Coping With Sexual Concerns After Cancer
By Dr Lee Boon Ooi
Assistant Professor, Nanyang Technological University
Psychologist, National Cancer Centre

Cancer and its treatments (e.g., chemotherapy, radiotherapy, and surgery) may affect patients physically, emotionally, and socially. Besides experiencing pain, lethargy, nausea and other physical discomforts; patients may be depressed, anxious, fearful, or angry. Some may have the fear of dying or relapse, become frustrated because of lifestyle and physical changes, or face financial difficulties because of unemployment and high medical bills. They may also become pessimistic, hopeless, helpless, and socially isolated. This poor physical and emotional well being may affect the patients’ quality of life including sexuality and sexual relationship. The more common sexual concerns, which can be temporary or permanent, include:

These problems affect both the patients and their partners. For example, mastectomy or hysterectomy may cause a woman to have poor sexual responses, suffer from poor self-image, and become doubtful of her sexual functioning or attractiveness. She may then avoid having sex with her partner who in turn becomes frustrated. As a result, their relationship may deteriorate and in return worsen their sexual problems.

Thus, it is important for patients and their partners to learn to cope with their sexual concerns. Firstly, they may work with their doctors to identify the causes of the problems. They may consider applying artificial lubricant to reduce pain and dryness during genital intercourse, using a vibrator or sexual stimulant drugs to increase sexual arousal and sensations, or adopting less strenuous sexual postures. As sexual problems are usually accompanied with negative feelings and thoughts, sharing them with their partner, close friends, or professionals may be therapeutic. Physical or relaxation exercises, and social activities may also help to lessen such unpleasant feelings and thoughts.

Next, patients and their partners may have to adjust their sexual expectations, needs, frequency, positions, and habits. They may have to accept that the patient is unable to perform certain sexual acts or to respond in his or her usual ways. They may have to redefine the meaning of their sexual relationship by replacing genital intercourse with caressing, kissing, mutual masturbation, or other intimate activities. Some couples may have to practise abstinence and to refocus on other life aspects such as spirituality and children. As for singles and unmarried couples, it is important for them to make decisions on marital and family planning issues.