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Sexuality and Intimacy

You may be concerned about how blood cancer and treatment will affect your current or future relationships and your sexuality. Sexuality refers to physical, psychological, social, emotional and spiritual factors. It includes self-image, body image, reproductive ability, emotional intimacy, sensual feelings and sexual functioning.

Sexuality-related concerns may arise from the physical aspects of your disease or treatment, as well as from emotional aspects. Anger, guilt or worry — about illness and survival, treatment or finances — may affect sexuality. Some physical or emotional effects resolve over time or when treatment ends. Other effects may be long lasting.

Cancer or cancer treatment may affect your sexuality in several ways:

  • You may have a different sense of self-worth and self-confidence than you did before being diagnosed with cancer.
  • You may feel depressed or anxious or have little or no interest in sex.
  • You may feel embarrassed or worry that others see you differently because of physical changes, such as weight gain, weight loss, hair loss, swelling, scars or the presence of a central line or port.
  • You may have few chances to be alone or intimate with your partner because of hospitalization or treatment schedules.
  • Survivors of childhood cancer may be self-conscious about underdevelopment or delayed development.
  • Treatment side effects, such as peripheral neuropathy or graft versus host disease, may make your skin sensitive or uncomfortable.
  • Fatigue, pain, nausea or vomiting, problems with erection or premature ejaculation, vaginal dryness or discomfort during intercourse may interfere with your ability to be interested in or enjoy sex.
  • Your oncology team may advise you to abstain from intercourse for a period if your total white cell or platelet counts are low or for other medical reasons.

Questions to Ask Your Doctor

Be open with your doctor about sexuality and intimacy so he or she can help you. If you're not sure of how to bring up the topic, here are some questions you can ask your doctor:

  • Will my treatment affect my ability to have sex? If it will, how long will this effect last?
  • Is it safe for me to have sex while I'm in treatment?
  • Will my illness or treatment affect my ability to become pregnant (or father a child)?
  • Where can I get information about fertility and family planning options?
  • Who else can I speak with about this topic? Are there counselors, sex therapists, support groups or other support services in my area?
  • (For hospitalized patients) Can you help me arrange for some private time with my partner, as long as it doesn't interfere with my medical care?
  • What do I need to know about birth control and protection from sexually transmitted infections (STIs)?

It's important to use barrier protection (condoms or dental dams) during intercourse or oral sex to protect you and your partner from STIs or from possible exposure to residues of chemotherapies that may be present in semen or the vagina. If you're of childbearing age, birth control is important because some cancer treatments can harm an unborn child. For some therapies, your doctor may advise you to use birth control for up to one year after treatment ends. Ask your healthcare team for more information.

To help you talk with your healthcare providers, you may want to:

  • Bring your partner to your next visit with your physician or counselor. Give your partner a chance to ask any questions he or she may have.
  • Ask if you can record the questions and answers. By recording what your physician or counselor says, you'll be able to replay the information as many times as you need later on.
  • Keep a journal or notebook of questions to ask your physician or counselor at your next visit. Leave space for answers so that you can refer to them afterward.

Members of your oncology team can also give you referrals to other healthcare professionals. A consultation with a gynecologist, urologist or family physician, an oncology social worker or a certified sex therapist may also be helpful. You may want to get information from support organizations, including information about maintaining intimacy in your relationships and ways you can feel more attractive. You may find value in talking with cancer survivors to learn how they're dealing with self-image issues and other aspects of their sexuality. 

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