Chemotherapy and sex: Dr Andrew Dean

Dr Andrew Dean, Director of the Cancer Editorial Advisory Board, explains the importance of intimacy and sex during on-going cancer treatments.

Transcript

Let’s talk about the embarrassing stuff: sex and intimacy.

Patients undergoing cancer therapy often are reluctant to bring this up in the consultation. Sometimes, after a number of months of treatment, there will be a small comment from the husband or wife just saying, “Well, of course, we don’t do that anymore.” And when I hear that I’m actually sad because I think that sex and intimacy are so important in a healthy relationship. And when you’re fighting an illness such as cancer you want every bit of help you can get, and that means the love and intimacy that you share with your loved one.

So, what does that actually mean?

What it means is that having chemotherapy does not mean that you can’t kiss your loved one; it doesn’t mean that you can’t cuddle; it doesn’t mean that you can’t hold a newborn baby, which are all questions that are asked of me by people who are concerned that when they’ve had chemotherapy they are somehow toxic.

How much is okay and how much isn’t? Am I all right to have sex? Can I have oral sex? And the answer is: Yes, you can. You just need to know more about it. And that is what many people worry about, when they get their chemotherapy education: that they get told how horrific the chemotherapy is and worry that somehow they become toxic, and that they pose a risk to their loved one or to newborn babies that they hold. I never cease to be amazed by how many people ask me if it’s okay after they’ve had chemotherapy to hold their new granddaughter or their new grandson.

The answer is that having chemotherapy does not make you toxic. Chemotherapy floats around your body; it gets metabolised by your liver; it gets broken down and excreted. Sometimes it’s broken down into harmless chemicals that pose absolutely no risk at all, and sometimes it gets excreted in the urine in a form which potentially could be hazardous in large quantities.

The guidelines for many institutions suggest that you use condoms when you’re having sex after chemotherapy. That’s probably a good advice for some drugs such as anthracyclines, such as adriamycin and idarubicin. Being honest with you, most people who are having those drugs – idarubicin, doxorubicin, adriamycin – probably don’t feel like sex for the first few days after chemo. Once you actually feel a bit better in yourself, those drugs have almost certainly been excreted and eliminated from your body. So the absolute risk that you transmit those chemicals to your loved one is probably very small.

Not everybody agrees with the strict, stringent guidelines that are recommended by these bodies. Many feel that these recommendations are driven by concerns about medical-legal liability and “what happens if my partner develops cancer 20 years after I’ve had my chemotherapy?” I think that this is something which is very contentious and really does need to be thought through logically and discussed with your oncologist, your nurse practitioner or your chemotherapy educator.

More information

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