Resuming after treatment

Friday 31 May, 2013

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On this page: Adapting to changes | Staying sexually confident | Masturbation | Communicating with your partner | What if I don't have a partner? | Reviewers


While some people find sexual intimacy is the last thing on their mind after cancer treatment, others experience an increased need for closeness. An intimate connection with a partner can make you feel loved and supported as you come to terms with the impact of cancer.

However, cancer can strain a relationship, particularly if you had relationship or intimacy problems before the diagnosis. Cancer need not mean the end of your sexual life. But you may need to develop more openness and confidence, in and out of the bedroom. Your favourite love-making positions may become less comfortable temporarily or change over time. Try to keep an open mind about ways to feel sexual pleasure.

Adapting to changes

There are many ways to prepare for sex during or after treatment:

  • Talk openly with your partner about any fears you have about resuming sexual activity.
  • Let your partner know how you feel: when you're ready to have sex, what level of intensity you prefer, if they should do anything differently and how they can help you to feel pleasure.
  • Ask your partner how they're feeling: they may be worried about hurting you or appearing too eager.
  • Take it slowly: It may be easier to start with cuddles or a sensual massage the first few times rather than penetrative sex. 
  • Plan ahead: sex may need to be less spontaneous after treatment. Choosing the time can help deal with pain and fatigue, and help build arousal.
  • Focus on other aspects of your relationship: many relationships aren't dependent on sex. But be mindful if this is a problem for your partner.
  • Try exploring your sexuality on your own: to develop an understanding of what's changed and what feels good, then talk about this with your partner.
  • Be patient: Things often improve with time and practice.

Staying sexually confident

If you feel unsure about yourself as a result of the cancer, you may also lack confidence sexually. It can be especially difficult to maintain sexual self-esteem if you're feeling unwell and still working, all while coming to terms with having cancer. Things that make you feel good and lift your general sense of wellbeing will help to improve your sexual confidence.

Sexual attractiveness is sometimes judged by physical characteristics, but sex appeal is a combination of looks and other personal attributes such as personality and sense of humour. It may help to express how you feel with your partner, a friend or family member you can trust, or a doctor or counsellor.

Masturbation

Self-pleasuring (masturbation) can be a positive and satisfying way to enjoy sexual activity when you don't have a partner or if you're not ready for intimacy with a partner. It can help you find out what your body is capable of sexually. Many couples enjoy mutual masturbation as an alternative to penetrative sex.

If you've had treatment in your breast or genital region, it may help to spend time alone touching these areas to find out if there is soreness or numbness, what feels different and what feels good. This preparation may help to let your partner know what feels good and what doesn't when you're ready to be intimate.

Communicating with your partner

If you have a partner, you may need to work together to adapt your sexual activities during and after your cancer experience. If you had a good relationship before the diagnosis and found it easy to communicate your needs, the process will probably be easier.

However, problems can arise due to misunderstandings, differing expectations and different ways of adapting to changes.

Talk with your partner about your feelings, concerns and what you want. It may be hard, but try not to let embarrassment get in the way. Avoiding the topic can lead to frustration and confusion, as neither of you will have your needs met.

It may help to acknowledge that your relationship is undergoing change and that it may take time for both of you to readjust.

Reconnect over a meal, go for walks together or have a date night, and then try non-sexual touch like hugging, skin-to-skin contact or massage. Some ways to start talking to your partner include:

  • "I'm going to show you the way I like to be touched and the places that are sore and out of bounds."
  • "There are some things I'd like to try to do together that will help us feel close and connected, without ‘going all the way'."

When you are both coping with the demands of cancer and treatment, it can be difficult to act on relationship concerns. Don't be afraid to seek support through counselling – call 13 11 20.

What if I'm in a same-sex relationship?

It's important to feel that your sexuality is respected when discussing how treatment will affect you. Although many of the major issues will be the same for you as for heterosexual people, recognition and validation of your sexuality is a crucial part of receiving support. Your clinical team should be able to openly discuss your needs and support you through treatment.

Try to find a doctor or nurse with whom you feel comfortable talking about your sexuality and relationships. If you have a partner, take them along to your appointments with doctors. This will show your doctor who's important to you and will enable your partner to be included in discussions and treatment plans. 

What if I don't have a partner?

Many people face cancer and treatment without the support of a partner. But in time, you may wish to meet new people and possibly start a relationship. Some cancer survivors say that a new relationship helped them to restore their sexual confidence.

You may decide that you don't want to be in a relationship, either temporarily or for the long term, because of what you've been through. This is a natural reaction and it's your choice.

If you've had major body changes after treatment, finding a new partner can seem daunting. You may worry that you're no longer attractive. It's difficult to tell a new person in your life that you've had a breast removed, had a breast reconstruction or have a stoma.

It's natural to be worried about their reaction to seeing your body for the first time. You may wait to tell them, but it will depend on the relationship you have with that person. Take your time and only do what makes you feel comfortable.

It may be easier if you practise what you want to say. It may also help to show them any body changes before any sexual activity so that you can both get used to how that makes you feel. 

Sharing your concerns with someone who's been in a similar situation can help. Call 13 11 20 for more information on support groups and Cancer Connect, a peer support program. 


Reviewers: Dr Lesley Yee, Sexual Health Physician and Psychotherapist, Australian Centre for Sexual Health, NSW; Sandy Hutchison, Executive Manager, Cancer Counselling, Cancer Council Queensland; Helena Green, Clinical Nurse Specialist and Breast Nurse, Sexologist, RELATE Sexuality, WA; Sam Gibson, Cancer Nurse Coordinator, St John of God Subiaco Hospital, WA; Carole Arbuckle, Cancer Support Nurse, Cancer Council Victoria; Deb Roffe, Gynaecological Research Nurse, Queensland Institute of Medical Research, QLD; and Garth Wootton, Consumer.
Updated: 31 May, 2013