For Cancer Patients, Someone to Love Helps

The good news is that cancers of all types are no longer a death sentence. Treatments have improved so much that many people survive and thrive for years after a diagnosis and treatment. As a result, substantial research is now dedicated to “quality of life” for cancer survivors.

Quality of life is highlighted in patient-centered care, which broadens treatment beyond a focus solely on elimination of the cancer and survival of the patient to include a holistic perspective on the patient’s life. Thus, quality of life becomes a consideration in treatment.

Many factors contribute to a person’s quality of life, ranging from economic factors to physical function to relationship status and satisfaction. For patients, the effect of treatment on these factors becomes a salient consideration in adjusting to receiving the diagnosis (De Luca et al 2017), as well as making decisions about acceptance of and adherence to treatment (e.g., Liang et al 2016). Because partners/spouses often are also caregivers, the quality of that relationship takes on particular significance.

The significance of partners in the care and well-being of cancer patients has been recognized by the Institute of Medicine in their document entitled "Cancer Survivorship Care Planning." This document requires the inclusion of information on the possible effects of cancer on marital/partner relationship and sexual functioning, among other factors related to quality of life.

A cancer diagnosis disrupts one’s life at every level, including intimate relationships that have a significant effect on quality of life. One cannot assume that the diagnosis and treatment of cancer will have a uniform effect on relationships. In the case of prostate cancer, for example, some studies report partners express more distress than the patient while others report less (Chambers et al 2013). Relationship quality and satisfaction are affected by sexual dysfunction, which may seem obvious in cancers such as prostate or breast cancer. However, relationships of patients with other types of cancers are not immune to this effect.

In our recent study (Boccia et al., in press), we explored quality of life and its relationship to sexual function in a group of brain tumor patients. Sexual difficulties for women are common in the general population. Roughly 40% of women typically report some type of difficulty, with specific difficulties such as desire, arousal, orgasm, and satisfaction ranging from 17% to 28%. In our study, we found the percentage of patients reporting these problems roughly twice this level. An increased percentage of sexual problems was associated with lower ratings on an overall quality of life survey but was not always associated with a negative impact on relationships. Many patients reported that their partner relationship had grown stronger since their diagnosis.

These sexual difficulties can be addressed and help provided. I have worked with couples struggling with their relationship following cancer diagnosis and treatment. Sometimes, the goal was to restore full sexual functioning. In other cases, it was to find new ways to connect sexually despite some type of dysfunction. Always, however, the goal was to restore the quality of their relationship and find ways to experience satisfaction in their sexual relationship.

Unfortunately, many medical providers are not knowledgeable about and/or are uncomfortable with discussing the sexual aspect of their patients’ lives. There are, however, physicians, physical therapists, and sex therapists equipped to help in this area. There are also professional associations that provide resources for patients such as the International Society for the Study of Women’s Sexual Health and the Sexual Medicine Society of North America. It is not necessary to suffer in silence. Help is available.