14 August 2009
Gynaecological Lymphoedema Physiotherapist, Dina Marie Bam
Three-quarters of people say cancer affected their sexual relationship.
'I feel inadequate about my body, and scared of sex itself. I also feel that my husband is frightened of hurting me.'
‘Unloved and 'sullied'. I have never had the confidence to enter another relationship.'
Three-quarters (72%) of cancer patients surveyed by Macmillan Cancer Support said cancer had affected their sexual relationship, either as a direct side-effect of treatment such as drugs or surgery, or because they’ve lost body confidence.
As a result, Macmillan Cancer Support has launched its Sex and Cancer campaign to break the silence surrounding the impact cancer has on sexual relationships and to encourage patients to speak to health professionals about their problems.
Macmillan also found that:
A third of those who said cancer had affected their relationship said they felt unable to talk to their partner about it.
Half of those who are single said they were put off starting a new relationship.
One in seven even said they separated permanently as a result of the cancer’s impact.
Doctors and nurses mainly focus on the medical side of cancer treatment, so help is rarely offered. Two thirds said their doctor had not spoken to them about this, or offered any advice.
Cath Lindley, General Manager for Macmillan Cancer Support in Wales said:
'Cancer can leave a lasting impact on a person long after treatment ends. People usually think of the hair loss and other side effects of cancer, but often it is how it affects a person’s feelings about themselves that can be most distressing. It can leave people’s confidence shattered, body image low, and make it psychologically or physically difficult to have sex at all.'
NICE guidance on cancer services for Wales and England states that all patients should have access to psychosexual support but our survey found that although 34% of the people surveyed had experienced some form of sexual dysfunction as a result of their cancer or treatment, 68% had not been spoken to by a health professional about the possible effects of cancer on their sexual relationships. Commenting on this finding, Cath Lindley said:
'We are aware that there is some good practice taking place in parts of Wales, however, our survey shows clearly that the NICE guidance on sexual rehabilitation services has not yet been fully implemented. Health professionals must talk to patients about the impact of cancer on their sex lives at the earliest opportunity.'
Macmillan has written to the Chief Executives of all the Local Health Boards in Wales urging them to work with the Cancer Networks on the implementation of the rehabilitation element of the NICE Guidance. The charity also provides resources to help health professionals talk to patients about sex and cancer.
Macmillan has recently funded a Gynaecological lymphoedema physiotherapist in Singleton Hospital, Dina Marie Bam, who works with women who have had surgery and treatment for gynaecological cancers including cervical, vulva and ovarian. Dina’s work concentrates on the prevention and reversal of lymphoedema, an uncomfortable and often painful condition that results in fluid build up in the limbs and genital areas and is often caused by the removal of lymph glands during surgery. It can occur a few days after surgery or years after treatment and so prevention is key to Dina’s work.
'Lymphoedema is a very visual condition. My patients experience swelling in the heels, feet, legs and genital areas. Due to the swelling women can find it difficult to find clothes that fit and this will impact on their confidence and body image. They may experience embarrassment because they feel ‘big’ and uncomfortable. This can affect their relationship with their partner but often women don’t feel able to talk about how they feel and so it can become a problem.
'That is why I discuss sexual relationships with my patients. Some of my patients want to know when they can be intimate with their partner and I encourage them to share any concerns they have with me at the earliest possible opportunity. It is a vital aspect of their health that we discuss sexual function. It’s an important part of their lives and so I have incorporated it into a six-week course that patients are offered a few months after their surgery.'