Cancer and Love Life

QUESTION: After being treated for cancer, I'm afraid my love life will
change. Will it?
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ANSWER: Chances are, it will. During a medical crisis such as the one you've
been through, there are bound to be all sorts of adjustments to be made--both
physical and emotional. However, with good communication between intimate
partners, many of the sexual dysfunctions that result from cancer and its
treatment can be overcome.
For women, gynecologic cancer surgery can cause a reduction in the depth
and width of the vagina, and common problems following chemotherapy can
include vaginal atrophy and loss of vaginal lubrication. Commercial
lubricants can restore the lubrication, and it is recommended that partners
use coital positions that allow the woman to regulate the degree of
penetration. To prevent vaginal atrophy, early resumption of sexual activity
is strongly advised, particularly since it may also help to relieve a
patient's anxiety which can cause sexual problems in itself.
Loss of sexual drive can also occur after cancer treatment. This can
have a biological basis since chemotherapy can cause menstrual abnormalities
and the onset of an early menopause. However, psychological factors such as
cancer-related depression or a difficult adjustment to the changes in one's
body image can certainly reduce one's sexual desire as well. Therefore, the
quality of your interpersonal relationship has a strong bearing on your
adjustment. Nonsexual expressions of love such as touching and prolonged skin
contact can frequently rekindle sexual desire and a healthy, fulfilling love
life can usually be achieved.
For men, erectile impotence is the major type of sexual dysfunction
resulting from prostate cancer. In radical prostatectomy, severed nerves are
responsible for the problem, and until recently, this was a constant
complication. Now, however, there is a nerve-sparing procedure and the
pudendal nerve, which carries penile sensations, lies outside the operative
area. The patient remains unable to gain an erection, but orgasmic function
is retained. For such patients and their partners, mutual intimate touching
is recommended for a continued satisfactory love life.
There are, however, other alternatives for dealing with erectile
impotence. There are a number of drugs that can be taken orally which will
enable a patient to gain an erection, but as a rule, they are only effective
for a few months and only work for a modest number of patients. Intrapenile
injections are successful for a large number of patients and can be easily
administered. However, repeated use may cause penile fibrosis (scarring)
which eliminates the option for a penile implant. Rigid, semirigid, and
inflatable implants are popular alternatives for couples for find penile
injections unacceptable. The inflatable ones are usually the preferred type
since they closely reproduce a physiologic erection.
Male patients, like female ones, often experience a decreased libido, and
frequently for the same reasons. Self-image and psychologic reactions to
cancer and its treatment play a major role in one's sexual image. Explore
new and alternative ways of expressing your affection for each other if the
old ones no longer work. Seek counsel with your doctor. And be assured that
you can still have a fulfilling love life.