You are here: Home Colorectal Cancer Colorectal ... Summary
Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Summary

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

To Learn More

Myths About Colorectal Cancer And Sex

Myth: Once a person has colon or rectal cancer, sex goes out the window.

Reality: Sexuality is a part of life. It doesn't disappear because of cancer or its treatment.  There may be a lack of interest for a while on your part, or on your partner's part -particularly during or immediately after treatment.  Lack of interest in sexuality is not permanent. 

 Myth: Older people are not interested in sex.

Reality: Sexuality is about how you define yourself as a man or woman, who you are attracted to, and whether you want a relationship. Sexuality doesn't go away.

On the other hand, the type of sex in which you are interested may change over time. For example, you may become more interested in cuddling or foreplay than having intercourse.  

Myth: Men enjoy sex more than women.

Reality: If sex is good, both men and women enjoy it.  

Myth: All physical contact must lead to intercourse

Reality: Cuddling and other physical activities can be satisfying. As noted in the summary, you can have satisfying intimacy without sex, much less intercourse.

Myth: Sex can harm the colon or surgical site and cause the cancer to come back.

Reality: There is no correlation between sex and cancer recurrence.

Myth: Sex is a failure if both people do not reach orgasm.

Reality:  Men and women can have wonderful sexual relationships without orgasm or penetration. 

How Colorectal Cancer Can Affect Sexuality And Sex Drive

The emotions and physical chang es that come with a diagnosis or living with a debilitating or chronic health condition can have an impact on sexuality and sex drive ("libido"). For instance: 

EMOTIONS

  • Depression or Anxiety
    • Both men and women who are diagnosed with cancer are 15 or 20 percent more likely to have depression or anxiety. 
    • Depression and anxiety can affect mood, your connection with your self, your connection with your partner and children, and with your co-workers. 
    • For information about how to cope with depression, click here. For information about coping with anxiety, click here.
  • Fear of Recurrence
    • An ongoing fear of recurrence can cause both patients and their partners to feel less secure which in turn can affect sex drive.
    • For tips about dealing with fear of recurrence, click here.
  • Negative feelings about self
    • Because of physical changes such as hair loss, scars, weight gain or loss or an ostomy, patients can have decreased self-esteem which can lower sex drive. If a lack of self esteem affects your life, consider speaking with a mental health professional. 
    • For the different types of mental health professional, click here. For practical tips about choosing one, click here.
  • Role changes
    • If a bread winner is diagnosed and has to stay home or needs physical help, the partner has more to do - and may even have to return to work. The partner is also likely to change from being an equal to being a caregiver. These changes can cause conflict and can lower self esteem.  Low self esteem can lower sex drive.
  • Reproductive concerns
    • Chemotherapy and other treatments can affect fertility. In turn, this can have an emotional impact as well as the physical result of no longer being able to have children.
    • For information about preserving the ability to have children, click here.  
    • If fertility has already been affected, consider adoption. Your health history as such does ot prevent adopting. For information, click here.

PHYSICAL CHANGES RESULTING FROM A HEALTH CONDITION.

  • Treatment such as surgery, chemotherapy, or radiation. 
    • To learn about each treatment for colorectal cancer and how it can affect sex and sexuality, see the other sections of this document.
  • An ostomy can cause loss of interset in sexuality and sex. 
    • For information about an ostomy and sexuality, click here.
    • To learn how to live with an ostomy, click here.
  • Hair loss can cause loss of interest in sexuality and sex. To learn how to cope with hair loss, click here.
  • Weight gain or loss can affect interest in sexuality and sex. For coping techniques, click here.
  • Medications to treat the disease or emotional stress. 
    • For example, anti-anxiety drugs or anti-depressants. 
    • If the side effects of a particular drug interfere with your life, let your doctor know. Perhaps there is an alternative drug that will not have a similar efffect.
    • For information from purchasing to safe handling, storage and disposal of medicaitons, click here. 

NOTE: Use of alcohol and smoking can cause erection difficulties and lack of interest in sex.

To Learn More

How Surgery For Colorectal Cancer May Affect Sex And Sexuality

It is best to wait until several weeks from the date of your surgery pass before having sex.

  • If you have a question about when it is okay to engage in sex in general or specifically about intercourse, speak with your surgeon or his or her nurse.

Possible side effects of surgery which can affect sex and sexuality include: 

  • Physical changes such as wound healing, scarring, and possibly an ostomy  Having an ostomy brings with it many issues. .For information about sexuality and an ostomy, click here.
  • Changes in sensations due to nerve impingement which may be temporary or permanent.
  • Being on an emotional roller coaster, with the possibility of getting stuck in a depression. 
    • For information about dealing with emotional issues, click here
  • Urinary or bowel dysfunction (“Incontinence”) which can make a person anxious about engaging in sex because there may be a leak or smell, or concern about what your partner thinks.  Incontinence can lead to not wanting to engage in sex. It can also lead to a lack of desire, or a desire to respond, particularly if nerves are damaged.
  • Pain can affect interest in being sexually active in addition to the function of sexual organs.  
    • For more information, see the section of this document “Pain And Sex
  • Men:
    • Erection difficulties  
      • For information about dealing with erection difficulties, click here.) 
    • With an abdominal perineal resection, you can have “dry” orgasms if there is damage to the nerves that control ejaculation. 
      • In some cases, the surgery causes semen to go backwards into your bladder (“retrograde ejaculation”). 
      • If you want to have a child and experience retrograde ejaculation, sperm cells which can be used to impregnate a woman can be recovered from your urine. If sperm cells cannot be recovered from your semen or urine, they may be retrieved directly from a testicle by minor surgery.
    • Pleasure at orgasm may become less intense.
  • Women may experience diminished orgasms.
  • Poor body image 
    • For information about identifying and dealing with poor body image, click here

NOTE: Safer sex techniques  prevent pregnancy and transmission of sexually transmitted diseases. For information about safer sex techniques, click here.

How Radiation For Colorectal Cancer May Affect Sex And Sexuality

You can have sex during treatment. 

  • Sex during treatment is not recommended if:
    • Your immune system is low (“immunosuppressed”) including your white blood cells
    • You have very low red  blood cell countsor anemia
    • You are in the first weeks of recovery after surgery
  • It is not advisable for a woman to become pregnant during radiation treatment. Pre-menopausal womenshould use safer sex techniques to prevent pregnancy and transmission of sexually transmitted diseases. To learn more, see:    Sexual Activities: Level Of Risk Of Transmission of HIV and Other STDs .  (A 1387)
  • Having sex or being intimate does not expose a partner to radiation.
  • Check with your doctor or his/her nurse before having sex to make sure there are no problems

Possible side effects of radiation which can affect sex and sexuality:

  • Skin irritation which can vary from mild to severe, and may be internal and/or external. Even cuddling may be uncomfortable.
  • Bladder irritation (which may be a permanent side effect). 
    • Bladder irritation can lead to bleeding, diarrhea and frequent urination. Your doctor may have suggestions about reducing these symptoms if they occur. 
    • For information about dealing with diarrhea, click here)
  • Fatigue. 
    • While fatigue from radiation is not generally as great as fatigue from chemotherapy, it can last longer. 
    • For information about dealing with fatigue, click here)
  • Women with pelvic radiation may experience vaginal dryness and/orr narrowing (“stenosis”) which causes tightness. Penetrative sex by either a penis or an object may be uncomfortable or may cause pain.
  • Inability or difficulty in achieving an erection (For information about dealing with erectile dysfunction, click here)
  • Diminished orgasms, and/or vaginal irritation in women.
  • Being on an emotional roller coaster, with the possibility of getting stuck in depression. For information about dealing with emotional issues, click here.
  • The ability to have children. The risks are higher if the radiation is in the pelvis or surrounding areas. (For options to consider, click here 
  • Poor body image (For information about identifying and dealing with poor body image, click here.

How Chemotherapy For Colorectal Cancer May Affect Sex And Sexuality

You can have sex during treatment. 

  • Check with your doctor or his/her nurse before having sex  to make sure there will not be complications.
  • Sex during treatment is not recommended if:
    • Your immune system is low, including low count of white blood cells (“immunosuppressed”)
    • You have very low red  blood cell counts ("anemia")
    • You are in the first weeks of recovery after surgery
  • It is not advisable to become pregnant during chemotherapy treatment. Pre-menopausal women should use safer sex techniques to prevent pregnancy and transmission of sexually transmitted diseases. To learn more, see:    Safer Sex: Level Of Risk Of Transmission of HIV and Other STDs .  

Side effects of chemotherapy which can affect sex and sexuality

Most effects from chemotherapy go away soon after treatment ends.

Possible side effects include:

  • Hormonal changes such as menopausal symptoms, including hot flashes.
  • Hair loss or thinning (For information about coping with hair loss, click here)
  • Nausea and vomiting (For information about coping with nausea and vomiting loss, click here )
  • Loss of appetite  (For information about coping with loss of appetite, click here )
  • Hand and foot swelling and peeling of skin. For information, click here. 
  • An emotional roller coaster, with the possibility of getting stuck in depression. . (For information about dealing with emotional issues, click here.
  • Women:
    • Dryness of the vagina which can be painful even if there is no penetration.  
    • Narrowing (“stenosis”) of the vagina can cause pain on insertion of a penis or object.  
    • Early onset of menopause (“Medical menopause”) can include hot flashes, lower sex drive and an increase in vaginal dryness.
    • Mouth dryness and/or sores, thrush or candidiasis can result in the feeling that the last thing you want is anyone near your mouth. (To learn about preventing and dealing with mouth dryness, click here. For information about dealing with oral sores, click here.
    • Fatigue (due to low red blood cell counts) (To learn about dealing with fatigue, click here) 
    • Changes in sexual desire (“libido”).
    • Dry skin. (To learn about dealing with dry skin, click here
    • Fertility or ability to conceive. (For options to consider, click here
    • Low white cell count which can result in an increased risk of infection..
    • Bleeding or bruising after minor cuts or injuries because of a decrease in f blood platelets.
    • Poor body image (For information about identifying and dealing with poor body image, click here. 

NOTE: It is recommended that if you have sex during chemotherapy, use precautions such as a condom or dental dam so no fluids are shared. Chemotherapy chemicals can be found in semen or vaginal fluid. 

How Targeted Therapies For Colorectal Cancer May Affect Sex And Sexuality

Targeted therapies are procedures that go after a part of cancer cells that make them different from normal cells.

As a general matter, you can have sex during treatment with targeted therapies. 

  • Hhowever, sex during treatment is not recommended if:
    • Your immune system is low including your white blood cells (“immunosuppressed”) 
    • You have very low red  blood cell counts ("anemia")
    • You are in the first weeks of recovery after surgery
  • Check with your doctor or his/her nurse before having sex.
  • Safer sex techniques will prevent pregnancy and transmission of sexually transmitted diseases. To learn more, see: Safer Sex: Level Of Risk Of Transmission of HIV and Other STDs . 

Side effects of targeted therapies which can affect sex and sexuality

Depending on the drug used, the following are potential side effects of targeted therapies.

  • An allergic reaction during the first infusion which can cause problems with breathing and low blood pressure.
  • Acne-like rash.
  • Dry skin. (To learn about dealing with dry skin, click here)
  • Fatigue. (To learn about dealing with fatigue, click here
  • Fever
  • Constipation or diarrhea  
    • For information about dealing with diarrhea, click here)
    • For information about dealing with constipation, click here)
  • Bleeding
  • Holes forming in the colon
  • Slow wound healing
  • Blood reactions such as high blood pressure, blood clots, low white blood cell counts
  • Headaches
  • Mouth sores or dry mouth
    • To learn about preventing and dealing with mouth dryness, click here
    • To learn about mouth sores, click here.
  • Loss of appetite (For information about coping with loss of appetite, click here 

Pain And Sex

Tips for having sex if you are experiencing pain include the following:

  • Plan for when pain is less intense and you are at your best.
  • Take a pain medication one hour prior to intercourse.
  • Position yourself in a way that is most comfortable. In particular, avoid applying pressure to the painful area.
  • Use lubricants and vaginal dilators when indicated to help stretch the vagina and rehabilitate the muscle so it is not as painful.
  • Practice deep breathing. 
    • Deep breathing involves taking a breath down to your belly, and then out again, while breathing slowly. 
    • Deep breathing 25 minutes a day is therapeutically about the same as 2 hours of sleep. 
    • Deep breathing gets oxygen into the blood and makes you feel more refreshed. 
    • Also try relaxation techniques.
    • To learn about deep breathing, click here. For information about coping with stress which includes relaxation techniques, click here.
  • Help each other get aroused. Encourage foreplay and/or massage either prior to intercourse or instead of intercourse. 
  • Speak with your disease specialist or primary care doctor if you have any questions or concerns. Women can also speak with their gynecologist.

Fatigue And Sex

Plan sexual activity for when your energy level is the highest  - or at least are not at a low point .

The easiest way to do this is to start keeping a diary of your energy level – and what changes it. For example, many people with fatigue find that it has different intensities depending on the time of day. There may also be a change due to activities or food.

For more tips  on dealing with fatigue in general click here




Emotional Issues And Sex

Anxiety, anger, fear, poor body image, and depression are common at all stages after a diagnosis and can affect sex and sexuality.

For discussions about these feelings and tips for dealing with them, see the documents in "To Learn More."

Keep in mind that advice about physical and emotional issues around sex and intimacy is available through a referral to a sex or couples counselor. The two are likely intertwined.




I Do Not Feel Attractive Because Of Colorectal Cancer Or Treatment

Not feeling attractive is a very individual thing. Some suggestions to consider to help you feel better are:

  • There is no magic wand to make things better. It takes work to see yourself as an attractive sexual being again – often a lot of work. 
  • Focus on the things that have not changed (as compared to the thought that everything about you has changed).
    • Particularly focus on the things that you like about yourself.
    • Look for at least three things that you like about yourself. For example, the way your eyes light up when you see children.
    • Wear clothing that is comfortable and  helps you feel confident.
    • If you have an ostomy, see: If You Have An Ostomy 
  • Consider speaking with a social worker or mental health counselor who can help you work through negative thoughts. It is particularly helpful if the person is oncology certified.
  • Good nutrition and exercise can make you feel better about yourself. This can be harder during treatment, but is worth pursuing. Be sure to get input input from your oncologist before making significant changes.
  • Consider joining a support or self help group. In addition to support, you are likely to gain valuable information. For information about support groups, click here. For information about self help groups, click here.
  • Be patient. As you feel better, you will adjust and things will get better. This can take time so patience is required.
  • The American Cancer Society has a program called LOOK GOOD, FEEL BETTER that includes local classes as well as a book. Historically the program has only been for women, but it has been expanded to include men in some areas of the country. In those areas where there are no classes for men, some of the people who teach this information schedule one-on-one conferences. To learn more, go to www.cancer.org offsite link or call: 800.ACS.2345.

Sex, Sexuality And An Ostomy

 An ostomy can have a serious effect on a person's feelings about sex and sexuality. There are steps to take to help.

Tips To Help Improve Sexuality 

  • Wear clothing that hides the ostomy if you prefer
  • If you need help changing your look so the ostomy cannot be seen, speak with a stylist or personal shopper at a department store.
  • If you have a poor body image because of your diagnosis, treatment or other issues, take steps to improve your body image and to accept your body as it is. For tips, see: Tips To Help Improve Your Body Image 
  • If you are suffering from emotional issues that keep you in the down or depressive part of the emotional roller coaster that generally accompanies a diagnosis and treatment, deal with them in a support group setting, with a colorectal cancer buddy, and/or with a mental health professional.  See the documents in “To Learn More” for more specifics.

 Tips For Having Sex

  • Talk with your partner.
    • Educate your partner. The more educated the person is, the more comfortable and relaxed he or she is likely to be. Education should include:
      • What to expect.
      • That sex will not hurt an ostomy.
      • What you are comfortable doing
      • What not to do. 
    • Add humor to the discussion if you can.
    • Find out what he or she is comfortable doing.
  • Make sure the appliance fits well. If you would like, tape it down before sexual activity.
  • Wear a closed-end pouch, a mini-pouch or a stoma cap during sexual activity.  The pouch should be opaque or enclosed in a pouch cover so the contents cannot be seen.  One of the places you can find informationabout products available, how to locate them and buying tips is the website of the United Ostomy Associations of America, Inc.: www.ostomy.org offsite link
  • Empty the colostomy and clean it before starting sex.
  • If you are worried about:
    • The smell:
      • Suggest that your partner put a little lavender oil or peppermint oil under his or her nose.  Consider putting either of the oils on your neck or other areas that will be close to your partner’s face.
      • Don't try to hide a smell with colognes or perfumes. They can become overwhelming.
    • Gas or watery discharge:
      • Check and empty the pouch just before sex.
      • During the day, avoid food that create gas and/or strong odor such as garlic, onion and broccoli. 
      • Remind both yourself and your partner that gas is natural. It happens even without an ostomy.
    • The bag leaking:
      • If your bag leaks during sexual activity, take your partner and jump into the shower – then start again. Consider having fun  with each other in the shower.
    • Seeing the bag.
      • You do not have to be naked to engage in sexual activity. Ostomies can be hidden from both you and your partner’s view. Consider the following techniques for hiding an ostomy. Some of the techniques can be used by both men and women, some by women.
        • Men and Women
          • Use a cover. You can buy one from an ostomy supply company such as cmostomysupply.com offsite link or you can make your own.
          • Tuck the ostomy into a cummerbund, belt or sash.
          • Wear a T shirt to hide the ostomy.
        • Women:
          • Depending on where the bag or ostomy is, panties can be worn high enough to cover the appliance, keeping it closer to the abdomen or your side so it is hidden.  Or you can wear crotch less panties.
          • Put on something you feel sexy in, such as a sexy slip.
          • Wear a fancy shirt or a cami.
    • Putting too much pressure on the ostomy
      • Choose a position to keep weight off the ostomy. For instance, lay on your back if that protects the ostomy.
      • Consider putting a small pillow over the ostomy site to feel as if it is protected. 

Tips For Having Sex During And After Treatment

Tips for having sex during and after treatment are divided as follows:

  • For men and women with colorectal cancer
  • For the partner
  • For a couple 

For The Man Or Woman Diagnosed With Colorectal Cancer

  • Before engaging in any intimate activity, feel as comfortable in your body as you can. 
  • Get to know your body again. Find out what feels good, what feels bad, and what you feel safe doing. For example:
    • Consider self-stimulation if it is acceptable with your own and your religion’s belief system. Self-stimulation can enable you to regain sexual interest if you are too tired to have sex with a partner. It can also help you learn what is pleasurable, so you can share the information later with a partner.
    • Get into a bath or shower and spend 15 or 20 minutes to gently feel and massage your body. Find out what feels good, what feels bad, and what you feel safe doing.
  • Go to a day spa or spend the day pampering yourself. Rebuilding a connection with your body helps to reconnect not only with your body but with other people.
  • Rest during sex or sexual play. Sex is not a marathon. You are there for each other.
  • If your interest in sex has changed, you can retrain your body to remember what it used to be like to be aroused. For example, you can fantasize about what it was like to be aroused at an earlier period in your life.
  • Consider teasing exercises with your partner throughout the day. For example, leave notes for each other or text messages. Reduce the lighting and light candles. 
  • If anti-depression medications are causing low sexual attraction, there may be a medication that does not have the same side effect. You will not  know for sure until you try. Talk with your doctor or mental health therapist. 
  • When you are able to, reconnect with your social life. If necessary, adapt your social life to meet your needs. For instance, ask friends to come join you. If nothing else, have friends over for tea or to watch a movie.
  • Exercise to the extent that you can. Exercise can make you feel better about your body and enhance your mood. (For information about exercise, click here.) 
  • Men:  If you are concerned about desire, erection and/or performance, there are several options including:
    • Medication such as Viagra and Cialis. They are not right for everyone. For instance, these drugs do not address depression or anxiety. For information, speak with one of your doctors.
    • Assistive devices such as a pump or vacuum.
    • To learn more, see our document about Erectile Dysfunction.   
  • Women:
    • Moisturizing the vagina is important.  On a daily basis, consider using 100% Vitamin E oil to help with reconditioning your vagina and with moisture retention both internally and externally. Vitamin E is natural. It helps with softening skin and scar tissues. Use it inter-vaginally and on the labia. (Do not use Vitamin E as a lubricant during sexual activity . It is sticky.)
    • Warming creams and clitoral heighteners can help with increasing blood flow which heightens sensitivity.
    • The web site PureRomance has a “S.S.S Program” to help women with breast cancer recapture their sensual and sexual selves. Information on the site can be helpful for women with colorectal cancer.. The program includes individuals trained as consultants to help women learn about safe products which can help enhance their sexual experience. The site also provides information about how to choose the best product for your needs. PureRomance also sells items that you may not feel comfortable going into a sex shop to buy. The shipping box is nondescript. See www.pureromance.com/sss offsite link.
    • If there is a change in your vagina, talk with your gynecologist about exercises that may help.
    • If you are having a difficult time climaxing, try moaning and groaning. (Remember the scene in the Movie: When Harry Met Sally?) Moaning and groaning creates a kind of vibration in your body which may help you peak.
    • If you are having difficulty climaxing because of vascular changes that can happen from pelvic radiation, consider using a small clitoral vibrator. You can control the speed. Sometimes, all you need may be  faster stimulation than your partner Is able to provide. 

For The  Couple Sharing a Diagnosis of Colorectal Cancer

  • If you haven’t engaged in sexual activity in a while, it is better to start slowly. Starting slowly will provide a way of being physically close and intimate without pressure and anxiety:
    • Use non-sexual touch and massage to stimulate closeness.
    • Focus on parts of the body that do not cause distress.
    • Stay away from genital touching during the first weeks of engaging in these exercises.
    • Experiment with different positions. It may help decrease anxiety.
    • As Dr. Sage Bolte says: “Communicate, Communicate, Communicate… We don’t read minds!”
      • People are often shocked to find that their partner doesn’t start sexual play because of reasons like “I don’t want to be selfish.” “I don’t want to hurt you.” “I didn’t think you were interested.”
      • To communicate, state a fact, a feeling or belief, and an action. For example: 
        • A fact: Ever since my cancer diagnosis, we stopped cuddling and having sex at night. 
        • A belief: I believe you are not attracted to me any more. 
        • A feeling: This makes me feel sad. 
        • An action: What I need is for you to cuddle with me at night, or reach out to me at least once a week for sex. 
  • To help work through road blocks, see a mental health therapist or a sex therapist . To find a sex therapist, speak with a social worker at your cancer treatment center or contact  the AmericanAssociation of Sex Educators and Therapists by clicking here offsite link. For information about the types of mental health therapists, click here

Keep in mind that any marital or relationship problems you had before the diagnosis don’t go away just because of a diagnosis. They may go underground for a while but they are likely to bubble again after treatment ends. If the two of you cannot handle these issues yourselves, consider speaking with a mental health professional.

For the Partner

  • Communicate about your own desires. This is not selfish or insensitive. 
  • Be honest. 
  • Ask your partner:
    • What he or she would like to do
    • What he or she would like you to do. 
  • Show affection in a relaxed way. For instance: 
    • Reach for his or her hand 
    • Rub the back of his or her neck 
    • Grab the knee 
    • See a romantic comedy together 
    • Touch each other 
    • Schedule time with each other. Think about having a date (as compared to your patient/caregiver roles).
    • Take a weekend trip to celebrate end of treatment or to reconnect – even if all you do is sit and play cards and laugh and massage each other’s feet.  Sex or intercourse does not have to be part of it. Get back to the pleasures of touch and intimacy.
    • Show affection in a relaxed way so your partner knows you are still interested and that he or she is not being rejected.
    • Do what you can to stay positive. That does not mean not talking about your concerns or fears. You can do both. For suggestions about how to stay positive, click here
    • If you have questions, ask your partner and/or the health care team. If you are concerned about asking a doctor for sex information in front of other people, ask for a few minutes of private time with the doctor or his/her nurse.

To Learn More

Tips For Involving A Partner In Sexual Concerns

Discuss your sexual concerns and issues with your partner or person with whom you want to have sex.

  • If you keep the matter to yourself while changing your behavior, it  will send mixed signals which can easily be misinterpreted as a lack of interest in sex or in the other person.

When communicating, consider using the rule: state a belief, then a fact, then an action. For example: 

  • A fact: Ever since my cancer diagnosis, we stopped cuddling and having sex at night. 
  • A belief: I believe you are not attracted to me any more. 
  • A feeling: This makes me feel sad. 
  • An action: What I need is for you to cuddle with me at night, or reach out to me at least once a week for sex. 

Approach the subject openly, Being open avoids blame, helps you stay positive, and gives your partner a better sense of how you are feeling.

Ask the other person to discuss his or her concerns and issues.

  • It is not unusual for other people to be confused about how to behave. There may be an underlying fear or anxiety that can be reduced or eliminated with communication.
  • Try to be open-minded as you listen to your partner's point of view.

Be patient.

Keep a sense of humor. A sense of humor is a must. (If you have difficulty finding humor in the situation and/or in life, you can learn tips by clicking here.)

Consider asking your partner to accompany you to your visits with your specialist. He or she can be part of the discussion about sex and intimacy issues, as well as about possible solutions. He or she can also act as a patient advocate. (To learn about the role of a patient advocate, click here.)

If sexual issues cannot be resolved between the two of you, consider meeting with a couple’s counselor or a sex therapist. You can locate a sex therapist in your area through a social worker at your cancer treatment center or through the American Association of Sex Educators and Therapists, www.aasect.org offsite link