A person's sexuality has a mental, an emotional, and a physical component, which means that often how a person sees themselves in a mirror has nothing to do with how he or she feels about his or her body or intimate relationships. For women, breast cancer can affect feelings of sexuality, as breasts are associated with fertility and sexual attractiveness. Having one or both breasts removed or having scars from treatment can lead to altered sensation in the breast area or self-consciousness in intimate situations.

For men, perhaps the most drastic, and rare, surgery for cancer is a penectomy, where a portion of or the entire penis is removed due to penile cancer. Far more common is the effect prostate cancer has on men. Even though the prostate gland is located inside the body and therefore cannot be seen, treatment for prostate cancer can damage nerves and cause impotence (inability to achieve or maintain an erection) and urinary incontinence (inability to control urination). Fortunately, more precise surgical techniques, along with prosthetic implants and some pharmaceuticals, can sometimes help men achieve a satisfactory level of sexuality.

For both men and women, the physical changes brought on by surgery or chemotherapy can have a constant effect on their well-being and body image.

Many cancers affect sexuality

It's important to note that penile, breast, and prostate cancers are not the only types of cancer that affect sexuality. Colon cancer, especially if a temporary or semi-permanent ostomy bag is used to collect bodily elimination; ovarian cancer, with its subsequent effects on hormones and possible abdominal scars; and any head or neck cancer that has left scarring or disfigurement, may drastically affect a person's sense of physical integrity and sexual function. It is understandable, in a society that places so much emphasis on beauty and physical perfection, that people who have experienced cancer and its treatments may feel nervous or anxious about resuming or beginning an intimate relationship.

Common sexual concerns shared by people with cancer

There are some common worries related to sexuality that many people with cancer share.

• Embarrassment over physical changes, including hair loss, scars, and other changes from treatments
  
  
• Concern that their partner will not find them attractive anymore, or that their partner will worry that touching can transmit disease
  
  
• Anxiety about sexual performance

A single person who is dating may have different sexual concerns than someone who is married or someone who has been in a long-term relationship. For someone who is married, often the spouse already knows the medical history, whereas, for someone who is single, there may be anxiety and fear of rejection when explaining the situation to a new partner. Feelings about changes in sexuality also vary across cultures, ages, and ethnicities.

Resources are available

Fortunately, health-care professionals have resources to help individuals restore their feelings of sexuality. These resources may include access to cosmetics (wigs, make-up, breast prostheses), reconstructive surgery or a referral to a plastic surgeon to help restore bodies radically changed by surgery (including radical oral and facial surgeries), and referrals to health-care professionals who specialize in self-image and sexuality concerns, such as sex therapists and marriage counselors.

Support groups and individual or couples' counseling is often helpful. Some problems are emotional (shyness about exposing a surgical area) and some may be physical (tenderness or pain around the affected area). Regardless, health-care professionals agree that open communication, no matter how awkward, is vital to restoring a person's sexuality following cancer treatment.

Additional resources

Lance Armstrong Foundation: Female Sexual Dysfunction

Lance Armstrong Foundation: Male Sexual Dysfunction

American Cancer Society: Sexuality for Men and Their Partners

American Cancer Society: Sexuality for Women and Their Partners

CancerCare: Caring for Yourself/Talking to Others