Sex and Cancer
Can I still have healthy sex while I have cancer?
Yes – although it is important you consult your care team if you are not sure, they will be able to talk you through any concerns you have. The frequency of your sex life – solo or partnered – won’t affect your cancer, or the chances of its recurrence.
While your main priority might be treating your cancer, you do not need to neglect your physical and emotional needs.
There are times you might be advised by your medical team that you do need to pause sexual activity, and if you are not sure, talk to your clinical nurse specialist about when it is possible to resume sex. It is likely you will need to pause sexual activity:
- When recovering from some invasive surgeries, especially those on or around the genitals or bum.
- When undergoing some radiotherapies that can cause internal inflammation around the genitals or bum area. For more information, see: Sex and Cancer: Radiotherapy – OUTpatients
Considerations for LGBTQIA+ People
Sex and cancer may present particular issues for LGBTQIA+ people. People who may already experience gender dysphoria may find additional challenges going through cancer, cancer treatment, or recovering from cancer. If you are unsure about where to start you can talk to your doctor or nurse, asking them to use particular gendered or de-gendered language about your body.
Everyone who is fertile and is considering having a family in the future should be given the opportunity to discuss the impacts treatment may have on this and future options. If you feel your clinical team may be overlooking this because of your sexuality or gender identity raise this with them if you feel comfortable. Otherwise you can speak to someone else in the department to seek guidance.
Some types of cancer may make certain types of sex very difficult or impossible to do in the future such as anal sex caused by bowel and anal cancers, or oral sex caused by head and neck cancer.
People who have had treatment for head and neck cancer often experience particular difficulty after their treatment, even years later. If you have been treated for head and neck cancer or any other type of cancer and are struggling with post-treatment side effects, please reach out for support.
What can I do to make sex with cancer easier?
If you have a regular partner or partners it is important to have an open conversation about how you are feeling, and whether you feel comfortable to have sex. You may feel apprehensive to have this conversation or feel like you have to only think about the diagnosis.
People going through cancer treatment often experience negative side effects that may make sex more difficult. You can talk to your care team about these side effects to expect and how to manage them.
You may feel that you require additional emotional support and want to access counselling. The Rainbow Project offers co-cultural counselling to LGBTQIA+ people – call 028 9031 9030 for Belfast or 028 7128 3030 for Derry/Londonderry to seek support. Alternatively email us at info@rainbow-project.org.
The Cancer Care Map website also offers a directory of support groups that may offer cancer-specific counselling services.
When do I bring up sex with my care provider?
There are times you might want to ask these questions, but not sure when it is appropriate. Cancer can involve a lot of different clinical appointments, specialists and people involved in your care.
There is a box for ‘sex and relationships’ on the holistic needs assessment – this can be a good time to bring up that sex is an important factor for you. You can ask your doctor, or your clinical nurse specialist. You should talk to your surgery team about sex as well, especially if you are not sure if there are any factors that may need to change in the short or long term. If you need support having these conversations, reach out to our team.
Will the way I feel about sex or my body change with cancer treatment?
You might notice some changes that can impact the way you have sex or your body image. Cancer treatment can impact lots of areas of your life, including sex and relationships. Some types of radiotherapy may also require you to wear protection. Many changes caused by cancer treatment to your sex drive are temporary, and get better after treatment, but some can be longer lasting or permanent.
Possible side effects of some cancer treatment that can affect your sex life include:
• Erectile dysfunction
• Painful ejaculation
• Vaginal stenosis, or increased dryness
• Early menopause
• Pain
• Fatigue
• Changes in physical appearance – such as hair loss, or surgery to remove cancer sites
• Low mood or changes to mental health
• Weight loss or weight gain
• Anal or rectal (bum) changes
• Peripheral neuropathy – numbness, tingling, or a burning sensation
• Changes to fertility
• Sex drive loss or change – can be caused by hormonal or emotional impacts of cancer
• Body dysmorphia
• Sensation loss
Don’t feel pressure to be intimate during treatment if you find your sex drive changes, or you experience side effects that change how you feel about it for a while.
If you feel like it’s mental and emotional barriers stopping you having a sex life rather than physical ones, you might want to talk to someone about it, such as a counsellor or sex therapist. Often there are specialists within Trusts that you can be referred to, but the teams need to know what is going on for you to make this referral. Our team are also here to talk through any worries you might have.
How do I keep myself and my partner(s) safe?
People with cancer or going through treatment can often have weakened immune systems, this can be especially impactful for people with existing conditions that already weaken your immune system such as HIV.
It is important to practice some positive sexual health practices such as:
- Using protection during sex – to prevent STI transmission, avoid passing on drugs in bodily fluids, and to avoid unwanted pregnancies. Even if your treatment reduces your fertility, or even if they say you hear terms like infertile – it is still possible that you may develop a pregnancy that won’t carry to term. Make sure your care provider thoroughly explains what contraceptives are necessary for your sex life during and post-treatment. Some hormonal contraceptives may not work while undergoing certain types of treatment. Some types of chemotherapy and radiotherapy may require you to wear protection to protect your partner – your CNS can provide more information as this depends on the type of treatment you have.
- Regular testing – you can call The Rainbow Project at 028 9031 9030 – to arrange a free confidential rapid test for HIV and Syphilis. See our Sexual Health page for more information.
- Having frank and open conversations with your partner(s) about their sexual/ testing history, as well as your own
- Tell your doctor if you experience any bleeding during sex; attend hospital if the bleeding does not stop
- Use silicone-based lube while having anal sex – it reduces the risk of infection through small tears
- Clean dildos, sex-toys and sex-objects between uses or if a partner uses them
Resources
For more information on sex and cancer click the articles below:
- Macmillan – Sex and Cancer
- Macmillan – Sex and Cancer uncovered blog
- Macmillan – Talking about Sex and Cancer: “All good sex starts with a conversation”
- Macmillan – Online Community
- Macmillan – Ouline Community: LGBTQIA+ cancer forum
- OUTpatients UK – Sex & Cancer Hub (LGBTQI+)
- Maggie’s – Sex, Intimacy and Cancer
- Cancer Research – Sex, Sexuality and Cancer: Resources and Support
