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Navigating Intimacy: A Guide for Couples During and After Cancer Treatment

If you’re diagnosed with cancer, you face one of life’s most challenging situations. As you’re dealing with treatment or its after effects and the emotional strain, you may find that cancer is impacting your sexual health and your relationships. But intimacy is especially important during this time since it can bring comfort, support and emotional healing to you and your partner.

“Roughly 90% of cancer patients experience a change to their sexual well-being throughout a cancer diagnosis or treatment,” said Audra Zachman, a gynecologic oncology specialist with Banner MD Anderson Cancer Center. “And sexuality is intrinsic to your sense of self throughout your life. It can be a vital form of expression that helps relieve suffering, offer meaning and maintain connection in the face of illness.”

How cancer can impact intimacy

“There can be several challenges in maintaining intimacy throughout a cancer journey. They can include alterations in sexual desire, arousal, functionality and satisfaction,” Dr. Zachman said.

Cancer can cause physical and emotional changes that can affect your sexual health. Physically, cancer and its treatments can cause fatigue, pain and changes in your appearance and your sexual function. Uncertainty about the future and the challenges of treatment may raise mental health issues. Understanding these changes can help you begin to overcome them.

During and after cancer treatment, you may worry about how your partner perceives you. And your partner may feel as though they don’t know what to do to support you. You may have changes in sexual desire, concerns about fertility and trouble communicating. These concerns are all normal reactions when you’re dealing with cancer.

How to foster intimacy and sexual well-being

“Your sense of connection with others and your ability to accept and recognize yourself may be challenged throughout your cancer journey. If the ability to express intimacy feels challenged, taken away or changed, it can decrease the quality of life for many people,” Dr. Zachman said.

You and your partner will want to address your fears and share your concerns. You both need to be heard, understood and supported as you nurture intimacy in your relationship. 

The first step is to communicate openly and honestly, sharing your thoughts, hopes and fears. “With unpredictable changes occurring to your sexual self during cancer diagnosis and treatment, having an open line of communication is vital. This may be a foreign area of conversation. But keep in mind that it’s normal for these changes to affect you, your partner and your relationship,” Dr. Zachman said.

Listening actively and without judgment is key to your conversations. It can help to:

  • State your concerns or desires with “I” statements like “I feel...” or “I would like...” to help avoid blame and encourage understanding. 
  • Be patient and understand that discussing intimate matters may take time. Give each other space to express thoughts and feelings at a comfortable pace.
  • Express your emotional needs and concerns. This can deepen your emotional connection.

Adjusting to physical changes

Cancer and cancer treatment may cause scars, hair loss, weight fluctuation or changes in your skin tone. These changes may affect your self-esteem and body image. “Anticipating and understanding some of the physical changes that are likely to happen during and after your treatment plan is key to management and acceptance,” Dr. Zachman said.

Dealing with changes can take patience, understanding and support. It can help if you and your partner:

  • Discuss how physical changes are affecting each of you and how you can support each other.
  • Explore forms of intimacy that can strengthen your emotional bond, such as deepening your communication and sharing experiences and activities.
  • Learn what’s causing your physical changes and what to expect by speaking with health care providers. If possible, attend appointments together.
  • Ask your health care provider for advice and resources. They can connect you with specialized retailers and organizations that offer tools to help with intimacy.

Rediscovering intimacy

You and your partner may want to explore forms of intimacy beyond physical connection. You can build a deeper emotional bond by sharing thoughts, dreams and fears. Talk about what intimacy means to each of you and share your desires and boundaries.

Emotional and psychological intimacy can help you and your partner deepen your bond, navigate difficult times, promote resilience and improve your well-being.

Create a sense of closeness and connection by holding hands, hugging and being present for each other. Strengthen your bond by sharing hobbies, enjoying nature or exploring creative activities.

Professional support can help you build intimacy

Sharing your concerns and challenges with your health care providers is important. They can provide medical insights so you can make decisions, give advice focused on you and your situation, include intimacy as part of your treatment plan and connect you with resources and support. 

These professionals and resources may help:

  • Sex therapists can work with you as you manage changes in sexual function, desire and communication. Look for a therapist who has experience in cancer-related intimacy issues.
  • Counselors with experience in cancer or relationship counseling can give you a safe, supportive space to talk about challenges with your emotions or relationship.
  • Support groups focused on intimacy and cancer can help you connect with others facing similar challenges, share experiences and gain insights.
  • Online resources dedicated to cancer and intimacy may have articles, forums and webinars that offer information and perspectives.

Intimacy after cancer treatment

When you reach the end of cancer treatment and move into survivorship, it’s a major milestone. But the emotional impact of dealing with cancer may still be part of your life. You may feel a mix of emotions, such as joy, relief and fear. 

It can be helpful for you and your partner to share your emotions, talk about how you have both changed and adjust your expectations, since life after cancer may not be the same as it was before your diagnosis.

This may be a good time to set goals for the future together, giving you a sense of purpose. You can also find new ways to connect emotionally, mentally and physically. 

Remember that you will both change physically and emotionally over time and working through these changes together can keep your relationship thriving. 

The bottom line

The physical and emotional changes you go through during and after cancer treatment can take a toll on your sexual well-being. By knowing what to expect and communicating with your partner, you can take steps to maintain intimacy.

If you would like professional help addressing sexual health concerns and cancer, reach out to an expert at Banner Health or connect with the Sexual Wellness Clinic at MD Anderson Cancer Center.

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