Tag Archives: Goals

Intimacy, Sexuality and Cancer

Cancer can have an impact on just about every aspect of a person’s life but one of the more common long lasting effects of cancer, especially breast cancer, are issues relating to body image, intimacy, and sexual function. This supports the principle that these concerns need to be focused on and the opportunity created to discuss them at any stage of the treatment pathway.

There are many definitions for human sexuality and 1  how we feel about intimacy, sex, sexuality, and sexual relationships depends on a range of issues and it’s important to remember it’s not unusual to have sexual difficulties, even in times of good health and well-being. There are numerous reasons for this and often it can come down to inadequate information and education concerning sexual or reproductive health.

So why is it important to talk about sexuality and intimacy when diagnosed with cancer? It’s because this topic is very often overlooked and not discussed. This can be because it is often felt there are more important things to think about and discuss at this time, such as treatments and treatment schedules. Of course, it’s not going to be the first question someone asks their doctor but it commonly is an issue that comes to the fore at some point during or at the end of treatment. Understanding this will help you feel more confident to know when to talk more about it with someone who can help.

Living with cancer can affect a person’s sexual functioning in various ways, some of these effects may be due to the cancer itself, the treatments, or a person’s sense of self and/or their emotions at the time. Some of the sexual issues people with cancer have to deal with can be relatively minor, but sometimes they are ongoing and can be more serious and importantly, these questions change from the time of diagnosis, through treatment, and then into recovery.

As well as a cancer diagnosis, people may also have other conditions such as depression or hypertension, or they may be trying to manage menopause symptoms and along with this, their partners may be dealing with their own medical, psychological, and sexual issues. In fact, one of the best predictors of sexual concerns after a cancer diagnosis is to look at what a person’s intimate life was like before their diagnosis.

Sometimes, cancer can intensify these issues and while people may have managed different levels of desire before, cancer can complicate things and it can have an impact on both patients and their partners. People often say they experience loss of libido and interestingly, partners can too during this stressful time.

There are many solutions, and often a first step is knowing how to bring the topic up and ask for guidance. All patients should receive information about the possible side effects of the disease and treatment on sexuality and intimacy such as altered physical function and libido; problems regarding fertility; and menopause symptoms. It is, however, a difficult topic to bring up, not only for women but also for health care professionals who are also hesitant to initiate discussion and wait for the patient to voice their concerns –and consequently it often becomes an endless circle of inaction, frustration, and sadness.

It is also very important to acknowledge that these worries are valid regardless of a person’s age, whether or not they are in a relationship, the stage of their disease, and the type of cancer and surgery they are dealing with.

Here are some words you could use to help you bring the topic up.

How to bring up the topic with your health care provider:

“Is it safe to have sex / continue with our normal intimate relationship?”

“I have heard this treatment may affect my relationship with my partner.   Can you tell me what might happen?”

“My partner is worried he may hurt me if we have intercourse. Is this something I should be worried about?”

“I don’t feel attractive because of my scars and I’m worried my partner may not find me desirable any more. Can you recommend someone I can talk with about this?”

“I have developed vaginal dryness and its very painful and uncomfortable especially during intercourse – what can you suggest?”

And this may be helpful for health care professionals:

“I always ask how things are going with sexual relationships because it’s really very common to have difficulties after treatment. Is that something you would like to talk about?”

“I’m really pleased to hear the treatment side-effects are settling down. I find for most people at this stage another area of concern may be about intimacy and sexual function. Are there any issues you would like to discuss?”

If connection with a physiotherapist is available to you, their expertise can assist with advice relating to positioning and exercises to help improve pelvic floor strength. A breast care nurse or general practitioner may also be able to provide information regarding the appropriate use of gels and creams – and this is a topic we can provide more information about at another time!

Importantly, be kind to yourself and have realistic expectations.

1 W.H.O. Gender and reproductive rights: sexual health. 2002. who.int/reproductive- Health/gender/sexual_health.html. Accessed May 2007

By Janine Porter-Steele RN PhD and Leonie Young DUniv

This article first appeared in Reach to Recovery’s Bloom magazine, Issue 33 – December 2021.

So what is motivation ?

Motivation is the determination to reach our personal goals or desires. It is influenced by how much we want to achieve that goal, what we might gain from the achievement and what we from expect from ourselves.
There is little doubt that when it comes to health and wellness, the ability to stay positively motivated and continue with good physical activity and nutrition habits can be a struggle. Often we start out strong and then ‘life’ gets in the way and we go back to our old, perhaps not so good, behaviours. So here are some quick tips to help you stay motivated. 

- Self-belief to stay motivated is important as it influences our thinking. Developing a positive and high self-belief can create successful changes in our behaviours especially during exercise and help us reach our goals. Use positive self-affirmations.

- Find your reason why you want to achieve this goal, write it up somewhere and keep your focus on it, this is often a good way to stay motivated if you feel you are faltering.

- Set realistic, rewarding goals and regularly review them. This is a key aspect of keeping yourself motivated to get the positive benefits. To start with, it is sometimes helpful to just set one achievable goal and work it into your daily routine, break it down into manageable parts.  For example if your goal is to exercise, start by doing a daily walk for 30 minutes. Have a timeframe for when you want to have achieved this a s regular activity and then build on it.

- Keep a good and regular routine – Use an app or a reminder system so you can’t let the day escape before you have achieved your daily goal – some people make this work by creating a daily appointment for themselves just as they would for any other appointment for example the hairdresser, doctor, dentist or a friend. Being busy’ or ‘being too tired’ often causes a break down in the routine that was
initially set.

- Use your family and friends as support – tell them about your goals and encourage them to help keep you motivated. Buddy up with someone so you can help and motivate each-other or get yourself a mentor to guide you. Check your goals and your progress frequently. Seeing good progress is a great motivator in itself, and can also improve your self-confidence.

- Keep goals fun and reward yourself when you have achieved them, make a plan for when and how you will do this. Put a note on your calendar for reward day so you keep progressing towards the goal.

Remember …..
If you lose motivation for a day or two, don’t let that deter you. Pick yourself up and carry back on again, see it as a challenge not a failure, setbacks are normal.

Alcohol

Alcohol consumption is always a risk and the risk further increases if there is an excess on a regular basis or if binge drinking occurs. Excess alcohol consumption by women can cause issues in weight gain, high blood pressure, and increases risk for many health conditions including cancers and diabetes. Health and wellness in relation to alcohol does not have to take away alcohol all together for women, however promoting a healthy lifestyle whereby alcohol is not relied upon can ensure you are not consuming too much. These are some useful tips for the home and the workplace to promote this balance and provide positive healthy living messages surrounding alcohol intake:

1. Try not to make staff or other outings in places that promote alcohol consumption.
2. Always have water/other options available instead of alcohol at work functions.
3. Attempt to set goals to reduce the amount of standard drinks you have per day/week.
4. Avoid binge drinking.

These few tips can reduce the risks that come with consuming alcohol. Though avoiding alcohol all together would be the ultimate goal to avoid the many risks that can come from its consumption, remember there are other options. By placing smaller goals like specific weeks or months with no alcohol it is recommended to decrease the chances of getting a life-threatening illness and increasing overall health and wellness.

Goal Setting

Goal Setting can be an important action in ensuring health and wellness. Setting goals both large and small can provide direction and focus and promote healthy habits to provide positive outcomes. Here are five goals that the Women’s Wellness Program focuses on to encourage healthy change:

  1. Healthy weight and waist circumference.
  2. Physical activity.
  3. Reducing unhealthy habits.
  4. Healthy eating.
  5. Reducing stress.

Setting small goals within each area gives a starting point. Goal setting should start with goals that are not easy but not impossible. Starting with smaller goals allows you to put in the effort to do something and be able to maintain it. This can include reducing consumption of certain foods/alcohol/smoking daily or increasing physical activity per week. This can also lead into taking time in your day to attempt to reduce stress levels. From here goals can be increased and placed in more specific areas of weight goals, physical activity goals, and beating unhealthy habit (smoking/alcohol/caffeine) goals. Each of these is an important part of maintaining a healthy lifestyle and increasing overall wellness.