[Narrator]

Intimacy, sexuality, and fertility issues are often neglected topics for cancer survivors. At the time of treatment, the focus is on achieving cure or control of the disease. But, during and after treatment, cancer survivors may experience changes in their desire to be close to other people, their levels of sexual desire and ability to enjoy usual sexual activities, and sometimes in their ability to have children.

In this section, we will openly discuss sensitive material about intimacy and sexuality, and will offer practical suggestions for people who may be affected by problems commonly reported by cancer survivors. If this section is not of interest, please skip to the next section, "Family Communication." 

Intimacy involves sharing yourself with another person in more ways than through sex. Holding hands, touching, hugging, and caring deeply about another person, as well as sharing feelings, hopes, dreams, fears, emotions, and religious values are all aspects of an intimate relationship. If you were involved in a relationship as you went through treatment, that relationship may have become stronger through the course of your treatment. In some cases, however, a relationship will not last because of the stress of treatment or because of other issues that surface during or after treatment. Your feelings about life may change, and this may affect your intimate relationships.

Whether you were involved in a relationship during treatment or not, you may become involved with someone new in the future. Think about when, and how, you will share the fact that you have had cancer. Talking about your cancer history is personal and can be very important, especially early on in a new relationship. You may want to consider waiting until you and your partner have had a chance to get to know one another and feel comfortable with each other before discussing your cancer experience in depth. Once you have established good communication skills and feel comfortable being with, and talking with, each other, it may be easier to talk about your cancer experience.

When you do decide to share this information, don't assume that your partner will react in any particular way. If you are defensive or confrontational, you might frighten your partner. Television shows and movies have portrayed cancer as a painful, traumatic, and often fatal disease. An unfortunate, but normal, response to hearing the word "cancer" is to be afraid and to believe that the person with cancer will die. Be open to helping your partner understand the effect your cancer history has had on your health and on the way you lead your life now.

Some types of cancer, like cancers of the breast, prostate, urinary tract, uterus, ovary, vagina, cervix, or testicles, are associated with obvious changes in sexuality. However, it's important to keep in mind that any type of cancer can affect sexuality. Sexuality is more than just the physical acts involved in intercourse. Human sexuality is a reflection of how we see ourselves both as individuals and in relation to others. It includes how we feel about our bodies, our need for touch, our libido or level of interest in sexual activity, communicating our sexual needs to a partner, and the ability to enjoy sexual activity. Sexuality is complex and involves many factors, including the desire for emotional intimacy. For some people, the ability to have children can affect their sexuality.

A cancer diagnosis, and the treatments that follow, can affect sexuality in many ways. As a cancer survivor, you have probably experienced physical, emotional, psychological, and spiritual changes in your life. Any of these can have an impact on your sexuality and your desire for intimate contact with others. Additionally, the use of some medications, fatigue, or emotional stress can lead to a loss of the desire for sexual activity.

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