Right now, sex may be the last thing your loved one is thinking about – focusing, as he or she no doubt is, on survival. It is entirely normal to temporarily lose interest in sex and intimacy during treatment and even for some time after treatment. But having a sexual relationship and the intimacy that goes along with it contribute to our zest for living and remind us that we are truly alive. For that reason, it’s important that fears and other impediments to resuming intimacy be understood and addressed.

This article touches on one of the many sexuality issues that are common to both men and women who have or have had cancer. But, as we all know, men and women are different. So, we have two expanded versions of this article on our Web site – one for men and one for women.

Sex Defined

Unfortunately, most of us define sex with one word: intercourse. This is a myth. In truth, sex is any kind of physical expression of intimacy – including kissing and simple, sexual touching. Sex is one manifestation of our need for closeness, caring, and pleasure. Even when sex becomes difficult, such as during a severe or terminal illness, this kind of physical expression remains important to our lives.

Points to Keep in Mind

Just as good nutrition, exercise, and activities are important during cancer treatment, so is intimacy. Sometimes people need to be reminded of this and of the following points:

• No matter what kind of cancer treatment someone is undergoing, the ability to feel pleasure from touching almost always remains. Few cancer treatments damage the nerves and muscles involved in feeling pleasure from touch or in reaching orgasm. Sexual touching alone is often a satisfying experience that produces orgasms. Pleasure and satisfaction are possible, even if some aspects of sexuality have changed.
• Some people have a narrow definition of what is “normal” in sex, so they will need to keep an open mind about ways to feel sexual pleasure. There may be times, for example, when intercourse is not possible. Those times can be chances to learn new ways to give and receive sexual pleasure. At times, just cuddling can be pleasurable.

Coping with Changes in Appearance

This is usually the area that most impedes a person’s resumption of intimate relations. If cancer treatment has left visible changes, someone may feel unattractive and assume that others will thus find him or her undesirable. This usually is not the case. Even in the best of times, we are all more critical of ourselves than others are. That’s why it’s important for people to first address their own feelings about themselves, taking stock of their good points and working to dispel negative thoughts.

Taking Stock

• Many people look in a mirror and notice only what they dislike about their looks, such as pale skin, hair loss, an ostomy appliance, or skinny legs. They fail to see their attractive features. The following mirror exercises can help people adjust to body changes:
• People should find a time when they have at least 15 minutes of privacy. Then, using the largest mirror they have, they should study their appearance carefully, noting which parts of their bodies they look at most and what parts they avoid looking at. It’s important for people to be aware of having any negative thoughts about the way they look.
• The mirror exercise should first be tried when fully dressed, as if going out among others. If clothing or accessories to disguise changes from cancer therapy are normally worn, they should also be worn at this time. Then, looking in the mirror, they try to find three positive things about the way they look. This will help them to see themselves as strangers might see them.
• The next mirror exercise is done when dressed as they would like to look for a lover. An ostomy, for example, could be covered with an attractive robe. Then, looking in the mirror, they repeat the steps in the first exercise, asking what they find most attractive and sexy about themselves. They should pay themselves at least three compliments on how they look.
• Finally, the mirror exercise should be tried in the nude, without disguising any changes made by the cancer and instead, focusing on those changes until they adjust to them. Then, they should find three positive features or remind themselves of the three compliments they paid themselves before.

Over time, these mirror exercises will help people to feel more relaxed and confident when their lovers look at them.

Changing Negative Thoughts

Negative thoughts can be changed and it’s important that people try. A lot of sexual experience is in the head, so thoughts can make the experience good or bad. People often set themselves up for failure with thoughts like, “How could someone want a woman with one leg?” Or, “How could any woman want a man without testicles?” Almost everyone has put him or herself down as a lover before, but this exercise can lessen that.        

• People can write down the three negative thoughts they have most often about themselves as lovers. Some may be connected to their cancer treatment, but other thoughts may have started years ago.
• Next, they can write down a positive thought to counter each negative thought. For example, if a negative thought was “No one wants a lover with an ugly urinary ostomy,” women might counter with “I can wear a lacy ostomy cover during sex.” Or, men might counter with “I’ll just wear a nice white T-shirt during sex.” The next time they are in a sexual situation, they can use the positive thoughts to override the negative ones they usually have.

Boosting Self-Esteem

One of the things that can suffer during cancer treatment is self-esteem. People may not feel good about themselves and may assume that others feel the same. That’s why it is good to encourage loved ones to try to change these negative thoughts to positive ones. Remind them of their good qualities and encourage them to do the same. If they have features people have always admired, suggest that they play these up, even indulging themselves a bit.

Communicating With Partner

This may be the most important part of resuming sexual activity during cancer treatment. Many people react to cancer by withdrawing. They fear their partners will feel burdened if they share fear or sadness. Or they fear their partners might view them as weak. Sometimes men are the ones who have trouble sharing feelings, but women do, too. Unfortunately, the result is that each partner is left alone to cope with his or her own feelings. No couple gets through cancer diagnosis and treatment without some anxiety. That’s why you may want to encourage your loved one to discuss fears and concerns with his or her partner, especially if that partner is you.

If the person you are caring for is a woman, you may want to review these appearance-related pages on her behalf.

• Look Good…Feel Better^®: Click here.
• “tlc” Tender Loving Care™: Click here.