not a lubricant that contains oil (i.e., baby oil or petroleum jelly), since such products can weaken the condom. Nonoxynol-9 is no longer recommended as an HIV preventive.

If you are the spouse or partner of the patient, you need not worry about getting cancer from sexual intercourse. Cancer is not passed from one person to another. Sexual activity does not cause cancer, nor does sexual activity increase the risk that cancer will return. The causes of cancer are complex, such as exposure to certain toxic chemicals, tobacco use, or genetic factors. It is medically impossible to pass cancer from one person to another. However, some chemotherapy drugs can be present during treatment in semen or vaginal fluid. If your partner is receiving chemotherapy, use condoms for the first 72 hours after chemotherapy is finished to avoid any exposure to the drugs.