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Colorectal Cancer: Sex, Sexuality and Intimacy

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FOR MORE INFORMATION ABOUT THE FOLLOWING, SEE THE OTHER SECTIONS OF THIS DOCUMENT

Colorectal cancer is likely to interfere with your sexuality, sex life, and intimacy. A diagnosis is not a reason to stop feeling like a sexual being, unloved, or without sex or intimacy in your life.  Finding a new normal that works after the diagnosis of colorectal cancer is a challenge. This document helps you understand the challenges – and how to overcome them.   

Sexuality is the way we think about ourselves as sexual beings. It involves both physical and non-physical parts and is different from person to person. Sexuality involves the clothes we wear, the way we move, the way we have sex, with whom we have sex, and even cultural and religious beliefs about sex. How we think about ourselves as sexual beings influences our behavior. If we have negative feelings about ourselves, we are likely to feel down and withdraw from other people – even from a partner and children.

Intimacy is the sharing of our innermost thoughts and emotions. Intimacy can involve sex and/or touching, but it doesn’t have to.

When thinking about sex, it is worthwhile keeping in mind that intercourse is not the only sexually satisfying activity. For example, kissing and/or cuddling with someone you care about and who cares about you can be very satisfying and very intimate.

If sexual or intimacy issues are a concern, see the sections which are part of this document for suggestions that can help.

As a general matter, you can have sex during treatment. However, it is advisable to always check ahead of time with the doctor who is overseeing the treatment. 

  • Different treatments have different side effects. Side effects for colorectal treatments and tips for dealing with them are described in an attached section. As you look at the list of potential side effects, keep in mind that people experience different side effects and experience them differently. If you are looking for information about dealing with the other aspects of a particular side effect, see the documents in “To Learn More.”

If you don’t find an answer that makes sexuality, sex and/or intimacy work for you, speak with your doctor. Don’t wait for him or her to bring up the subject. While doctors consider quality of life subjects important, they tend to focus more on the physical aspects of your condition and/or treatment. Many physical issues can be treated. Your doctor may be able to help pinpoint the cause of issues you are having. Perhaps a medication can be prescribed or a treatment can be changed. Your doctor may also have suggestions about working through emotional issues.

If sexuality, sexual or intimacy issues become unmanageable, consider couples counseling or consult a professional such as a licensed sex therapist who is experienced in dealing with people with your health condition or particular situation. You can find a sex therapist through a social worker at your cancer treatment center or through  the American Association of Sex Educators and Therapists, www.aasect.org offsite link

NOTE:

  • Men and women:
    • If you are considering undergoing resection surgery, there are exercises known as Kegel Exercises that you can start before surgery to help manage fecal or urinary incontinence. The exercises can also be helpful with an erection for men.  To learn more, click here 
    • If treatment could render you unable to have children, you can preserve the ability to have a child by banking eggs and sperm prior to starting therapy or having surgery. To learn more, click here. Adoption is also an option. To learn more about adoption after a diagnosis, click here
  • Women:
    • If you are considering undergoing radiation or surgery anywhere near the pelvic area, or if you are pre-menopausal and are considering chemotherapy, ask your doctor about starting dilative therapy early. Dilative therapy will help keep your vagina from narrowing because of scar tissue or shrinking. (“stenonsis”). 
    • If you experience stenosis, there are pelvic therapists who are trained in vaginal reconditioning. The odds are there are at least a few such experts in gynecological practices in every metropolitan area.

The content of this document is based in large part on work by Sage Bolte, PhD, LCSW, OSW-C, Oncology Counselor, Inova Cancer Services, Fairfax, VA e mail: sage.bolte at inova dot org

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