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CancerQuest > Introduction to Patient Information > Survivorship: Overview > Emotional and Psychosocial Effects of Cancer > Intimacy, Body Image

Intimacy, Body Image

Introduction
People undergoing cancer treatment may lose their hair, experience weight changes, get surgical scars or have body parts surgically altered/removed. It is normal for these events to change a person's sex drive and body image. Cancer/cancer treatments affecting reproductive organs (breast, prostate, testicles, etc.) may cause patients to question their social and sexual identity as a 'man' or 'woman'. ^{(1) (2)} This is true for people of all ages, genders, cultures, cancer types, and is independent of partnership status. ⁽¹⁾ Because doctors may not discuss this issue, patients may incorrectly feel they are abnormal to be concerned about their sexuality and sex life. ⁽³⁾

In fact, most people going through cancer treatment feel that their needs and concerns about sexual and intimate changes are not adequately met by their health care professionals. ⁽¹⁾ Doctors trained in traditional Western medical schools learn ways to handle the functional aspects of patient sexuality such as fertility, erectile dysfunction, or menopause. Frequently, their training does not prepare them to provide guidance about sensuality and intimacy issues. ⁽²⁾ Doctors often avoid the topic of intimacy because it is not a 'life or death' issue, there is not enough time, they themselves are embarrassed about the topic, or they do not have experience in this area. ^{(4) (5) (6)} Some health professionals also struggle to accept the fact that people with life-threatening illnesses, particularly elderly people, have sexual concerns. ⁽⁷⁾

Importance
Desire for survival can take precedence over other concerns when people are first diagnosed with a life-threatening disease like cancer. ⁽⁸⁾ Cancer patients may lose interest in sex and even though few talk about it, this is quite normal. Over time, patients may wish to 'get on with life' and return to normal activities. ⁽⁸⁾ Sexuality can be important to a person's identity and a change in body image can affect intimate and social relationships. ⁽⁸⁾ Intimacy with a partner can also be an important way to communicate, alleviate suffering and retain a sense of self. ^{(7) (8)}

Treatment
It may take time and patience to adjust to fatigue, altered sensations, or prostheses. Patients should speak with their health care professionals about any concerns or questions they may have.⁽⁸⁾ Unfortunately, there has not been much research about how to best deal with changes in sexuality, body image and intimacy related to cancer. ⁽²⁾

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References for this page:

1. Hordern AJ, Street AF. Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs. Med J Aust. 2007 186(5): 224-7 [PUBMED]
2. Hordern AJ, Street AF. Constructions of sexuality and intimacy after cancer: patient and health professional perspectives. Soc Sci Med. 2007 Apr;64(8):1704-18. Epub 2007 Jan 29 [PUBMED]
3. Wilmoth MC. The aftermath of breast cancer: an altered sexual self. Cancer Nurs 2001; 24: 278-286 [PUBMED]
4. Stead, M. L., Brown, J. M., Fallowfield, L., & Selby, P. (2002). Communication about sexual problems and sexual concerns in ovarian cancer: A qualitative study. Western Journal of Medicine, 176(1), 1819 [PUBMED]
5. Stead, M. L., Brown, J. M., Fallowfield, L., & Selby, P. (2003). Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. British Journal of Cancer, 88, 666671. [PUBMED]
6. Lemieux L, Kaiser S, Pereira J, Meadows L. Sexuality in palliative care: patient perspectives. Palliat Med 2004; 18: 630-637 [PUBMED]
7. Hordern A, Currow D. A patient-centred approach to sexuality in the face of life-limiting illness. Med J Aust 2003 179 (6 Suppl): 8-11 [PUBMED]
8. Hordern A. Intimacy and sexuality for the woman with breast cancer. Cancer Nurs 2000; 23: 230-236 [PUBMED]