Sexuality and Body Image

Let’s talk this month about sexuality, body image, and cancer.

First, sexuality is important to many people, whether or not they have a physical illness, such as cancer, to contend with. In addition, sex is a great way to feel alive, a sensation that is particularly gratifying to those who may be facing the possibility of the alternative. So don’t be shy about asking your doctor questions about sexual functioning or fertility, just because you are thankful to her or him for saving your life. For cardiovascular conditioning, guided (or unguided) imagery, and massage therapy, there’s almost no activity as healthful as sex.

Unfortunately, if you have cancer or are undergoing chemotherapy, surgery, or radiation, you may not have the same level of sexual desire that you used to. Your mind is on other things and it may be hard to even imagine undertaking a sexual encounter. The moral therefore is, do the best that you can, if you feel like it, and if you don’t feel like it, don’t.

Your body may be slightly or considerably different than before. Mastectomy involves removal of a frequently involved sexual organ. Catheters protrude from where there formerly was no protrusion. Hair loss from chemotherapy makes you look and feel changed. Hormonal changes cause variable effects on sexual desire and function.

Because of these very real bodily changes, it is important to remember that the mind is the most important sexual organ, even more than body parts more frequently associated with sex. Of course, it may not be easy to feel sexual or feel entirely good about the way your body looks and feels, but over time, it is possible for sexual feeling and activity to become an important part of your life. To feel like a sexual person, it is important to feel good about yourself and who you are inside a body fighting illness. Letting go is an important aspect of sexual activity; similarly, learning to let go of negative feelings about your body can allow your mind to remember what it is like to feel desire and arousal.

Medically, all of the sexual response stages, (desire, excitement, orgasm, and resolution) may be affected by cancer, cancer treatment and medications. Depending on your individual situation, some effects may be reversible, others not. Fertility may be affected and desires for childbearing should be discussed with your physicians prior to treatment. Modern reproductive technologies are extraordinary; you may be surprised by the possibility, even if you thought there was none. Sperm or egg banking may be an option.

As well, your partner if going through considerable stresses of his or her own, his or her sexual desire and functioning are certainly not going to be what they used to be, though the magnitude and even the direction of the change are individual. Communication and negotiation with your partner are particularly important, as you both may feel like you are walking on egg shells.

Sexuality and sensuality cover a broad range of experiences, and may, but not necessarily have to, involve sexual intercourse, or even genital contact. All of our senses have a capacity to be aroused, if given the chance. Sight, hearing, smell and taste can all be deeply felt and be an important part of closeness with a loved one. Maybe a fire would be nice, perhaps even a few sips of wine (consult your physician). Music, message oil, and candles may be enjoyed. Carefully timed pain medication at proper dosages can control discomfort and allow awakeness. Consider earlier scheduling if you tend to get exhausted later in the day.

Certainly, the issues involving sexuality and cancer are considerable, and vary depending on the individual, illness and the treatment. Still, information and support are available. Depending on your situation, consultation with a variety of health care professionals may be helpful.

Beauty, Cancer & Sexuality

The American Cancer Society publishes booklets by Leslie R. Schover, PhD,
For the Man Who Has Cancer and His Partner and For the Woman Who Has Cancer and Her Partner. With forty pages of invaluable information and resources the books cover a wide variety of subjects in detail, and are highly recommended as further reading.