Cancer and Intimacy: Breaking the Silence

Cancer affects every aspect of life — including intimate relationships. Yet this is one of the least discussed topics in Pakistan, leaving many patients and their partners feeling isolated, confused, and unsupported.

Why does cancer affect intimacy? Cancer and its treatments can affect physical intimacy in multiple ways:

• Surgery: Mastectomy, pelvic surgery, or colostomy can change body image and physical function
• Chemotherapy: Causes fatigue, nausea, hair loss, and hormonal changes affecting libido
• Radiation: To the pelvic area can cause vaginal dryness, pain, or erectile dysfunction
• Hormonal treatments: Menopause symptoms, reduced libido
• Psychological impact: Depression, anxiety, grief about body changes

This is a medical issue, not a taboo: Changes in sexual health during cancer treatment are common, expected, and treatable. They should be discussed openly with your healthcare team, just like any other symptom.

For women:

• Vaginal dryness can be treated with lubricants or local oestrogen (discuss with your oncologist)
• Pelvic floor physiotherapy can help
• Open communication with partners is essential

For men:

• Erectile dysfunction following pelvic surgery or radiation is common
• Treatments are available (medications, devices)
• Referral to a urologist or sexual health specialist is appropriate

For couples:

• Intimacy is more than physical — emotional closeness, communication, and touch are equally important
• Counselling (individual or couples) can help navigate this difficult time
• Many cancer centres offer psychosocial support

Cultural considerations in Pakistan: The topic of sexual health is stigmatised in Pakistan, but cancer patients deserve support in all aspects of their wellbeing. If you feel unable to speak to your regular doctor, ask for a referral to a psychologist or social worker at the cancer centre.

Key message: Changes in intimacy during cancer are common and not your fault. Help is available — please ask for it.