Can sexual activity actually cause
Not in the strictest sense of the word. In practical terms, the development of a few cancers may be influenced by a virus that is passed from one person to another during sex. Cancers of the cervix, vulva and penis seem to be linked to the human papilloma virus. But very, very few people who have one of these viral infections get cancer as a result. There are many factors other than the virus at work, such as: the genes we inherit from our parents; whether or not we smoke; our age; and our general health. These dictate whether or not an infection with a virus might affect the development of a cancer.
However, some people still see sex as bad or sinful and at some unconscious level fear that their cancer may be `punishment' for some past sexual disease or sin. One patient of mine, for example, asked me if God was punishing her for an affair she had 20 years previously. If you are worried or guilty about your cancer having been given to you as a punishment then you'll need to talk this through with a religious pastor or a counsellor.
Can I catch cancer from my partner?
No. If your partner has a cancer, you cannot catch it like a cold from any known sexual activity.
Could sex make my cancer worse?
No. On the contrary, I believe that sex and all the love and caring that goes with it can be helpful to those who have cancer. So many people feel depressed, unlovable, guilty or afraid when they have cancer or are being treated for it, their partner's affection and acceptance can make a big difference.
Are there times when sex should be avoided?
Yes there are. First of all, it's safest either to avoid sex or to be sure to wear a condom during and after chemotherapy. Although it may seem excessively cautious to some, I would advise wearing a condom for a month after chemotherapy. We simply do not know enough about what comes through in semen. Also the vagina, especially when aroused, is a highly absorptive organ. Wearing a condom gets over the problem and avoids the stinging sensation some women report. For women who can still have children, it also reduces the theoretical likelihood of foetal damage should any of the chemicals be absorbed.
Vaginal intercourse is probably best avoided very soon after pelvic surgery in women. The time to get back to sex will vary greatly according to the sort of operation you had and how quickly you are healing.
Some types of cancer (of the cervix or bladder, for example) cause bleeding from the vagina or in the urine. If this sort of bleeding is made worse by intercourse then it's sensible to stop until treatment has controlled matters.
Are there any good positions for making love after cancer?
This will depend a lot on which part of the body is affected by the disease. If it is the woman's pelvic area then it will take some gentle and patient experimenting to discover which lovemaking positions now suit you both. This can also be true after a mastectomy, when some women say that they don't want their lover's weight resting on them. Maybe making love side by side, or with the woman on top, will be better. Most couples find that with loving communication they can sort out what suits them best. And this will change with time, so be prepared to change what you do.
How can I overcome problems of tiredness?
Be flexible about the time of day you make love. Experiment with less demanding positions for lovemaking. And agree with your partner that lovemaking need not mean going the whole way.
I'm embarrassed about my mastectomy scars but still want to make love. Any
Certainly. Why not try making love in the semi-darkness to avoid being seen so clearly? Some women also say that they find having sex with their bra on after a mastectomy makes them feel sexier. This both accommodates the prosthesis, if there is one, and hides scars. Or you might like to wear sexy undies, which can be a real turn-on for your lover and hide any scars.
Most women find their lovers are much less concerned by their scars than they imagine, and once the subject has been discussed openly they can feel more relaxed about the changes in their bodies.