Cancer and its treatment can affect every aspect of a patient’s life, and many patients talk about how to find a “new normal” after a cancer diagnosis. Sharon Bober, PhD, director of Dana-Farber’s Sexual Health Program, says part of this new normal can be changes in your sexual and intimate life.
“If you’re not feeling great or don’t feel like yourself, you may not want to be sexually active in the same way you were before treatment,” Bober says. “But that doesn’t mean you aren’t able to maintain intimacy.”
Here are four tips Bober recommends for patients on how to maintain intimacy during treatment.
Find what feels pleasurable for you.
Patients on chemotherapy may not feel physically well, and those on hormonal therapy may be in early menopause or otherwise experience changes to their sexual desire or ability.
“Take time to check in and ask what would actually feel relaxing, comforting, and build connection,” Bober recommends. This may include something like a back rub, or spending time alone with your partner holding hands and taking a walk.
Patients who have had surgery may experience loss of sensation or have new scars that cause body image concerns. Bober stresses the importance of recognizing these changes and working through them rather than waiting until you feel like “yourself” again.
“The goal is to figure out what would feel pleasurable where you are right now and what would help you feel closer to your partner,” she says. “It may be figuring out what kind of touch is comfortable, close, and feels intimate. It may be physical, but it may not be.”
This might include focusing on pleasuring your partner, Bober adds.
“Your biggest sex organ is your brain – and pleasuring your partner can be a turn on for many men who may not be able to have an erection,” she says. “Sex doesn’t have to just be intercourse; it’s important to be creative and explore what feels pleasurable for you both.”
Self-touch can be an important way to reconnect with your body and learn what feels comfortable for you. Women may need to “remap” the parts of their bodies they feel comfortable being “in play” during intimate activities. Breast surgery, for example, may cause body image issues or a loss of sensation in an area that may have been a big part of your experience before. Negotiate with your partner what feels OK and what doesn’t, Bober says.
Be open with your partner.
Physical and emotional changes related to cancer are often on both partners’ minds, and can be a cause of added stress, worry, and guilt during an already difficult time.
“It’s often the elephant in the room for many couples because no one wants to upset the other,” Bober says. She recommends having these conversations in a neutral place – not in bed at 11 p.m. – and recognizing the changes to your intimate life without pressuring the other person.
Avoid making assumptions.
Some patients who have scars, or lack of sensation or ability to get an erection, may feel “damaged” and think their partner or potential partners may not want to be intimate with them. But Bober stresses that your experience of sexuality is not defined by any one body part or activity.
“The capacity for giving and receiving pleasure is not narrowly defined, or just about intercourse,” she says. “There often are a wide range of expectations about what an intimate relationship may look like, and it’s important to not assume that your own assumptions are what everybody else is thinking.”
Get into a dating mindset.
Bober recommends taking things slow after a cancer diagnosis – whether you are partnered or not, together for many years or dating someone new.
“Cancer is a new chapter in your intimate life, not a continuation of the same,” she says.
As many often do when dating, Bober recommends dipping a toe in and building a repertoire of what feels nice before jumping into intercourse. Some things might not work, but removing the pressure that things will be the same as they were before treatment can prevent some frustration.
“We have to establish new routines in much of our lives after cancer,” Bober explains. “We have to do that in our intimate lives as well.”
Learn more about sexual health, intimacy, and cancer from Bober’s recent chat with Dana-Farber, during which she answered live questions from patients and their partners.