News & Articles

A diagnosis can change physical and emotional closeness. Honest conversations and other approaches can help.

A CANCER DIAGNOSIS AND THE INTENSE TREATMENTS THAT FOLLOW MAY DISRUPT MANY ASPECTS OF LIFE, INCLUDING SEXUALITY AND INTIMACY, WHICH CAN SIGNIFICANTLY AFFECT A PATIENT'S QUALITY OF LIFE. However, in a predominantly Asian society that values modesty, discussions about sexual issues are rare. This silence might lead to secrecy, misunderstandings and unnecessary suffering. Furthermore, issues related to sexuality are often sidelined in cancer care, even during recovery.

Why Sexuality and Intimacy Matter

Research has shown that cancer affects sexual function, self-perception and relationship intimacy. These changes can contribute to loneliness, emotional disconnection between partners, anxiety, depression and feelings of inadequacy. Studies also indicate that sex and physical intimacy can reduce stress, improve mood and help patients cope with pain through the release of feel-good hormones. Addressing concerns about sexuality and intimacy is crucial — not only to reduce these repercussions but also to promote the overall well-being for individuals and their relationships.

What are Sexuality and Intimacy?

Sexuality encompasses attitudes, thoughts, desires and behaviours related to sex and physical intimacy. Intimacy is the feeling of closeness and emotional connection with another person, which is essential in healthy relationships. While sex can enhance intimacy, the two are not synonymous. Intimacy can exist even without sexual activity. Being affectionate, communicating openly and showing respect to your partner are key ways to foster intimacy.

How Does Cancer Impact Sexuality and Intimacy?

Some factors that can affect sexuality and intimacy during the cancer journey include cancer treatments, viewing a partner as a “patient” and fatigue from the demands of caregiving.

Having cancer and undergoing treatments can profoundly affect sexual function, relationship intimacy and self-perception, regardless of whether the cancer directly involves sexual organs. While cancers of the breast, cervix, prostate and testicles may alter bodily sensations during sexual activity, other cancers can also significantly impact sexual well-being. Side effects such as hair loss, pain, fatigue, nausea and weight fluctuations can reduce sexual desire and function. These changes may cause individuals to feel less attractive or less feminine or masculine, further diminishing their sexual drive.

Additionally, partners often shift from “lover” to “caregiver”, making it difficult to maintain a sexual connection, especially when caregiving involves managing incontinence and assisting with daily tasks such as feeding, bathing and mobility. Some partners may also perceive sexual activity as inappropriate during cancer and treatment. When coital sex becomes difficult or undesirable, couples might avoid all forms of physical intimacy. This avoidance can stem from an overemphasis on coital sex, a lack of awareness of alternative forms of intimacy and difficulty communicating openly about sexual boundaries and preferences.

Recognising the Positive Impact of Cancer on Intimacy

While cancer can challenge relationships, it can also deepen intimacy. Research suggests that, in some cases, the experience strengthens a couple's bonds. The absence of sex does not necessarily diminish intimacy. Instead, some couples find greater emotional closeness through appreciation for one another, shared resilience and improved communication.

Sexuality and intimacy are crucial to well-being and quality of life, even during the cancer journey. While cancer may change how intimacy is experienced, it does not need to end. By fostering open communication, embracing alternative forms of connection and seeking support when needed, patients and their partners can navigate these challenges together with greater understanding and empathy.

What Can You Do?

Here are some ways you can adapt to help yourself and your partner:

I) Normalising Difficulties with Sexuality and Intimacy

Due to the physical and emotional changes caused by cancer, many people experience challenges in their sexual life and sense of intimacy. Sexuality may no longer feel the same, and individuals often do not feel like themselves. Many patients and their partners experience reduced sexual desire, feelings of low desirability and lower self-esteem. These difficulties are common, and you are not alone. Acknowledging these challenges as normal can help reduce feelings of isolation and encourage couples to seek support.

II) Accepting Unpleasant Emotions

Changes in sexual life, including reduced or absent intimacy, can lead to feelings of loneliness, low self-esteem, sadness and anger for both patients and their partners. Recognising these feelings as valid is crucial. This provides space for the acknowledgement of losses and the adjustment to new sexual realities, which fosters emotional healing.

III) Managing Difficult Thoughts and Emotions

Acknowledging and accepting difficult thoughts and feelings can make them easier to manage. Reflecting and writing them down can be therapeutic and help identify rigid or false assumptions, such as “I’m unattractive because I lost my hair”, which overlooks a patient’s other positive attributes.

Take your time to appreciate your body and recognise its strength and resilience in managing cancer. In some cases, professional support may be helpful in navigating these thoughts. Engaging in restorative activities such as yoga, stretching or walking can also help in managing difficult emotions.

IV) Embracing Flexibility in Sexuality, Intimacy and Beauty Concepts

While some cancer patients successfully renegotiate sexual activity and intimacy after treatment, many struggle with these changes, as studies have shown. Maintaining an open and flexible mindset about alternative forms of intimacy and expanding concepts of beauty and self-identity are important. Intimacy is not limited to coital sex. Manual stimulation, the use of sex toys and affectionate acts such as cuddling, touching and kissing can be fulfilling and help partners stay connected.

V) Managing Body Image

Take control of your body image and explore ways to feel and look good. Wear clothing that boosts your confidence. Consider makeover workshops and tutorials designed for cancer patients. They offer beauty tips and techniques to enhance your appearance — you might be pleasantly surprised. Exercising and eating well can also improve self-confidence and overall well-being.

VI) Encouraging Open Communication about Needs and Desires

Many people struggle to discuss their sexual needs and concerns with their partner or healthcare professionals. Caregivers may worry that doing so seems insensitive, while patients may feel hurt by a partner’s lack of sexual interest.

Open communication is key to navigating these concerns and finding new ways to connect intimately. It is worth noting that some couples thrive without a sexual component in their relationship, focusing instead on other forms of bonding. Though discussing these topics may feel difficult at first, open and respectful communication on one’s needs and desires can deepen understanding and strengthen relationships.

Using “I” statements can reduce defensiveness and provide context to improve your partner's understanding. For example: “When you don’t hug or kiss me like before, I feel insecure and less desired.”

VII) Discussing Sexuality Issues with a Healthcare Professional

Patients and their partners often hesitate to raise concerns about sexuality issues with healthcare professionals due to discomfort or the belief that these issues are trivial. However, discussing them with your healthcare team can help normalise them and identify coping strategies. When healthcare professionals take the initiative to address sexuality concerns, it reinforces the importance of these issues and encourages couples to manage these changes together.

Reflecting on your concerns ahead of medical appointments may make it easier to raise these topics. Some questions to consider asking include:

• What are the potential sexual side effects of my treatment?
• Is it safe to have sex? Do I need to use birth control?

VIII) Adopting a Sex-Positive Attitude

A sex-positive attitude recognises sex as a natural and healthy part of life rather than a taboo or something to be ashamed of, while also respecting diverse sexual preferences and consensual practices. Cultivating this mindset can help couples experience the benefits of intimacy. A positive approach to sexuality can enhance quality of life, boost self-esteem and strengthen bonds. Enjoying intimacy with your partner may also help reduce pain through the release of feel-good hormones. This can foster positive feelings about yourself and strengthen the relationship.

Sexuality and intimacy are crucial to well-being and quality of life, even during the cancer journey.