After the bouts of radiation and chemotherapy are over, many cancer survivors are left to face the often unspoken side effects in the bedroom.
Sexual dysfunction is a common yet neglected side effect of cancer. About 90 percent of all female cancer survivors will experience sexual difficulties as a result of the disease or treatment. But South African clinicians say patients are often unprepared to deal with this.
Cancers affecting women’s reproductive tracts – like those of the cervix, ovaries or uterus – are treated either with surgery, chemotherapy or radiation. Surgeries like hysterectomies can lead to early menopause as well as pain during sex, decreased arousal and make it more difficult for women to orgasm. Radiation can also decrease a woman’s sex drive and lead to vaginal dryness – as does chemotherapy.
But sexual dysfunction does not just affect female cancer survivors.
Prostate cancer rates are rising in Africa, according to Luca Incrocci, associate professor of radiation oncology at the Netherlands’ Erasmus MC Daniel den Hoed Cancer Centre.
“If you take all the African countries together, prostate cancer is the most common cancer in men,” said Incrocci while speaking at the Aortic International Cancer Conference that ended on Sunday in Durban.
At least 30 percent of all prostate cancer patients who undergo surgery to remove some or all of their prostate gland complain of erectile dysfunction following the procedure, Incrocci explained. As many as 40 percent of men will also experience impotence following radiation treatment.
“Once they get erectile dysfunction, they never recover from it,” he said. “So it is a big problem.”
Dr Ros Boa from UCT’s Department of Obstetrics and Gynaecology said cancer’s side effects were not just physical.
“Cancer and its treatment profoundly affect a person’s sexual wellbeing and their intimate world,” Boa said.
According to sexologist Dr Marlene Wasserman, it is not uncommon for couples to separate after cancer.
Yet most South African doctors do not counsel patients about the sexual difficulties that come with cancer.
“Only 25 percent of physicians said they would discuss sexual issues, even if they believed that there was a problem,” she added. “Even then, most rarely address sexual issues.”
Wasserman said doctors commonly gave the excuse that patients’ sexual health was not their responsibility, or they did not feel comfortable or have the time to talk about it.
Boa and Wasserman said there was hope for patients with cancer-related sexual dysfunction.
“Sexual functioning might not be as it was before, but there is hope that patients can develop a ‘new normal’,” Boa said.
“The focus is on rehabilitation, not treatment because it never changes,” Wasserman said. “We refer to it as the ‘new normal’ because there isn’t a return to what was normal for them beforehand.”
Boa said patients should be encouraged to resume sexual intimacy and can use vaginal lubricants and moisturisers.
“Physical pleasure and emotional intimacy are life affirming, relieve stress, and promote closeness and healing for both survivors and partners,” Boa said. – Health-e News Service