Intimacy and Colorectal Cancer

Sexuality and relationships during and after cancer is extremely important to patients (especially early-age onset patients!), however this remains one of the least talked about concerns. We would like to change that! If you want to learn more about common side-effects of cancer and treatment, and how to discuss these with your healthcare provider, you are not alone. This blog post will cover a range of sexuality and relationship issues and will provide resources to gain more information.

First, let’s start by defining what we mean by sexuality and relationships. Sexuality (also known as sexual health) is broadly how people express themselves sexually. Sexuality is unique to everyone, but can be shown through actions, behaviours and in relationships. Sexuality is not just the act of sex, but also includes intimacy in many forms, such as holding hands, hugging, kissing, cuddling, or even the clothes that a person wears. Relationships can be with an intimate partner, but also include those with friends and family members. Our sexuality and relationships can be altered after a colorectal cancer diagnosis, which affects overall health and quality of life.

Patients

Having a conversation with your care provider about sexuality, relationships and fertility is extremely important. Not all care providers will start the conversation about these aspects of treatment, so it is important to be your own advocate. If you have an intimate partner, it may be beneficial to include them in these conversations with your care provider, if you feel comfortable doing so.

Research also suggests that care providers may not know how to ask questions regarding sexual orientation and gender identity. Again, it may be necessary to start the conversation with your care provider regarding how you identify yourself now and what sex you were at birth. If you are a transgender male or female, it is important to discuss procedures, medications or hormones that you are taking. It may seem scary to discuss these details with your care team, but it will assure that you get the personalized care that you need. Remember that all information that you share with your care team is entirely confidential, and starting the conversation is the hardest part.

Caregivers & Partners

Caregivers and partners play a vital role in maintaining a high quality of life for the patient. When the patient trusts their caregiver or partner, and is comfortable sharing intimate details, they often feel more attractive and confident. Open communication is key, and having your caregiver or partner attend follow-ups and check-ups can also be beneficial, as they can help you to articulate your side-effects or concerns.

Having these conversations with your caregiver or partner can be scary and intimidating, so starting small is a great approach. Discussing less intimate subjects, such as concerns about self-esteem, may be a good place to start before discussing more intimate topics such as sexual function. As a caregiver or partner, you can also take the lead in having conversations about intimate aspects of cancer and treatment, however it is extremely important to ensure that your loved one is comfortable. If you bring up a topic area that your loved one is not yet ready to discuss, do not force it.

To learn more about sexuality and relationships for colorectal cancer patients and caregivers, read this article by the American Cancer Society: How Cancer and Cancer Treatment Can Affect Sexuality.

Pre-Treatment

Prior to surgery and treatment, patients and caregivers or partners should be aware of any changes that may occur to their body or sexual function as a result. Every patient and care plan is different, so these details are unique to you. Having these conversations with your care team can help you make informed decisions about your sexuality and relationships. This may also be a good time to discuss fertility preservation with your care team if this is something that is important to you.

To learn more about fertility preservation for colorectal cancer patients, read Fertility Preservation: The Good, The Ugly & Giving Cancer the Middle Finger by the Colorectal Cancer Alliance.

During Treatment

Treatment can impact sexuality, intimacy and relationships in a number of ways. Men can experience low testosterone levels during and after chemotherapy, and radiation can cause sexual function issues such as erection problems. Men can also experience a reduced sperm count as a result of radiation. Women can experience sudden or premature menopause due to chemotherapy, and some women have their ovaries removed during colorectal cancer surgery. Additionally, all cancer patients may have concerns about sex and intimacy with an ostomy, which is totally normal! Again, every patient and treatment plan is different, so appointments prior to or during treatment are an ideal time to discuss these issues with your care team. Your caregiver or partner can be a great support system in these difficult conversations.

After Treatment

Some of the side effects of colorectal cancer treatment may linger long-term, or even for life. However, these are usually manageable and do not need to take a major toll on a patient’s confidence, self-esteem, relationships and sexuality. Your care team can help you manage these, and your caregiver or partner can support you through these physical and emotional changes.

To learn more about common physical changes due to colorectal cancer treatment, read Sex Life by Cancer Research UK.

To learn more about sex during and after treatment, read Sex After Colon Cancer by the Colorectal Cancer Alliance.

Palliative Care and End of Life

Sexuality and relationships are an important aspect of a good quality of life for palliative patients. Talking to your health care team about sexual function issues is just as important as any other physical side-effects or issues that you may be experiencing. Many sexual function issues can be managed if they are brought to the attention of your health care team, so again, communication is key!

If you are experiencing concerns or issues with sexuality, relationships and intimacy after your colorectal cancer diagnosis, know that you are not alone! Most patients do experience changes to their sexuality, but unfortunately, it is simply not talked about enough. Ultimately, communication with your caregiver, partner and health care team are the key to high quality of life through treatment and beyond.

We are here for you! If you would like to discuss sexuality and relationships with our Patient Support team, please reach out to info@colorectalcancercanada.com.

If you are an early-age onset colorectal cancer patient or caregiver, please consider completing our survey to help us learn more about your experiences: Patient & Caregiver Experiences with Early Onset Colorectal Cancer in Canada.

To learn more, check out this research article in the Annals of Oncology Journal: Sexual (dys) function and the quality of sexual life in patients with colorectal cancer: a systematic review