For most teens, relationships of all kinds are really important. Cancer and its treatment may affect not only your body, but your feelings about your body, yourself, your relationships and your sexuality.
Q. What is meant by “sexuality”?
A. Sexuality includes the ways our body works, our gender, our sexual orientation, and our values about love and relationships. It affects how we look, how we speak, how we act and think about our bodies. Sometimes a person’s sexuality can be affected by a serious illness, such as cancer.
Having cancer can affect how you feel about your body image and how you feel you look to others. It can also affect how tired or active you feel, and how you talk or express yourself. All of these make a difference in how you experience your sexuality when you have cancer.
Q. Who can I talk to about the questions I have about sex and sexuality?
A. Talking about sex can sometimes be difficult or embarrassing. But it is really important to ask questions and to talk with your healthcare team about your concerns. Your healthcare team can talk to you about these things during an office visit or over the phone. Do not worry—these conversations will be private.
Q. What do I need to talk to my doctor or nurse practitioner about?
A. If you are having intimate contact (like kissing, sexual touching or sexual intercourse) with anyone, it is important to talk to someone on your healthcare team about it. Even if you are not having intimate contact now, but think you might at any time during treatment, it would be good to talk to your doctor or nurse practitioner about this. There are some times that you might need to avoid sexual contact to stay healthy. Someone on your healthcare team can talk to you about when it is OK.
Q. When can I be sexually active while in treatment?
A. Even if you are very careful about avoiding infections from sex during treatment, there are still some times when it is important to avoid sexual contact. This is when your blood count tests become really important. When your counts are doing OK, then sexual contact is usually OK. When they are low, it is important to avoid any sexual contact (including masturbation, oral sex or any other kinds of sex).
Your provider will talk to you about this more, but here are the guidelines about when you need to avoid sexual contact:
- When your absolute neutrophil count (ANC) is under 1,000. When your ANC is low, you are prone to infections.
- When your platelet levels are under 50,000. When your platelets are low, you are at a higher risk for bleeding.
Q. How might treatment change my sexuality or sexual activity?
A. There are a lot of physical changes that happen during treatment that can affect sexual relationships. Treatment affects the way you look and the way you feel. So it might make a difference in your sexuality and how you have relationships.
Some of the things that might happen to your body that affect sex and sexuality:
- Vaginal dryness
- Higher chance of yeast infections (especially if you are on steroids)
- Higher chance of getting other kinds of infections, like urinary tract infections (UTIs) and sexually transmitted infections (STIs)
- Higher chance of bleeding from sexual contact
- Chance of exposing partners to chemo or radiation chemicals that stay in your body after treatment
Q. What can I do about these things?
A. There are some things that you can do to prevent problems.
- For dryness, use a water-soluble lubricant, like K-Y Jelly or Surgilube. Use fragrance-free lubricants only. Avoid Vaseline and oil-based lubricants.
- Sexual contact always has a chance of passing infections, but as you know, infections while in treatment are really important to avoid. Avoid kissing someone who has canker sores or mouth sores, who is sick, or who has an infection. Use condoms during sexual contact to prevent STIs. Avoid unprotected oral sex to prevent spreading STIs and infections from the genitals to the mouth.
- It is very important to avoid sexual contact that is more likely to make you bleed, like anal sex.
- You cannot give someone cancer by touching them or having sexual contact with them. But some chemo and radiation stays in your bodily fluids for a few days, and may be harmful to people who come into contact with them. “Bodily fluids” include saliva, urine, semen and vaginal fluids. We don’t really know how much chemo or radiation stays in bodily fluids, for how long or what they might do to someone else. But to be safe, most doctors suggest waiting at least 72 hours after chemo or radiation before having sexual contact.
- If you are having sex, it is best to have only one partner to reduce your risk of infections.
- Always talk to your doctor or nurse practitioner right away if you have any problems or symptoms of an STI or other infection.
- Talk to your doctor or nurse practitioner about risks of pregnancy. It is possible to become pregnant or to get someone pregnant during treatment. Chemo and radiation can do a lot of damage to the fetus if you become pregnant during treatment.
For more information about sexuality and relationships during and after cancer treatment, see these resources: