When you’re finished with cancer treatment, you might feel relieved and excited to start a new chapter in your life. It can be a hopeful time.
However, treatment itself can have side effects that last for years, in ways that you might not expect. For example, chemotherapy might have an effect on your memory or ability to communicate. Or you might feel fatigued much of the time, no matter how much you rest.
Fortunately, help is available for many of these issues through cancer rehabilitation. The goal of cancer rehab is to help you adjust to life after cancer and rebuild skills that might be impaired by treatment.
Cancer rehabilitation can apply to sexual health, too. Let’s look at some examples.
Some men develop erectile dysfunction (ED) after cancer treatment. ED is particularly common in men who have had a radical prostatectomy (surgical removal of the prostate gland) to treat prostate cancer. Penile rehabilitation aims to restore erectile function. Medications - such as pills, injections, and suppositories – are used to induce erections so that the penis can “practice” becoming erect on its own again.
Vaginal Stenosis and Dryness
Treatment for gynecological cancers and colorectal cancer, including surgery and radiation, can make the vagina shorter, narrower, and dry. A specialist can teach women how to use vaginal dilators. Dilators are plastic tubes that usually come in a set, gradually increasing in size one by one. During therapy, dilators are placed inside the vagina to widen it. Specialists can also advise on lubricants to make penetration more comfortable.
Sexual Pain and Incontinence
Pelvic floor muscles are sometimes compared to a “hammock” that keep your pelvic organs in place. Some cancer treatments, such as radiation and surgery, can weaken pelvic floor muscles, which may result in incontinence, painful sex, and erectile dysfunction. A physical therapist can help patients regain strength in the pelvic area to improve symptoms.
Emotional and Psychological Health
Coping with sexual issues after cancer treatment can take a toll on self-esteem. You might worry about your attractiveness after surgery, feel anxious about sexual pain, or struggle to communicate your needs to your partner.
Therapists trained to work with cancer survivors can help you and your partner adapt to any changes in your relationship. A counselor can also help you re-build your sexual self-confidence and suggest adjustments and strategies to improve your sexual satisfaction.
Sometimes, cancer treatment affects body parts and functions that you might not immediately associate with sex. Here are some examples:
- Speech. Radiation used to treat head and neck cancers can affect a person’s ability to speak. Speech therapy helps restore this function, making it easier to talk to a partner or continue a conversation on a first date.
- Fatigue. Cancer treatment can be exhausting, and it can be difficult to muster up the energy for sex and relationships. Specialists can help patients recover their energy levels through exercise and education.
- Peripheral neuropathy. Chemotherapy often leads to peripheral neuropathy – nerve damage in areas like the hands, feet, and genitals. When this happens, it becomes more difficult for the brain to send the messages that trigger sexual arousal. Occupational and physical therapy may not address sexuality directly, but recovering nerve function could help with sex.
- Balance and walking. Physical therapy and exercise programs help patients regain their balance and avoid falls, allowing them to enjoy more activities with their partner, even if it’s just a simple walk through the park.
Which services are available to me?
To find out more about cancer rehabilitation for your personal situation, start by talking to your oncology team or healthcare provider. They can refer you to specialists who work with cancer survivors.
It’s also a good idea to talk to your health insurer. Coverage for cancer rehabilitation services can vary from carrier to carrier. Be specific about the services you need and be sure to understand the details of your coverage. Don’t hesitate to ask questions if you don’t understand.
Smith, Lori, BSN, MSN, CRNP
“Radiation-Induced Vaginal Stenosis”
(July 20, 2012)
Howe, Nancy Litterman, MS, CES
“Is Cancer Rehabilitation a Good Option for You? It’s Never Too Late to Ask for a Referral”
International Society for Sexual Medicine
“What does a penile rehabilitation program (PRP) involve?”
“What is a penile rehabilitation program (PRP)?”
“How Might Cancer Treatment Affect Sexual Function”
“Neuropathy a Common Cause of ED”
(July 29, 2015)
West Virginia University Health Sciences
Phillips, Kristin A., PT/DPT, WCS, CLT-LANA
“Pelvic Floor Physical Therapy and The Oncology Population: Managing
Symptoms of The Disease and its Treatments”