Coping with more than cancer

Cancer affects a patient's relationship as well as the patient. Today a new campaign is launched to try and help couples during a dark time.

Cancer and sex is something of a taboo issue.

But a cancer diagnosis can have a major impact on a person's relationship or sex life with their partner.

Today Macmillan Cancer Support has launched a campaign it hopes will break the silence surrounding the impact cancer has on sexual relationships, and encourage health professionals to speak to patients about their problems.

Three quarters of cancer patients surveyed by the charity said cancer had affected their sexual relationship, either as a direct side effect of treatment such as drugs or surgery, or because they've lost body confidence.

Some of the comments from people who took part in the study are heartbreaking.

"I feel inadequate about my body, and scared of sex itself. I also feel that my husband is frightened of hurting me," said one woman.

Another patient commented: "Unloved and sullied. I have never had the confidence to enter another relationship."

Macmillan also found that:

• A third of those who said cancer had affected their relationship said they felt unable to talk to their partner about it

• Half of those who are single said they were put off starting a new relationship,

• One in seven even said they separated permanently as a result of the cancer’s impact.

• Doctors and nurses mainly focus on the medical side of cancer treatment, so help is rarely offered. Two thirds said their doctor had not spoken to them about this, or offered any advice.

Shropshire woman, Debbie Byrne, who was diagnosed with two malignant tumours to her right breast at the beginning of October 2004, and had a mastectomy, is backing the new campaign.

Debbie, 44, of Newport, had chemotherapy and radiotherapy and has also been treated for what is known as bone mets - the spread of disease to her left leg, hips, pelvis, spine and shoulders.

In June 2007 she underwent reconstruction surgery and in April last year had to give up work as a HR director for a medical technology company.

She has arthritis which has been brought on by drugs, suffers fatigue and has difficulty walking and driving.

Debbie says there are three issues which impact on sexual relationships with their partner.

Firstly there is the physical, such as having surgery, and the side-effect of drugs. There are wounds to be treated, scars, drips and drains, and follow-up appointments.

Partners see all this and tend to go along when the patient is having treatment.

Secondly there is the mental side of things which partners can't experience – the patient's self-perception, that they are no longer the same person because of the physical changes they have had to go through, worries about death and dying, the effects on their libido.

The third issue – and again partners can find themselves in limbo – is the emotional one and the impact cancer can have on love, desire, sensuality, sexuality.

"I don't consider that any of this is exclusively feminine," says Debbie.

"The sexual relationship can change, whether the patient is male or female.

"When receiving treatment it's difficult to find someone who can talk through all of these things. There is a gap.

"But sexuality, either femininity or masculinity, is deeply affected by life-changing issues, and is a powerful emotion between people."

However, says, Debbie, the act of sex is only one expression of intimacy, sexuality and love, and there are other ways to rebuild intimacy.

She has a number of key messages to patients and their partners.

It's ok to grieve for what was, and accept that what was can never be quite the same again.

There is a "black hole" for those diagnosed and treated for a serious life-threatening illness.

"The gap is between the excellent medical health professionals who treat people for the condition, side effects and recovery, and the individual patient's needs that they find difficult, awkward wordless and can't express," says Debbie.

For partners it's OK to withdraw to reflect and regret. But they shouldn't withdraw completely and should provide emotional cups of tea (kisses) and sticky buns (gentle hugs).

"If you can't find a way to talk to each other or family members, don't let it eat away inside," adds Debbie.

"Find someone who has been through it and talk it over with them. Talking is the best therapy.

"Get over the fact that sex is a taboo subject. It isn't. It's natural. We are surrounded by images, references, programmes and the internet.

"It's no longer taboo and,importantly, it's not a taboo for our children any longer.

"It's ok to say what you want and what you need, and what's worrying you."

By Dave Morris