CAN YOU TELL US, HONESTLY, HOW TREATMENT MIGHT AFFECT OUR SEXUAL FUNCTION?
This is the broadest and most obvious question, but many survivors or patients never ask it, especially if they don't realize that all cancers and all cancer treatments can impact sexuality and, potentially, fertility. "I'm not just talking about the physical mechanisms of sex, but about relationships, about body image, how we think and feel about ourselves," says, Sharon Bober, Ph.D., director of the sexual health program at the Dana-Farber Cancer Institute in Boston (a LIVESTRONG Survivorship Center of Excellence).
A 15-year-old boy with bone cancer, who has part of a leg amputated, may not have had a so-called "sexual" cancer, but "what should he expect when he starts being interested in girls and has to explain the part of his leg that's missing?," asks Dr. Gregory Broderick, M.D., a urologic surgeon and professor of urology at Mayo Clinic in Jacksonville, FL, and past president of the Sexual Medicine Society of North America.
A cancer such as leukemia may not at first seem "sexual," either. But, Broderick explains, "Knocking out bone marrow can have a tremendous negative impact on male and female sexual function because you are changing the hormones. Some chemo can damage vascular tissue and cause fibrous plaques in the arteries, so you get erectile dysfunction."
If the radiation could affect the testicles or ovaries, patients may want to think about saving (banking) sperm, eggs, or ovarian tissue. Truth is, many or most survivors haven't thought about the actual radiation "fields" that are delivered during the gritty part of radiation therapy.
These same questions apply to surgery and chemotherapy. Surgeons often move things around inside the body to get at or remove the cancer. "Collateral damage" is common. "Will I have a normal, receptive vagina? A 'foreshortened' vagina? No vagina at all?" Chemotherapy, while playing havoc with hormones, has the capacity to bring on early menopause or andropause (in men), temporarily or permanently.
Then too, head and neck cancer, which is diagnosed in roughly 40,000 Americans each year, affects body image, which in turn affects libido. Many patients, says Sharon Bober, Ph.D., director of the sexual health program at the Dana-Farber Cancer Institute in Boston, find that a common side effect of treatment, a lack of saliva, "makes it hard to kiss somebody. Sounds simple, but this can be a huge impact."