Sexuality and Cancer

Sexuality is an important part of a person's physical, emotional and social wellbeing. It includes sexual desire, intimacy, body image, relationships, pleasure and the way each individual experiences and expresses their sexual identity. Sexuality is unique to each person and may change throughout life. Current international oncology guidelines recognise sexual health as an essential component of comprehensive cancer care.

Cancer and its treatments can affect sexuality in different ways. Some people experience temporary changes, while others may have more long-lasting effects. However, many individuals are able to maintain or regain a satisfying intimate and sexual life with appropriate information, professional support and good communication with their partner.

How Can Cancer Affect Sexuality?

Cancer may influence sexuality through several interconnected mechanisms.

Physical Factors

Cancer or its treatments may cause:

  • Fatigue or persistent tiredness.
  • Pain or physical discomfort.
  • Hormonal changes.
  • Changes in sexual function (such as erection, vaginal lubrication or orgasm).
  • Temporary or permanent infertility.
  • Side effects of surgery, radiotherapy, chemotherapy, hormone therapy or immunotherapy.

Body Image

Physical changes resulting from treatment may affect confidence and self-esteem, including:

  • Surgical scars.
  • Hair loss.
  • Weight changes.
  • Stomas.
  • Lymphoedema.
  • Reconstructive procedures or amputations.
  • Changes affecting the breast, genitals or other parts of the body.

Emotional Factors

Emotions have a direct influence on sexuality. It is common to experience:

  • Anxiety.
  • Fear.
  • Sadness.
  • Stress.
  • Uncertainty.
  • Concerns about the future.
  • Fear of rejection or loss of physical attractiveness.

Relationships

Cancer may temporarily affect:

  • Communication.
  • Family roles.
  • Intimacy.
  • Expectations regarding sexuality.
  • Relationship dynamics.

All of these areas are interconnected. For example, fatigue or changes in body image may reduce sexual desire, while anxiety can affect arousal or enjoyment of intimate relationships.

Sexuality and Emotions

Emotions play a fundamental role in sexual wellbeing.

During diagnosis or treatment, some people may:

  • Temporarily lose interest in sexual activity.
  • Feel less attractive.
  • Fear rejection.
  • Worry about how physical changes may affect their relationship.
  • Experience conflicting feelings about sexuality.

It is also important to recognise that people respond differently. Some maintain their level of sexual interest, while others experience either an increase or a decrease in desire.

Strategies That May Help

  • Talk openly with your partner about feelings and needs.
  • Discuss concerns related to your body and sexuality.
  • Seek advice from professionals specialising in sexual health or psycho-oncology.
  • Participate in support groups.
  • Maintain realistic expectations and adapt gradually to changes.

Frequently Asked Questions About Sexuality and Cancer

Can Sexual Activity Cause Cancer?

No. Sexual activity does not cause cancer.

However, certain sexually transmitted infections can increase the risk of specific cancers. The most important example is Human Papillomavirus (HPV), which is associated with:

  • Cervical cancer.
  • Anal cancer.
  • Vulval cancer.
  • Vaginal cancer.
  • Penile cancer.
  • Some cancers of the oropharynx.

Most people infected with HPV will never develop cancer.

Can I Catch Cancer From My Partner?

No. Cancer is not a contagious disease and cannot be transmitted through:

  • Sexual activity.
  • Kissing.
  • Physical contact.
  • Sharing food or utensils.

Can Sexual Activity Make My Cancer Worse?

No. Sexual activity does not promote cancer growth, increase the risk of recurrence or cause cancer to spread.

For many people, intimacy and affection contribute positively to emotional wellbeing and quality of life.

How Can I Cope With Fatigue During Intimacy?

Fatigue is one of the most common symptoms during and after cancer treatment.

Helpful strategies include:

  • Choosing times of day when you have the most energy.
  • Prioritising intimacy when you feel rested.
  • Adjusting the duration of intimate activities.
  • Exploring forms of intimacy that require less physical effort.
  • Maintaining open communication with your partner.

When Can I Resume Sexual Activity After Surgery?

The answer depends on the type of surgery performed and your individual recovery.

It is advisable to discuss this with your surgeon or oncology team before resuming sexual activity, particularly after pelvic, gynaecological, urological or breast surgery.

Can Chemotherapy Drugs Be Present in Sexual Fluids?

Some chemotherapy medications may be temporarily present in body fluids during the first few days after treatment.

Recommendations vary depending on the treatment received. It is important to follow the specific advice provided by your oncology team regarding condoms or other barrier methods.

When Can I Try for a Pregnancy?

Pregnancy is not recommended during many cancer treatments.

The appropriate time to try for a pregnancy depends on:

  • The type of cancer.
  • The treatment received.
  • The risk of recurrence.
  • The recovery of fertility.

Family planning should always be discussed individually with your healthcare team.

What If Physical Changes Make Me Feel Uncomfortable During Intimacy?

Concerns about scars, physical changes or hair loss are common.

The following may help:

  • Talk openly with your partner.
  • Explain your concerns or insecurities.
  • Adapt the environment to help you feel more comfortable.
  • Use clothing or accessories that increase your confidence.
  • Seek psychological support if these concerns cause significant distress.

Many people find that their partners are far less concerned about these changes than they initially feared.