Table 6 Impact of changes to sexuality post-cancer on intimate relationships

Relationship strain

I feel that if your partner lacks sensitivity and understanding to your feelings after a total hysterectomy then that relationship is not worth keeping. After the operation I felt no longer attractive as a woman. Intercourse became painful so I would avoid it. I found it easier to end the relationship, not having to worry about someone else’s feelings. (W, 62, hetero, gynecologic)

My partner left me 6 weeks after mastectomy. He has huge fear of cancer- didn’t have the courage to face it, or support me. (W, 46, hetero, breast)

Loss of libido or desire has created a wall. (M, hetero, 77, prostate)

I feel as though I am constantly disappointing him. We are not as happy as we use to be. (W, 32, hetero, breast)

The relationship is incomplete now, and I am not a satisfying partner anymore. I feel at risk of losing any relationship. (M, 58, gay, prostate)

The relationship deteriorated rapidly. He expected me to be the same as before surgery and could not understand or didn’t want to what I was saying. He had an affair. (W, 62, hetero, genitourinary)

It was such a new relationship when my cancer was diagnosed - we had been together only 3 months. I feel as though I am letting him down, being unable to have sex, and that this is too much for a partner to deal with at such an early stage of a relationship. I also feel that having this cancer “traps” him in the relationship - he may feel too guilty to leave even if he wanted to (M, 26, gay, haematological/blood)

Difficulty in forming new relationships

I don’t feel pretty enough or skinny enough for anyone who is willing to look my way. I haven’t had a relationship in all my life, but just recently stopped seeing this guy after a few weeks. I think I blame myself for not being attractive enough for keeping his attention. I feel like if I meet new guys and have a connection with them, then once they learn about my cancer it will probably turn them away. (W, 23, hetero, breast)

My body was butchered … I have no relationship. (W, 51, hetero, breast)

Made me uncertain and unwilling to enter a relationship (W, 61, hetero, breast)

I feel ugly and that no one wants me and my husband left me when I was diagnosed with cancer haven’t found a new partner yet. (W, 42, hetero, breast)

ED (erectile dysfunction) has greatly lowered my confidence in locating a new partner (M, 71, hetero, prostate)

It makes me sad and a little depressed that I have no partner, more so since the cancer. It makes me feel like I will never have a partner again (W, 26, hetero, digestive/gastrointestinal)

Strengthened relationship

More open, prepared to deal with challenges by discussing with each other openly (W, 32, hetero, haematological/blood)

I find life different – not being able to get an erection and maintain it. Pleasure is now derived by digital and oral sex for my wife. Emotionally our relationship has deepened. (M, 68, hetero, digestive/gastrointestinal)

We are less emotionally and physically aroused but perhaps deeper in love and understanding (W, 75, hetero, breast)

Even though I look at myself as deformed, he doesn’t and he shows that he loves me more often. Both in and out of the bedroom. (W, 32, hetero, breast)

I’m very blessed to have a caring & loving husband who always tries to satisfy my needs. We both miss the spontaneity of our sex life since the onset of my cancer but we have a very strong and loving relationship which gets us through it all (W, 37, hetero, breast)

My sexual partner has always wanted to have sex with me - this made me feel good about myself after my surgery and when my head shaved. He didn’t care - just loved my body anyway. He was great (W, 51, hetero, brain)

Re-prioritising sex

Sex is not a big deal anymore for either of us. We enjoy each other’s company regardless. (W, 60, hetero, gynecologic)

I know my husband still loves me and cares for me. We are getting older and realize sex is not the most important thing in a relationship. We know we love each other no matter what happens. (W, 41, hetero, haematological/blood)

Being sexuality active or not does not define me or my relationship. It’s just not that important to me any more (W, 42, hetero, breast)

You’re naturally disappointed that you can’t sort of perform as you used to [chuckles], but you know it’s not a major problem with me sort of, as I say, getting on towards my 70s anyway (M, 68, hetero, myeloma)

I went through menopause and had started to accept the fact that, that physical sex, penetration, all those things, were just not there as much as they had been, or nor did I want them as much as I had. It’s different when you’re [laughs] over 60 than when you’re 40 or 50 (W, 61, hetero, anal)

Renegotiating or redefining sex

I can’t get an erection but I think we have, I would rate it as nearly as good a sex life as before the operation. So you know, in terms of, it depends what, how hooked you are on penetration (M, 68, prostate)

We were like, oh, two puppies playing together, even though I’m 59 and he’s 74. We sort of simulated sex - we’d get on top of each other and not actually have sex but, you know, sort of loving each other in a sex position (W, 59, hetero, lymphoma).

You can’t reliably have normal intercourse. You’ve got to, you know sort of do other ways either, sort of, manually exciting or that sort of thing, oral sex and that type of stuff. So um … ah they’re the changes but we have been able to sort of work through that and so that it’s not a massive problem (M, 68, hetero, myeloma)

In keeping the sexual relationship alive…that’s meant coming to terms with medication and cock rings and a whole range of sex aids that actually mean communicating pretty openly with, or very openly with my partner. (M, 65, gay, prostate)

Well, I guess we sleep together, so that’s a good thing, and cuddle up, and touch, and that sort of thing is always good. (W, 59, hetero, ovarian)

We hug a lot and we um, in bed, I would cuddle up as much as I can, [Pause] when he comes home, he always kisses me hello and so on. he’d just stop me in the kitchen and put his arms around me. I haven’t had an erection for nearly 12 weeks, and it’s impossible for me to get one. So that little aspect of intimacy is very important to me (M, 65, gay, prostate)