Macmillan Virtual Multidisciplinary Team

Women, sex, and life after cancer 

by Ben Heyworth

Writing in The Guardian (Sun 19^th Feb 2017), writer Marie de Hennezel shares her thoughts on sex, sexuality and aging:

“To me the goal of sensuality is not to preserve the body I had, but rather to maintain my health and desires. Perhaps for the first time, women my age are not afraid to …  reclaim our sexuality. We have desires that won’t go away as we age.”

Her comments on intimacy, eroticism and sensuality are notable for their similarities to the comments of younger women in the same article, which explore how the experience of sex and sexuality can change as women grow older, acknowledging physical and psychological changes. Indeed, rather than giving up on sex altogether, which in our youth-orientated culture could seem to be the want of the ‘older’ generation, for women sex after 50, 60, 70 or older is, according to de Hennezel, ‘a natural gift’, ‘tender and gentle’, and still imbued with ‘immense sexual pleasure’.

Above Marie de Hennezel

“I believe there is no age limit to love, sex and desire, even if we hide it after a certain  age. It is like a secret that we don’t want to reveal, but that plays a key role in the physical and psychological health of older people. We should talk about it more.”

But for many people diagnosed with cancer, talking about sex and sexuality with healthcare professionals, maintaining a ‘normal’ sex life, maintaining intimate relationships and feeling in touch with ones ‘sexual self’ can be very challenging.

Cancer Research UK offer advice and guidance to people affected by cancer and how it might affect feelings around sex and sexuality:

“Not everyone who has cancer will have changes in sexual desire or how they feel about themselves sexually. You may not notice any changes at all. But you may find that the changes cancer causes to your body image affect the way you feel about yourself and having sex. Some people lose interest in sex and feel very tired. But some people say that they want to make love more than usual. If you are in a relationship, a crisis can sometimes bring couples very close together.”

[http://www.cancerresearchuk.org/about-cancer/coping-with-cancer/coping-physically/sex-sexuality-and-cancer/how-cancer-can-affect-your-sexuality-and-sex-life]

It’s important to note that in many instances the type of treatment that is offered can result in both short and long term side effects that might have a negative impact on sex and sexuality. 

Some treatments can have a very direct impact on how you feel about sex and sexuality. For women with breast cancer, if you have had surgery to breast, it may be difficult to adjust to permanent and temporary physical changes to your body, including scarring, swelling, and bruising. You may be worried about the impact this may have on your relationships (or future relationships if you are single) and how you and others my react. You may feel a particularly acute loss if your breasts were an important part of how you respond sexually.

Here on the vMDT project, we are predominately dealing with those long term side effects that have proven to be very problematic for patients. At the moment, we are open to referrals from oncology teams who have been treating cancers found in the pelvis. This will include cancers found in the vagina, cervix, or womb. Treatment options available for these types of cancer (stage 2 and above) would almost certainly include radiotherapy and your oncology team will help you make an informed choice about whether this is suitable for you, and discuss any possible long term side effects that might arise. (NB. Ovarian cancers are usually treated with chemotherapy not radiotherapy)

Many women do encounter problems in the long term that are not immediately apparent immediately after treatment has concluded, and can be quite tricky to resolve. But with increasing numbers of people being treated successfully, the prevention and alleviation of late side effects after treatment have become a priority. We hope the vMDT project can play a significant role here.

There is no reason why your treating team cannot help you overcome any problems around sex and sexuality and please don’t feel that these topics are somehow ‘out of bounds’, a cause for embarrassment or something that don’t apply to women of a certain age.

Please visit www.macmillan.org.uk/vmdt for further information.