Assessment
Intimacy and sex can be important or unimportant to somebody throughout their life. Throughout somebody’s life cycle there are natural changes to sexual function and desire. These are often not described or taught.
Cancer and cancer treatments may impact on somebody’s desire for intimacy, changing the relationship with oneself and/or a partner and the need and desire for sexual intimacy. The desire and need for intimacy may change for the person having treatment, but may also change for their partner and have a significant effect upon a couple.
A partner can often feel it is selfish to ask to be intimate and have sex when their loved one is undergoing treatment or is recovering from treatment. This can be a ‘silent conversation’ (without discussing it with each other) - a presumption on either person’s part. Whilst this is done with the very best intentions, this can cause friction later down the line.
People who are not in a relationship, may equally experience changes in levels of arousal and/or the need for sexual satisfaction. The desire for self-pleasure exists and should not be underestimated.
It may be helpful to distinguish what is meant by intimacy and sexual intimacy.
Intimacy is the desire to have a cuddle, have a kiss and want to feel close to your partner. Just be with each other.
Sexual intimacy means to have oral or penetrative sex.
Experience has shown that people undergoing cancer treatment and for 9 to12 months afterwards, say they feel like ‘patients’ and not a wife, husband, partner or lover and this will naturally have an effect on interactions in a relationship. If sex and intimacy are not important to somebody before cancer treatment, the impact may be less afterwards as well.
If sex and intimacy are important in somebody’s life, they may find that initially there is just a need to know about going to get through treatment and be well and okay, although it is not uncommon that sexual relationships are important to people throughout their treatment and especially once they have recovered from their treatment.
After treatment has finished, individuals or couples who feel the need are searching to find their intimate and sexual selves again. This can be achieved through great communication together, or people may need help to talk through the issues with someone trained in psychosexual therapy.
Experience has shown that many medics, GPs and patients say ‘sex isn’t important, the person I am is alive and that is what matters’. Equally patients have said ‘if I can’t have sexual relationships again, I don’t want this life’. There needs to be life in extra years. There is no right or wrong, it is what is important to an individual, and what is important to them and their partner, that is crucial.
The very first step would be to identify for oneself and with one’s partner (if relevant, this applies to those without partners as well) one’s feelings and open the door to conversations about both needs and any worries, without putting any pressure on expectations on each other.
Rediscovering one’s sexual self can be very exciting, even if feeling slightly daunting. All too often humans can be creatures of habit. If somebody has always kissed and touched in a certain way, they may have been doing that for the last 10 years or more. Are the same moves stimulating, erotic and sensual or has this changed? Is it time to rediscover what both partners like and enjoy?