Sex After Breast Cancer? The Concern Is Too Often Ignored, Says Study

Will sex after breast cancer be the same?

A new study in the journal Current Opinion in Supportive Palliative Care is highly critical of our health care system’s record when it comes to caring for women’s sexuality and sexual identity after breast cancer.

Led by D.A. Male of the Department of Psychology, York University Odette Cancer Centre, the study looked at patient evaluations of responses by health care providers to their post-treatment needs concerning sexual functioning and sexual identity, with the results showing that in a majority of cases, women were dissatisfied with the amount and quality of care received around the topic of sexuality.

“There remains too wide a gap between the needs of this population and the healthcare system’s response to such needs,” the authors say. “To bridge this gap, oncology professionals across a range of disciplines must be better trained to identify, assess, and treat such difficulties, preferably using a multimodal approach that includes biological, as well as psychological and social, strategies.”

Researchers in Germany assessed 79 patients and found that sexual activity decreased from 71.9% before chemotherapy to a minimum of 47% at the end of chemotherapy.

Effects of breast cancer on patients’ body image and sexuality have been well documented. Aside from the physical manifestations which are often connected to cancer treatment – fatigue, vaginal dryness, decreased sex drive – there are well known mental and emotional impacts. Depression and anxiety surrounding sex are common, for example, as are feelings of sadness or loss due to the physical changes resulting from cancer treatment.

A recent study in the journal Supportive Care in Cancer looked at the influence of chemotherapy on women’s health-related quality of life.

Researchers in Germany assessed 79 patients and found that sexual activity decreased from 71.9% before chemotherapy to a minimum of 47% at the end of chemotherapy.

Subjective measures surrounding body image and desirability can also be deeply affected. In a 2012 survey of breast cancer survivors, more than a third of respondents were found to describe the emotional consequences of cancer on their sexuality in strongly negative terms, calling them “confusing,” “disturbing” and “soul destroying.” One patient wrote, “I feel as if an integral part of my life is no longer well within my reach. I worry about my loss of interest in sex and I miss the sexual aspect of my life” (65 year old woman, early breast cancer, 3 years post-diagnosis).

Jody Pelusi, Oncology Nurse Practitioner at Northern Arizona Hematology Oncology writes, “Sexuality is a complex and subjective concept. The effects of cancer and its treatment on sexuality are not usually included in assessments and plans of care for patients, nor are they often addressed in patient education.”

The Canadian Cancer Society reports that in 2015 it is estimated that 25,000 Canadian women were diagnosed with breast cancer, amounting to 26% of all new cancer diagnoses for women. 5,000 women will have died from breast cancer by the year’s end, representing 14% of all cancer deaths for women. About 1 in 9 Canadian women can expect to develop breast cancer at some point during her life and 1 in 30 will die from it.

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