Don't let sex be forbidden topic after cancer

While you were growing up, how many of you were taught that discussions about sex were inappropriate for casual conversation? For some of us, the topic was not only absent from social conversation, but also in our families. Obviously, this has nothing to do with the importance of sex and intimacy in our lives but more to do with our cultural background and a discomfort related to openly talking about highly personal issues. Unfortunately, that same discomfort may interfere with getting helpful information regarding changes in sexuality that frequently occur with various cancer treatments.

Several cancers or their treatments have the potential to impact sexual function and response. Any of the following cancer-related situations may lead to changes in our sexual response:

• The presence of surgical scars or removal of reproductive organs
• The inability to reach an orgasm
• The experience or fear of pain during intercourse
• A lack of desire for sex
• An increase in fatigue related to the diagnosis or its treatment

As healthcare providers, we know sexual concerns may be difficult to discuss. But frequently there are suggestions that can help. In the past, some people have told me that with a new cancer diagnosis, so much information was given that thoughts of sex didn't even surface in their minds. Others said it was one of the first things they thought about but were too embarrassed to ask questions. Others said that during treatment, they were either so sick or tired that it wasn't a concern. Once they were feeling stronger, however, sexual problems were a significant concern for them and their partner. Yet even then, they were hesitant to mention it to their healthcare provider.

Our need for intimacy and closeness doesn't stop with a cancer diagnosis. Getting the information and support you need to live life to its fullest is important. Everyone's situation is different regarding when and how you like to receive information. Some may want to have open conversations that are initiated by either person in a relationship or with their healthcare provider when a troubling situation occurs. Others are more private and prefer brochures or visiting a reputable website that provides reliable information.

I'd love to hear your thoughts about what would work best for you if you wanted information about your sexual concerns. If you prefer conversations with a healthcare provider on the subject of sex and intimacy, when is the best time for this to happen? Is it when making decisions regarding treatment options, during treatment or perhaps at follow-up appointments? Thank you for providing input on this important topic.