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JAMA Oncology Patient Page
December 2016

Intimacy, Body Image, and Cancer

JAMA Oncol. 2016;2(12):1667. doi:10.1001/jamaoncol.2016.1196

One of the most difficult subjects to deal with during and after cancer treatment is intimacy.

Remaining Whole During and After Cancer Treatment

This difficult disease and its therapies can make patients’ relationships with their partners, spouses, and even themselves seem like a tangle of fear, fatigue, depression, shame, and vulnerability. They may struggle to discuss their changed bodies and strain to define the shifting dynamics and needs of their sex lives. Factors like these make it challenging to discuss posttreatment changes in sexuality, rebuilding a healthy body image, and reestablishing intimacy.

Body Image and Cancer

Cancer treatment can cause physical, emotional, and mental changes that are difficult, sometimes impossible, to discuss with loved ones. Surgical scars and changes in weight and physical appearance can decrease confidence and induce anxiety. Body image also changes during treatment, with different effects on men and women. The most common physical changes are hair loss, fatigue, skin dryness, swelling of the face, legs, and arms, weight loss, weight gain, scars from surgery, skin discoloration from irradiation, and bowel and bladder changes. Some women experience early menopause after starting chemotherapy. Understanding how chemotherapeutic drugs, surgical treatment, and radiotherapy can affect a person is important to prepare for the physical changes that may take place during treatment.

Emotional Intimacy and Cancer

Reestablishing intimacy during and after treatment can be particularly challenging. It is important to understand that there are different kinds of intimacy. One of the most important types of intimacy, especially during treatment, is emotional intimacy. Maintaining an open dialogue through treatment will help to reduce the feelings of resentment, anxiety, guilt, withdrawal, helplessness, and overall stress for both patients and caregivers.

Feelings of isolation and depression are not uncommon during cancer treatment, and such feelings can be difficult to overcome. Patients sometimes want to withdraw from family and friends, or they find that their loved ones’ coping strategies are different than their own, which leads to further isolation. Open communication and healthy, intimately emotional relationships are effective tools in overcoming such negative feelings.

Physical Intimacy and Cancer

Cancer treatment can interfere with physical intimacy in many ways. Patients lose their sexual desire or find it difficult to engage in physical intimacy with their partner (sometimes because of adverse effects from treatment). Men and women will experience different challenges around physical intimacy during and after treatment. The most common for men are erectile dysfunction, loss of confidence, anxiety, depression, and infertility. Women are most often affected by pain during intercourse, loss of confidence, anxiety, depression, and infertility. Open communication in relationships and with clinicians about sexuality are effective tools in maintaining a healthy intimate relationship.

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Section Editor: Howard (Jack) West, MD.
The JAMA Oncology Patient Page is a public service of JAMA Oncology. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Oncology suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call (312) 464-0776.
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Article Information

Published Online: October 6, 2016. doi:10.1001/jamaoncol.2016.1196

Conflict of Interest Disclosures: None reported.

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