Study: How cancer affects your sex life – “It’s good to remember that sexuality is not the same as intercourse,” says Professor Timo Joensuu

The study report indicates that prostate cancer patients consider sexual activity to be the aspect of their lives that is affected by the disease the most. Of all the respondents, 38% said that the effect of the disease on the quality of their sex life was very considerable, while 27% said that the effect was relatively high. Half of the prostate cancer patients who took the survey said that their relationship with their spouse or their sexuality had suffered as their treatment advanced. Correspondingly, half of metastasised breast cancer patients also said that their intimate relationship or sexuality had suffered.

– Cancer treatment can affect intimate relationships and sex life. Nearly nine out of ten prostate cancer patients experience problems with having an erection. Erectile dysfunction is a major issue that may cause anxiety and raise various questions about sexuality: Can I enjoy sex anymore? What will happen to my virility? Maintaining an erection is one of the first causes of concern that come up when discussing with men with prostate cancer, says Professor of Oncology Timo Joensuu from Docrates Cancer Center.

– Women with breast cancer are typically less worried about their sexuality than men. The external body image of women changes more than the body image of prostate cancer patients. Scars, changes in the shape and size of the breasts, changed skin pigmentation and the loss of hair caused by chemotherapy, for example, can cause worry not only about personal health but also about one’s own femininity. Many fear that they are no longer woman enough for their partner, especially if a breast has been respected. Women can become afraid of showing their naked body to their partner as they feel that their body has changed so much as a result of the treatment.

Radiotherapy can protect erection capability better than surgery

– The later the stage of the prostate cancer is when it is diagnosed, the more the treatment will affect potency and sexuality. If the prostate cancer is diagnosed at an early stage, maybe even in its asymptomatic phase with the help of PSA monitoring, it is likely that the cancer can be gotten rid of in one go by optimising individual radiotherapy and protecting potency and sexuality, says Timo Joensuu.

In general, there are two options for treating prostate cancer: surgery and radiotherapy. According to Timo Joensuu, on average, sexual function in men is conserved better if radiotherapy is used instead of surgery.

– Cancer typically grows at the edges of the prostate, near the prostatic capsule. The nerves controlling erection go through the base and the back of the prostate, near the capsule. In most cases, the cancer is diagnosed when it has already grown through the capsule and nerves, which means that the nerves may be damaged in surgery. The advantage of radiotherapy is that its effect is targeted mostly at dividing cells. Potency nerves are completely differentiated and undivided, and if radiotherapy is limited to adequately small doses, it will not damage these nerves. Even with radiotherapy, the erection may be temporarily weaker, but the problem typically subsides within a few months, says Timo Joensuu and adds: – The individual treatment of a patient depends on the nature and extent of the disease. When the treatment has been planned, the physician can also assess the harmful effects related to it better.

– The development of radiotherapy and the better accuracy of treatment has also reduced the need for hormonal therapy associated with prostate cancer treatment and shortened the treatment process. The growth of prostate cancer cells is primarily caused by testosterone, and the purpose of hormonal therapy in the treatment of prostate cancer is to prevent the effect of testosterone in the pro static cells. The lack of testosterone can cause erectile dysfunction. The good news is that if a local cancer is diagnosed at an early stage, hormonal therapy is no longer needed. This protects the erection and libido of patients.

Great demand for mental support

There are both oral tablets and products injected into the penis which are available for dealing with erectile dysfunction. Timo Joensuu says that even more important—regardless of the type of cancer—is that the patient has someone to talk openly with about anything. This makes it easier to adapt to the changes in their sex life.

– It’s good to remember that sexuality is not the same as intercourse. In many cases, fighting cancer together has brought couples closer, where an honest and open discussion plays an important part. According to my experiences, not all men can talk about their needs and fears with their partner. In such cases, the services of an expert may be tremendously helpful. Male patients often ask me how to approach their partner, how to show their love and how they can support their partner in the difficult situation, says Sexual Adviser, Urology Nurse Sini Johansson from Docrates Cancer Center.

– In such cases, we go over the wishes of both the patient and their partner and I attempt to emphasise the meaning of discussion and physical touch and explain how sexuality and love can be shown in other ways than just intercourse.

Cancer patients can also talk about matters related to sexuality with the urology and sex therapist of Docrates Cancer Center. It is also possible to include the partner of the patient in the meetings to make them understand what the treatment and the related sexual problems are about from the very beginning.

According to the Suomi hoitaa 2022 study by Taloustutkimus, patients have a strong need for mental health support (16% of prostate cancer patients, 44% of breast cancer patients) and support in processing the social effects of the disease (3% of prostate cancer patients, 16% of breast cancer patients), much stronger than currently.

– Mental well-being is by far the most common issue breast cancer and prostate cancer patients want to be processed at an appointment. The reason is clear: According to the responses to the survey, mental well-being is only processed in 14% of prostate cancer cases and 19% of breast cancer patients, while the social effects of the disease are not processed at all. Finnish oncology has some room for improvement in this, says Joensuu.

For more information, please contact:
Anna-Sofia Malmi, Marketing and Communications Director
tel. +358 (0)50 4690 114, anna-sofia.malmi@docrates.com

Suomi hoitaa is part of the group of studies conducted by Taloustutkimus that aim to seek answers to interesting phenomena in the form of a standard survey. The patient paths of Finnish patients were studied in the survey, which was conducted online in June–November 2021. Patients were recruited for the survey through an extensive consumer panel arranged by Taloustutkimus and with the help of a patient organisation. Each case was examined separately and a total of 4,873 people took the survey (excluding the gene test, which was taken by 371 people). The respondents were allocated into different surveys according to their diagnosis. The sections for prostate cancer, breast cancer and lung cancer patients and gene tests were taken by 158, 334, 49 and 371 people, respectively. The margin of error for the total number of respondents is 1.4%. The source of the article has been also Eturauhassyöpä ja seksuaalisuus-article, written by Essi Kähkönen, 9/2021, Best Practice Nordic.

Docrates Cancer Center is a Finnish-owned, international hospital in Helsinki specialising in cancer treatment. We provide individual services for cancer patients throughout the treatment chain, from diagnostics to post-treatment follow-up. After diagnosis and imaging, the treatment can be planned and initiated without delay. Our unique concept attracts patients from all over the world. We have treated patients from more than 60 different countries. Together with our network of leading clinical experts, we provide genuinely individual state-of-the-art cancer treatment services.