Many types of cancer treatment (such as surgery and chemotherapy) can affect sexual functioning. Added factors include fear, cancer fatigue, depression, and poor communication. Also, it’s not uncommon for patients to experience partial or total lack of interest in sex while in treatment or for some time afterward. People often are embarrassed to talk about sex. They are hesitant to bring up the topic with their doctor or health care team, or even with their sexual partner. As a result, questions go unanswered and relationships suffer. It’s important to understand that a number of medical and psychological treatments are available to help you continue a satisfying sex life after cancer. The following are some questions you may want to discuss with your doctor, nurse, or social worker:
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Do I need to refrain from sexual intercourse for a certain length of time? If so, when can I be sexually active again?
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Will my cancer and/or treatment affect my sexual functioning? What changes should I expect? Will these changes last only a short time or will they be permanent?
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Can you recommend a sex therapist whom I might see if I need some counseling or help during my cancer treatment?
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Have you found that health insurance usually covers sex therapy that is related to cancer? Will you help me obtain coverage if it is part of my policy (such as writing a letter in support of sex therapy)?
With time and information you can often resolve sexual problems caused by your cancer or its treatment. There are excellent written resources, and you may find a support group helpful.
Fertility
Cancer and its treatment may also affect fertility and fetal development. Both radiation and chemotherapy can cause the fetus to be injured or malformed. Another concern is the risk of permanent sterility if the testes or ovaries receive direct radiation. If you have concerns about the effect of cancer treatment on your fertility, you should discuss the following with your doctor and health care team.
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Will the treatment affect my ability to have children?
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Is there another treatment that might preserve my ability to have children without reducing my chance of long-term survival?
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What is the risk of congenital abnormality (birth defects) in any children conceived after my treatment ends?
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Will you refer me to a fertility specialist to discuss my options before starting my treatment?
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Will preserving my fertility delay my treatment?
FOR WOMEN:
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Is there anything you can do to protect my ovaries from exposure to radiation (for example, surgical relocation)?
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Will you do a pregnancy test before starting treatment to make certain I am not pregnant now? If I am pregnant, how will this affect my treatment?
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Is it possible to harvest eggs, fertilize them, and store them as embryos before starting treatment?
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Can I still conceive a child when I am getting cancer treatment? Should my partner and I use birth control measures during treatment? What kind would you recommend or advise against? Why?
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What are the risks to me and to my child should I become pregnant during treatment for my cancer?
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Will the treatment induce menopause? Will the menopause last only a short while or will it be permanent? Would you recommend hormone replacement therapy in light of my cancer diagnosis?
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Should my partner and I use birth control measures after treatment is over? For how long? Why?
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If I am able to conceive a child after my cancer treatment is over, will there be any risk to my health?
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Once my cancer treatment is over, how long would I have to wait before trying to get pregnant?
FOR MEN:
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Is there anything you can do to protect my testicles from exposure to radiation?
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Is it possible to bank my sperm before starting treatment?
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Will you help me get insurance reimbursement for sperm banking? (Some health insurance policies will pay for sperm banking when treatment may result in infertility.)
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While I am in treatment, will I still produce sperm? Is it necessary for me to use condoms during sexual activity?
