Many cancer patients face sexual problems from cancer treatment. Diminished libido, arousal difficulties, pain, vaginal dryness, erectile dysfunction (ED), and ejaculation trouble are some of the more common effects.
In some cases, patients can make decisions about sexual function when they plan their treatment with their oncology team. The following slides offer some examples.
Testosterone
Testosterone is an important sex hormone for men, as it drives much of their libido and sexual function. Some men feel that their quality of life would suffer if they were not able to experience intimacy the same way as they did before cancer. They might opt for less aggressive cancer treatments that preserve testosterone levels, even if that means their prognosis is poorer.
Nerve-sparing Treatments
Nerves play an essential role in sexuality. When a person is sexually stimulated, nerves carry messages between the brain and the genitals. This starts the arousal process – such as an erection for men or vaginal lubrication for women.
Some cancer treatments, such as radical prostatectomy (surgical removal of the prostate gland) can potentially damage nerves related to sexual function. For example, the prostate gland is surrounded by nerves necessary for erections. In nerve-sparing procedures, surgeons preserve as many nerves as possible to lower the risk of ED.
Hysterectomies and colorectal surgeries may also be done in a nerve-sparing manner.
Nipple-sparing Treatments
Women with breast cancer may choose nipple-sparing mastectomy, which preserves the nipple area. Breasts can then be reconstructed around the nipple. Women may not feel the same nipple sensations as they did before surgery, but keeping the nipples can foster a more positive body image, which contributes to better sexual function.
Keep in mind that there is no one-size-fits-all approach for preserving sexuality after cancer treatment. Patients should ask their doctors what will work best for their personal situation.
While some physical aspects can be addressed, it is still important to maintain healthy intimate relationships with partners and take advantage of products and services that can help maintain sexual function.
For example,
water-based lubricants may make intercourse more comfortable for women with vaginal dryness. Treatments for erectile dysfunction is available, and men should not hesitate to ask about them. (Note: There many approaches to treating sexual problems after cancer, and one’s doctor can provide the best advice.)
Counseling and sex therapy – alone or as a couple – may also be beneficial.