How to Maintain Intimacy During Cancer Care

It’s a sad irony that during cancer treatment – when patients need their loved ones most – patients can feel disconnected, and thanks to changes in their bodies and energy levels, have little desire for intimacy.   

“Many couples go through a period of sexual inactivity during cancer treatment because of the pain, nausea, fatigue, and anxiety of going through therapies such as cancer surgery, chemotherapy, radiation therapy, or the new personalized biological treatments,” says Leslie R. Schover, PhD, founder of Will2Love, a website focused on sexuality and cancer.   

“In addition, it is hard to feel attractive when cancer treatment is changing your appearance in general, and especially for people who undergo surgery for mastectomy or breast reconstruction, or surgery that includes amputation or facial changes,” she says.   

Medical challenges 

For some patients, engaging in intercourse during chemotherapy, when blood counts are low, should be avoided, due to the risk of infection.1 Once blood counts return to normal, sexual activities can resume after talking to your doctor.   

But even with a medical OK, some patients may not feel up to it, due to low energy levels or apprehension over physical changes. Cancers that affect the reproductive organs, such as prostate cancer, can be especially problematic.

“[Cancer can cause] physical damage to the systems needed for a healthy sex life,” says Schover. The harm caused can include, “changes in hormone levels that impact sex drive and damage to the genital area and its blood supply from pelvic radiation, as well as the effects of long-lasting fatigue, chronic pain, and nausea.”    

The key to “getting back to a happy sex life,” she says, “requires some effort and collaboration, so individual coping skills and the strength of communication and caring in a relationship are key.”

Re-igniting your passion

Some strategies for re-igniting sexual intimacy during or after cancer treatment include experimenting with positions that require less energy, such as side-lying positions; planning time to be intimate when the patient is well-rested; massage or warm baths, which can relax muscles, lessening discomfort; and alternative forms of touch, including caressing and hugging. For women who have undergone chemotherapy, a water-soluble lubricant can help alleviate vaginal changes.1   

“I often suggest that couples experiment alone with self-stimulation just to explore their own ability to get sexually aroused without worrying about pleasing a partner,” says Schover. “Couples can start slowly with exchanging massages or back rubs, or just cuddling on the couch or ‘making out.’ It is not a good idea to plan a major ‘event’ like a second honeymoon and to hope that once lovemaking starts, everything will be just as it was before the illness intervened.”

Indeed, some couples may experience intimacy issues long after cancer treatment has ended. Schover recommends seeing a medical or mental health professional who understands cancer-related sexual problems and how to treat them.

“Most of the problems do not just fade away with time,” she says, “but require some medical and emotional investment to overcome.”   



1. Sexual intimacy during center treatment. Dana-Farber Cancer Institute. Accessed May 1, 2020.



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