Sexuality and Cancer

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When you are diagnosed with cancer, the focus of your treatment is on getting rid of the cancer. As your treatments progress, you begin to deal with quality of life issues. The impact of cancer or its treatments on quality of life is immeasurable. Often, sexuality is an overlooked quality of life issue. The health care professional assumes that if sexuality were important to the patient, you would bring it up, while the patient thinks if it is important, the health care professional would mention it. Consequently, while other quality of life issues are discussed, sexuality is not.

Sexuality is an important quality of life issue and includes how you feel about yourself as a man or a woman as well as how you relate to others. It is more than gender or sexual intercourse and, most importantly, cannot be destroyed. Regardless of your age, you are a sexual being.

Because the health care team focuses on living with cancer, sometimes sexuality is overlooked. It is also a difficult topic for most people to discuss regardless of being a health care professional or a lay person. By acknowledging the importance of sexuality in a person's life, the health care professional can help you deal with sexual changes that result from cancer treatment or the cancer itself.

It is important to be aware of the phases of sexual activity in order to give the physician or nurse accurate information about sexual changes that you may be experiencing. The first phase is desire or libido, while the second phase is arousal. During the arousal phase, the penis fills with blood and lengthens and widens and gets erect. For women, the vagina lubricates. The third phase is orgasm or climax: the height of sexual pleasure. And the final phase is the resolution phase where the genitals return to their unexcited state. Included in this phase is the refractory period in which the penis is unable to be get rigid. For young men, this might be a matter of minutes, while in older men or men who have an illness, it may be a matter of days. When there is a change in any phase, it can be considered a sexual dysfunction, even though the other phases are intact.

There can be a variety of influences on sexuality including physical, psychological and social changes. When you are experiencing side effects such as fatigue, pain, nausea, insomnia, or constipation, you are not going to be very focused on sexual activity. Likewise, depression or anxiety can also interfere with sexuality. Not being able to work or care for yourself or having financial difficulties can also detract from sexual thoughts.

Certain medications have side effects that can interfere with sexuality. Most people are aware of the sexual side effects of certain anti-hypertensives, as well as nicotine, and alcohol. But while taking chemotherapy, people often notice a decreased sexual desire and for men an inability to get an erection. Medications for nausea, anxiety, sleep, pain or seizures may also cause decreased libido and erectile dysfunction. It is important to know that this might happen so that you can ask your physician if a change in medicine might improve sexual functioning.

People do not communicate with each other about sexuality; consequently, couples often stop having sexual intercourse without any discussion. This can be very confusing for the partner who is well and interested in sexual activities, but reluctant to talk with the person with cancer for fear of making him/her feel worse. When sexual intercourse stops, other forms of intimacy also change. People don't hug and kiss as much as they did before for fear of arousing each other and not being able to have sexual intercourse. Sometimes the person with cancer is ashamed of this change in sexual functioning and hesitant to talk with someone else about it.

Planning for sexual activities may become important so that you can take medicine for pain or other symptoms 30 minutes before that you can be prepared for this activity. Sometimes people find that even though they may not have a sexual desire, when they engage in sexual activity, they are arouseable and able to enjoy it. Vaginal lubricants are helpful in dealing with vaginal dryness experienced by so many menopausal women.

Men with erectile dysfunction may be helped by sildenifil (Viagra), alprostadil (MUSE) penile suppositories, vacuum devices, penile injections or penile implants. All of these have to be prescribed by a physician. Using different sexual positions may be necessary, depending on the sexual dysfunction. Some couples find it helpful to read books, such as ``The Joy of Sex'', that give them ideas about alternative ways of sexually pleasing each other. The American Cancer Society publishes an excellent booklet, ``Sexuality and Cancer'', which can explain facts about cancer and sexuality.

Knowing that cancer can affect sexuality can give you permission to ask your health care provider about sexual changes that you have noticed. This will help you to have a better quality of life. After all, you are the one who decides what is a good quality of life and if sexuality is important to you, it is up to you to bring this to the health care provider's attention.

Submitted and used with permission by Mary K. Hughes, MS, RN
c/o Mary K. Hughes, MS, RN
The University of Texas MD Anderson Cancer Center
Department of Neuro-Oncology
Psychiatry Section
Clinical Nurse Specialist
1515 Holcombe- 100
Houston, TX 77030

[fucker]

I had cancer. I hate Doctors, and i hate everything i went through.  Im only 17.  Had it when I was 15 and everything in that article is pretty much true.  Chemotherapy kills all the cells in you body so it kinda stunned my growth.  My penis was 7 inches and shrunk to 6 and a quarter probably because i was so damn depressed that i masterbated more than usual and my body couldnt grow and recover because of the drugs. Even though 6 inches is still average just the fact that i had to go through all that shit made me want to kill myself.  I was on so many drugs and i was sick all the time. I was on medicine for constipation, steriods, antibotics, painkillers(vicoden, morphine) becuase the chemo makes you feel like you heads gonna explode. Im not gonna tell you all that i went throught because it makes me angry that doctors dont give a shit about you.  I dont even go to the doctor anymore. Trust me all you need is a chiropractor and a nutriotionist and you can feel better than ever.  Im out of remission an doing better than ever and i feel really good most of the time because i go to a homeopathic doctor and take a vege drink every morning.  Im am still depressed though suposively the chemo Fuc*** up my liver and that why im so depressed. The "Normal" Doctors and a couciler tried to put me on zoloft but that doesnt help me with what i want help with.  Zoloft decreases sex drive, causes erictile disfunction, and impotency and it practicaly stops your liver from working all together.  I Broke out in a horrible rash and stoped after 5 days.  I felt good the first 2 days of being on it but it was  bunch of bullshit because they said it doesnt work until after the first month which jsut means people dont need pills at all they just need to think and know that they are fine.  What i really wanted to know is if there is anyway i can increase my size to at least where i was at 7 inches i know there are manuals on the internet and pills but i dont have a credit card or access to that and i dont know what works everyone says increase you penis size up to 5 inches but that is bullshit i dont think there is anyway you can do that. I could get herbs and stuff easily becuase i work at a nutrition store but i only know that l-arginine helps with circulation and erection i dont know about anything else.  All i really want is some advice its really hard to talk to my parents i dont get along with my dad at all he barely talks to me and i dont want to talk to my mom about the size of my penis. Also if anyone else had to deal with depression that could give me any advice that would be great. Im still a virgin but i have done everything else but ever since i got cancer things have been going downhill and i just dont know what to do so any advice is greatly apreciated.

Thanks,
John

[kirsh]

Hi John,
  My name is Kelly and I am a 21 year old student from San Diego.  I read your posting because I was looking for inspiration to try and help my boyfriend.  My boyfriend has been struggling with a personal problem that he never shared with me until recently.  I found out that when he was 13 he had cancer and had to go through all the shit you talked about in your posting.  You see, I have had a hard past, so I wanted to wait to do anything sexual until I felt ready with him... suddenly I was ready, and I found out something that he had been keeping from me, the chemotherapy he went through during puberty had stunned his growth as well.  I think his case was a bit worse then yours since at 13 he wasn't anywhere close to fully developed.  We talked about his depression and how scared he was to lose me.  In all honesty, he is the most amazing man Ive ever met, and because of the hell he has been through, his character makes him stand far above anyone else.  He is more compassionate, understanding, and values life in a different way then the average person.  He use to be super depressed, as was I a depressed person, but when we met everything changed.  I know that he has options that can help him with his size, but most of the options are dangerous or have fertility side effects. 
As a woman, I want to tell you that the best thing you can do is be confident with what you have.  I can honestly tell you that the best sex ive had has not been with the "biggest" guy ive been with.  Its all about being aware of the woman you re with and being aware of what makes her feel best. 
I too am a big fan of homeopathic medicine, and I will be researching this further, if I find any relevant information ill let you know. 
Just know that you got a shitty hand.  Its not fair at all that you have to go through any of the shit that you do.  But my boyfriend decided that he didn't want to play a victim to his circumstances cause then he would just be miserable the rest of his life.  If you ever want anyone to discuss anything with or if you find out any information that can help my boyfriend.  I have myspace, or you can e-mail me at kellykirsh@yahoo.com.

[fucker]

thank you, i'm doing a alot better and i have some good friends. Its times like those where you find out who your real friends are. I will email you i know all the nutritional stuff and i know alot of nutritional stuff that could help your boyfriend that helped me i just got a mypsace too my email is fuhcq2@gmail.com