Sex Ed for Cancer Survivors is Often Missing
One of the common issues for people dealing with any kind of medical issue is how their health affects sexuality. Sometimes, the illness or injury has a direct effect on sexual pleasure or function. And sometimes, the treatment or the medication affects it.
When it comes to cancer, both are possible. Worries about money, health, or other stresses often result in putting sex on the back burner. Physical discomfort or pain can interfere with sex. And treatments, such as surgery, radiation, or chemotherapy, can leave people feeling uninterested in sex or can cause nausea, exhaustion or pain, which can definitely get in the way. Body image issues, whether it’s from hair loss, mastectomy, ostomy bags, erectile dysfunction from prostate surgery, and vaginal sensitivity or decreased lubrication from radiation therapy add to the mix.
Unfortunately, most doctors are simply unprepared to support people as they try to figure out how to make it all work. According to the article Assessing Gynecologic and Breast Cancer Survivor’ Sexual Health Care Needs, which was recently published in the journal Cancer, over 40% of women with gynecologic or breast cancer wanted medical help for sexual issues, but only 7% had asked their doctors for it. Younger women were both more likely to want such care and to seek it out. And women who had last received treatment more than a year in the past were more likely to want it, perhaps because things had settled down somewhat for them at that point.
One of the patterns that comes up over and over among medical and mental health professionals is the lack of training and support around sexuality. And even when they have the information, they tend to be hesitant to broach the topic. I’ve read quite a few studies that show that patients often want support but they want the doctor to bring it up because they don’t know if the doc has the skills or info. On the other hand, many professionals say that they’d be happy to talk about it, but that they want the patient to ask because they don’t want to make people feel uncomfortable.
Personally, I think that’s a bit of a cop-out because I believe that it’s the doctors job to talk about the effects that health, disease and treatment have on sex. After all, they have a responsibility to tell patients about side effects of medications or the risks of surgery without waiting for patients to ask, don’t they?
Fortunately, there are some good resources out there.
The American Cancer Society has two excellent books: Sexuality for the Man With Cancer and Sexuality for the Woman With Cancer, which you can read on their website or order a free copy by calling 1-800-227-2345. Oncology nurse Anne Katz also wrote two fantastic guides: Woman Cancer Sex and Man Cancer Sex. One thing about these books is that they assume cissexuality and are primarily focused on heterosexual folks. Katz’s books do have sections for gay and lesbian folks, but it’s not as integrated into the information as I’d like.
Dr. Sueann Mark is a clinical sexologist and cancer survivor. And she’s amazing. Plus, if you’re not in the San Francisco area, she does phone consultations.
And remember that your doctor may actually know more about sex than you think. While it’s unfortunate that they tend to not bring it up, it’s worth asking about it. If you don’t get the info you need, get a referral. You deserve the support you need to have a great sex life, no matter what your medical condition.