Sex, Relationships and Breast Cancer

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We acknowledge discussing sex and intimacy can be tapu/sacred and a sensitive topic for some cultural groups. We are open to your feedback on ways that we can improve our approach and information on this topic.

Our thoughts and tips are intended to apply to everyone, whether you’re heterosexual, gay or anywhere on the LGBTQI+ spectrum, whatever your age and ethnicity and whether your cancer is early or advanced.

Much of our advice applies whatever gender you are, but a lot of information relates to female bodies, given that more than 99% of breast cancer occurs in women, with around 25 men and 3,500 women diagnosed each year in Aotearoa New Zealand. There’s a section specifically on male breast cancer further on in this article.

Before cancer

Sex and sexuality are not fixed, they can and do change throughout our life stages. Our values, attitudes, upbringing and circumstances influence how we relate to our body, needs and desires. Sexual knowledge, history and ability to communicate about what feels good will influence how people respond to the challenges of cancer and the ways cancer treatments impact on sex and relationships. 

After diagnosis

There will be shock, grief, strong emotions and psychological distress for you and your partner if you have one. There's grief associated with having a cancer diagnosis. It is not unusual to lose interest in sex at times after a breast cancer diagnosis and during treatment. You may be focusing more on survival, learning about your cancer and coping with the treatments and their side effects. You may feel differently in your own body and how you feel about being touched or touching others, kissing, masturbating, having intercourse or penetration, and being physically or emotionally close with your partner, spouse or someone you are dating.

Effects of treatment

Surgery

Some will experience great relief after breast cancer surgery and feel comfortable with any physical changes. For some, breast surgery can change body image. This needs acknowledgement and time to process. It can also affect sexual arousal, especially if nipple or breast stimulation was a key aspect of your arousal pattern. After breast surgery, some don’t want their partner’s weight to press down on them. Try being on top or side by side to avoid pressure.

Scars can be a concern for some. Talking to partners about feelings and concerns about physical changes can help. You may want to have sex in semi-darkness or wearing a bra or crop top if you want to conceal scars or keep a prosthesis in place. A few women report increased erotic sensitivity at breast scar sites.

It's really important to have early detailed conversations with your surgeon about your breast cancer surgery options and to carefully choose what is best for you. This could help you avoid later concerns about how your body looks, which can be difficult to manage and live with. Remember to write all your questions down so you can ask them at your appointment. Take a support person to help you remember what was said and take notes or ask your supporter to do so.

Surgery may take a part of a breast or can remove the entire breast. If one or both of your breasts are removed, you may choose to have your breast(s) rebuilt through reconstructive surgery. There are several options for how this can be done so we advise doing some research and discussing these with your surgeon and others to make a well-informed choice that suits you. You could join a group of women who have experienced breast cancer and ask them about their experiences and choices.

Breast reconstruction may restore the shape and size of your lost breast, but it cannot restore normal feeling in the breast. Your nipple(s) also might be removed. Over time, the skin on the rebuilt breast may become somewhat more sensitive, but usually you will not feel the same kind of pleasure as before surgery. Still, breast reconstruction may help restore sexual enjoyment by boosting feelings of wholeness and attractiveness. After surgery you may not have perfectly symmetrical breasts. You may need more surgery if you want to even things up.  Remember it’s okay to say no to any more surgeries if you’ve had enough. It’s your body so it’s entirely your choice.  Don’t feel pressured by partners, whānau / family, doctors or specialists.

Instead of reconstruction, some women choose to “go flat”, i.e. to receive mastectomy without reconstruction. This is of course a valid choice. Some choose to wear a prosthesis after mastectomy, a breast form inserted into a bra or swimsuit with a special pocket.

Lumpectomy, or partial removal of the breast, may leave the breast misshapen. Prosthetics or further surgery may help to restore shape.

Some find they’re not entirely happy with their body after surgery. Improving body image and getting comfortable with your new body can take time.

You might try the following:•    Look at yourself in the mirror regularly. Try to be kind to yourself and accept your new body.•    Think of how much your body has gone through and how strong it is.•    Wash and dress to feel good every day, even when you are not in the mood.•    After breast cancer surgery, it is common to feel self-conscious about being nude during sex. Camisoles, lingerie or nighties might make you feel sexy and boost your confidence.•    Talk with your partner about what feels good or not sexually.•    Start a gentle exercise routine, as physical activity can improve your body image and mood. •    Seek the advice of health professionals experienced in treating women with cancer.•    Trust your own decisions.  •    Take part in a breast cancer support group.

Over time, these actions may help you adjust, release any negative feelings about your body and embrace the future with confidence.

BCAC Member Groups that can help:

PINC Cancer Rehabilitation Program can provide guidance on exercise after breast cancer. Click here and here to read more.

Aotearoa NZ Breast Cancer Community is an online peer support group - an inclusive and safe space that connects those who are at different points along the breast cancer journey by providing solidarity, support and the sharing of experiences. Learn more about this here and here.

Breast Cancer Support Aotearoa offers a safe, supportive and healing space for anyone with breast cancer and their whānau and friends. Read more about this service here.

Look Good, Feel Better offers free classes teaching tips and techniques that help participants look and feel more like their normal selves. They also run Feel Stronger, Live Better classes for men with cancer. You can read more about this here.

Chemotherapy

The side effects of chemotherapy can be difficult to manage and your desire for sex might be reduced. Symptoms of menopause, vaginal dryness or thrush can also occur with chemotherapy. Changes in skin sensations and sensitivity are also possible. These can be temporary and/or managed. 

Using vaginal moisturisers and lubricants can assist with vaginal dryness. These can be prescribed by your oncologist or GP or purchased at a chemist, see more details below. Do not use Vaseline or body lotions as these can cause irritation or infection.

Thrush can be treated with a cream or pessary (e.g., Canesten®, Clomazol®) and sexual partners might need to be treated, too.

In the days following chemotherapy, it is highly recommended to use a barrier (condom or dental dam) to stop chemotherapy drugs being passed on to partners via vaginal fluids or semen.

Head and body hair loss from chemotherapy can have a major effect on how you feel about yourself. Losing pubic hair makes some people feel less sexual but others might enjoy this change. Your hair, on your head and elsewhere, will usually grow back, although it may have a different colour and texture. Get in touch with Look Good Feel Better if you’d like to have a make-over and learn how to look your best while under treatment.

Weight gain or loss caused by chemotherapy may cause you to feel uncomfortable in clothing that no longer fits. You may have low energy, feel discouraged about changes in your weight and become self-critical about your body shape. Ask your medical team about diet and exercise to help you return to your healthy self.

Hormonal treatment

Menopausal symptoms can occur with hormonal therapy, including hot flushes, vaginal pain, dryness, discharge or atrophy along with reduced sex drive. Some may experience depression or weight gain. Managing these issues well is essential to regain your sexual self. Do not be shy raising these issues with your medical professionals to get the best supportive treatment. See below for strategies to manage symptoms.

Radiation

Radiation treatment can cause extreme tiredness, so an active sex life might be the last thing on your mind. On the other hand, gentle, less demanding, shorter sexual activities might work. Hugs and reassurance can help. Talk about the best time for sexual play. This can be in the middle of the day or any time but spend time together with your partner. A yummy siesta can be fun!

Radiation can also make the skin of the treatment site very sensitive, hot, burnt, red and itchy. This can take weeks to fully heal and any touch during this time can be painful, so let your partner know and guide their hands away from sensitive or painful areas to more sensual spots. Your oncologist or breast care nurse will advise on skin care before, during and after radiation treatment. 

Managing side-effects and overcoming sexual problems 

Breast cancer treatment such as chemotherapy and hormone treatment are very effective in treating your cancer and reducing your chance of cancer recurrence. However, they can cause side effects that affect your sexual life, including menopausal symptoms such as hot flushes, insomnia, vaginal dryness, pain during intercourse or penetration, reduced interest in sex, mood swings and loss of energy. This isn’t the case for everyone, but if it’s happening for you, it is very important to talk with members of your healthcare team to address these issues and find ways to make sex more pleasurable. You may also want to join a peer support forum to talk to other women who have had breast cancer to ask what worked for them, or speak to other people you feel comfortable with.

It's hard to overcome feelings of guilt and disappointment that you’re not the same sexy partner you used to be or that your body has betrayed you and your partner. Counselling and other mental health support can help you learn to be kind to yourself and overcome these feelings as you work through the issues. It’s OK to have bad days. Antidepressants help some to get through this time with less stress.

What felt good before treatment might not feel good right now. Try different sexual positions that let you control the movement and avoid pain. If deep penetration hurts, ask that this goes less deep. You may want to lie on your side, either with your partner behind you, or face to face. For pain that persists, talk with your gynaecologist and oncologist.

You may experience pain during penetration as a result of vaginal dryness, narrowing of your vaginal opening or tightening of pelvic muscles when you anticipate pain during sex. This may make penetration difficult or impossible. Ask for strategies to relax and stretch pelvic muscles. Regular use of vaginal moisturisers can help overcome the effects of treatments that cause vaginal dryness and reduce the thickness and elasticity of your vaginal wall. Examples are Replens® and YES VM®. Massage vaginal moisturiser into your vulval area and vagina. If you enjoy vaginal penetration, you’ll also need vaginal lubricant. Be sure to use plenty of good quality lubricant during vaginal penetration as this can improve elasticity, reducing pain and discomfort. Try different lubes until you find something that works well for you. You can buy vaginal moisturisers and lubricants over the counter from pharmacies or by prescription from your health professionals, but your local sex shop might stock the best range. Ask your breast care nurse if they can recommend a good adult store. Staff there should have expertise in recommending a lubricant that’s not too watery, is more viscous and will last longer during sex. Try silicone or oil-based products. If you’re too shy to visit an adult store you could order online. If pain persists you could ask your pharmacist for a topical anaesthetic or numbing cream to use in the lower third of your vagina. This may only be needed for only a month or so until you’ve become used to penetration again. Amitriptyline is a medicine that can be used to reduce nerve pain. It works on noradrenaline and serotonin in nerves and lowers pain signals to the brain. If none of this works you may want a referral to a vaginal dermatologist to find out whether you have a condition they can diagnose and treat.

If you have hormone receptor positive breast cancer, you may be wary of using a vaginal oestrogen cream or pessary to help restore your vaginal and vulval health. These deliver a low dose of oestrogen, but data is lacking on long-term effects. Talk to your oncologist about risks and benefits. Some women on hormone blockers stop treatment because of side effects, but this can increase the chance of your cancer returning, so try to stick with the plan if you can and work with your oncologist, GP and partner to manage side effects.

If your libido is diminished, sexual intimacy can drop off the radar. If so, you’ll need a plan to get back into the habit of having sex. You can practice by yourself when you’re not stressed. Maybe try a vibrator or other sex toy. Choose a particular time of the week for intimacy. You could put a recurring appointment into your and your partner’s phone to be sure it won’t be overlooked. Remember to use plenty of good quality lubricant. Take the time to explore your body to find new erogenous zones. Don’t worry if it takes longer to get aroused, just keep communicating so your partner knows what’s happening for you.

For a good discussion between patients and clinicians on sexual issues watch this webinar produced by Breast Cancer Trials (Australia and New Zealand).

How and when to talk about sex

If you have a partner

When it comes to talking about sex and intimacy, breast cancer can test even the strongest relationships. Relationships under pressure can change and some will end as a result of cancer and its impacts.

Women report a variety of concerns with their sexual lives. Mastectomy or lumpectomy may have left you without breasts or nipples. The swelling of lymphedema may change the way you feel about your body, dressed or undressed. Areas that when touched in the past gave pleasure, the vagina, the breast, other erogenous zones unique to you, may now feel numb, dry, painful, or just plain different. Some women question whether their partners will still feel attracted to them, even as they begin to learn the landscape of their changed bodies.

Partners report different feelings; worries about how to show support and affection, concerns about hurting you or causing you pain. Being in a patient/carer relationship is not inherently sexy, so you may both need to make an effort to revive the sexy element. Many partners look for direction about when to resume a sexual relationship. It is important to start talking about sex early. Communication is key to keeping relationships strong, but it’s not always easy to start a conversation about sex. Many couples don’t normally talk about sex, they just do it. 

Some suggestions:•    Start a conversation by talking about friends or common interests to make it easier to bring the conversation around to your fears or your concerns about your romantic relationship.•    Choose a quiet time to talk, with less chance of interruptions.•    Even if your partner isn’t a talker, that doesn’t mean they aren’t listening. Make eye contact and touch your partner as you speak, to connect and give your words greater meaning.•    Reassure your partner. Make it clear you want to know their concerns and feelings. This sends the message you are in the situation together. Let them know you want sexual intimacy to return to your relationship.•    If your partner is quiet, don’t assume they don’t care. Your partner may not want to burden you with their fears about your health, or simply may not know what to say.•    Write down your concerns. Sometimes writing a note or a letter and giving it to your partner is easier than saying the words face to face.•    If you decide to write a letter, find a quiet time to talk about what you wrote once your partner has had a chance to read it.•    Be clear with each other. Let your partner know where you do, and don’t want to be touched. If your partner worries about hurting you, agree on a signal you will use if you feel pain.•    It’s also important to let your partner know when something feels good so let them know.•    Use touch. Physical closeness, giving and getting a hug or kiss, or holding hands can help you stay connected.•    Encourage your partner to talk with friends or whānau. •    Seek advice from a couples’ counsellor or sex therapist. You could also join a support group. Do either on your own, or together.

If you’re single

A breast cancer diagnosis should not mean an end to romantic love, or a sex life, no matter what your age. Consider the following:•    Not everyone wants a partner. That’s your choice entirely.•    If you do want to find an intimate partner, think about the type of person you want to meet. Ask yourself what you want in a partner and what your priorities are.•    Get the word out. Finding good partners is tough under any circumstances. Don’t be shy about asking friends for an introduction to someone.•    Participating in activities you enjoy, taking a course or volunteering are also good ways to meet potential partners who may share your interests.•    Going online may help you meet prospective dates. Check advice on how to stay safe during online dating.•    Attend events. Attending conferences and cancer advocacy events may help you meet someone who shares your experience.

Meeting a new partner

If you meet someone new you’ll have to decide when to let them know about your breast cancer. There is no right or wrong time to do this, it depends on you and the other person. You might fear rejection. It’s a good idea to take the time to become friends before thinking about becoming intimate. They should get to know you before they know about the cancer. It’s not you, it’s just a part of your story. Bringing the issue up too soon may scare away a potential partner but waiting too long may make the person upset or annoyed that you withheld important information about yourself. It’s best to share your experience before your heart is too invested in the relationship. Practice the conversation with a friend so you’re ready to answer potential questions from your date. What is the worst that could happen? Be prepared for that, just in case.

You can read more about dating and relationships after breast cancer here.

Talking about sex with your medical professionals

It is important to ask questions to find solutions if your breast cancer treatments have created issues in your sex life. Write your questions down so you don’t forget them. Remember it’s your body and you are the boss of it. Your age, social and cultural background, ethnicity, religious beliefs or past sexual history might affect your comfort level in reading about sex or talking about sexual effects with your healthcare providers. Try to be upfront that you want to discuss this issue. You might ask to be alone with your trusted medical professional to have a private discussion. Your sex life is a big part of your health and well-being. It can be challenging to initiate this chat, especially if you haven't talked about sex even in general before. If your medical professional (e.g. GP) is a man, you might prefer to speak to a female doctor in the practice.

Here are some tips to start the conversation:

•    When you make your appointment, tell them that you would like a few extra minutes to talk about your intimate relationships.•    Write down questions and symptoms or difficulties before your appointment. This may help you overcome any shyness or embarrassment.•    Be specific. For example, say, “I have vaginal pain during penetration. Will the problem get better? What can I do to get relief?”•    Rehearse what you want to say before your appointment. Saying the words out loud, to a partner, a friend or in front of a mirror, can help.

Reproductive options

Birth control

If you’re a woman who is not in menopause before your breast cancer diagnosis and you are in a heterosexual relationship, it is essential to discuss birth control. During treatment, you should not become pregnant. Early in pregnancy, chemotherapy and hormonal therapy can harm a foetus and can lead to birth defects. Your periods may become irregular or stop for a time because of treatment, but you can still become pregnant.

Birth control pills should not be used because they are a type of hormonal contraception, so there is concern that this may impact your risk of cancer in the future. During treatment, you could use condoms. If chemotherapy produces vaginal changes, such as narrowing, latex may be irritating and uncomfortable. Lambskin, polyurethane, or polyisoprene condoms are thinner and may cause less discomfort. You can also apply plenty of lubricant to help reduce any discomfort.

You may also consider using a diaphragm, which is a shallow silicone cup inserted in the vagina and fitted over the cervix. To be effective, diaphragms must be used with spermicidal cream.

An intrauterine device or IUD can also be an option. IUDs are small, T-shaped frames made of copper and plastic (ParaGard®) or plastic alone that can be inserted into the uterus by an experienced nurse or doctor. They prevent sperm from fertilising an egg. Not all IUDs are the same, so be sure to use one, such as the ParaGard® IUD, that does not contain hormones.

Fertility preservation

If you haven’t completed your family and think you might want to get pregnant after breast cancer treatment, talk with your healthcare team about protecting your fertility as soon as possible after diagnosis or suspicion of breast cancer. Timing is critical, so talk to your specialist before treatment about whether this will impact your future fertility and how you can protect your chance of successful pregnancy. Be aware that some types of fertility treatment can delay breast cancer treatment, so these conversations and decisions need to happen early.

Chemotherapy can affect your ovaries, damaging developing eggs and reducing the number of eggs produced. Fertility may or may not return after treatment, so it’s important to ask for referral to a fertility clinic before you start. There are several fertility preservation options for you to choose from.

You may be offered treatment with a medicine that suppresses ovarian function during chemotherapy, protecting the ovaries. Another option is extraction and freezing of eggs for later pregnancy or even in-vitro fertilisation (IVF) and storage of frozen embryos if you have a stable life partner. Be aware that later use of embryos will need the consent of the partner who provided the other genetic material (sperm or eggs). Eggs and embryos can be stored for up to 10 years. These options are government-funded (up to two cycles of IVF) for women who have no children, are under 40 and have a body mass index of less than 32.

There may be cultural considerations associated with the collection, storage and possible future disposal of reproductive tissues (eggs, sperm or embryos) in terms of peoples’ understanding and beliefs about the sacred nature of tissue, and where and when a life begins. You can for example, seek support from local Māori service providers in your community, local marae (some have health clinics and provide rongoā services), or contact your Public Hospital and ask to speak to their cultural advisor.  Similar services may also be available for Pacific peoples and other cultures.

After treatment, ask your doctor how long you should wait before trying to safely become pregnant. Periods may start 18 months to two years after chemotherapy or they may not return if treatment has damaged your ovaries. It is still possible to become pregnant even if your periods haven’t returned. Women are generally advised to wait two years after treatment in case of cancer recurrence.

You can read more about fertility issues after breast cancer here.

After cancer

Many experience anxiety or fear of recurrence after breast cancer. This can impact your sexual desires. Both the Breast Cancer Foundation and the Cancer Society offer free counselling sessions that could help you live positively and confidently.

Living with cancer

If your cancer is advanced, try to prioritise your own happiness every day. Enjoy time with your tamariki/kids, parents and friends. You may feel decreased physical and emotional stamina and if so, find activities that are fun but less demanding. Like everyone else your sex life should be a source of joy and fulfilment and should suit your needs and preferences. All of the advice in this article applies to you.

If you have advanced breast cancer, you might like to join Metavivors NZ, a closed Facebook peer support group with over 500 members offering support, love, hope, courage and strength.  You can register here or by emailing bcac@breastcancer.org.nz.

You could also join Sweet Louise, an organisation that provides practical support and holds gatherings for people with advanced breast cancer.

Wellbeing and cancer

Many feel their wellbeing is enhanced by taking a holistic approach to their health after cancer. There’s good evidence that exercise is beneficial whatever type and stage of cancer you have experienced or are living with. A healthy, balanced diet and maintaining a healthy weight is recommended for everyone. Post-menopausal weight gain increases the likelihood of hormone receptor positive breast cancer so try to keep the pounds off. Psychological therapy is beneficial in achieving a positive state of mind.

You may want cultural support through rongoā Māori/traditional medicines or feel benefit from karakia/prayer, mirimiri/massage, or vitamins.

If you’re under active medical treatment for your breast cancer, be sure to let your oncology team know about any other complementary therapies you’re having as some may react with your medicines. You can read more about complementary therapies here.

Relationships with whānau / family, friends and colleagues 

Following your diagnosis, you might be thinking of your whānau, friends or work mates. How will you let them know that you have breast cancer? Will you tell them? When and how? How will they react or respond?

Some of us feel very protective of our parents, tamariki/children and/or mokopuna/grandchildren, and even of close friends or colleagues. You might want to shelter them or minimise the enormity of the diagnosis. Or you may simply want to keep an area of your life not impacted by your illness, if you can or for as long as you are able to. Or you might want to share what’s happening for you. The choice is yours.

It will help if there can be a selected few who are with you on your journey, your support crew. It’s your choice who these people are. They’ll be the ones you trust to be with you when you are the most vulnerable. You might want to keep the diagnosis close to your chest or go public and have social media as your window to link with others in similar situations or to keep others informed of your progress.

Thinking of your whakapapa, your DNA and the possibility of passing breast cancer to your tamariki/kids or mokopuna/grandkids can be a concern for some. Ask your doctors if there’s likely to be a genetic basis for your cancer and whether others in your whānau are likely to be diagnosed. Discuss the best ways of keeping them safe.  Support your whānau by encouraging them to be vigilant, self-examine and to have screening mammograms. BreastScreen Aotearoa currently only provides free mammograms every two years for women between 45 and 69 years old, although we’re advocating to extend this out to 74 and down to 40. We advise paying for mammograms from 40 if you can. If your cancer has a genetic basis your medical specialist may suggest your whānau start screening even earlier or have more frequent screenings. They may also suggest other screening technologies such as MRI or ultrasound.

Support and coping strategies for partners and whānau 

Supporting your partner and whānau while you’re dealing with your breast cancer diagnosis and treatment can be challenging and emotionally demanding. You may not feel up to it while you’re dealing with your own trauma. Your diagnosis will be tough on your loved ones too and they’ll need care, understanding and love during this difficult time.

Here are some ideas for partners and whānau to help them face the challenges ahead:

•    Communicate openly and honestly: Openly communicate your feelings and concerns about your partner’s diagnosis. Be a good listener, talk about how you are feeling and ask for support. Don't be afraid to discuss the cancer and its impact on both of you. Set aside time for you and your partner to talk about your intimate relationship and how you can continue to enjoy each other’s bodies. 

•    Educate yourself about breast cancer: Learn about the disease, its treatment options, and potential side effects to better understand what your partner is going through. Attend medical appointments with your partner if they are comfortable with that.  Write down your questions so that you can ask them at appointments and take notes of what the surgeon or oncologist says.  It’s easy to feel overwhelmed when you’re meeting with cancer specialists and forget to ask about the things you want to understand. If you hit the internet for information, make sure you only visit trusted, reliable sources that provide evidence-based material.

•    Seek out emotional support: You will need comfort and reassurance. Lean on your friends, ask for a listening ear and a shoulder to cry on. Express your emotions. See a counsellor, alone or with your partner.

•    It's OK to have OFF days: Sometimes you may feel like being alone, you may feel pouri/sad, you may feel riri/angry, you may be hoha/annoyed and want space to yourself.  You need to know that all of this is OK.  Don’t beat yourself up.  Recognise that if it is becoming too big for you, reach out to someone to talk to. Don’t try to deal with your feelings alone. 

•    Get help with daily tasks: Ask for help with household chores, childcare, or other responsibilities to reduce stress and workload. Consider hiring outside help if necessary.

•    Remember self-care: Maintain a healthy lifestyle and overall well-being. Eat well, get regular exercise, and rest when needed.

•    Be patient and understanding: Understand that both you and your partner may experience a range of emotions, including fear, anger, and sadness. Be patient with mood swings and changes in your emotional states.

•    Find a support network: Connect with support groups, counsellors, or therapists who specialise in cancer-related issues to help you cope with emotions and challenges.

•    Maintain a sense of normality: Continue to engage in activities and hobbies you enjoy as these can provide a sense of normality and reduce stress.

•    Show aroha/love and affection: Express your love and affection through words and actions. Supporting a partner with breast cancer can be emotionally taxing. It's crucial to take care of your own physical and emotional wellbeing to be the best support possible. Seek help and support from friends, family, or professionals when needed, and understand that it's okay and absolutely normal to have strong feelings, fears and concerns throughout this journey. 

Be an ally of people with cancer 

As allies of people with cancer, everyone can help break down barriers and challenge misconceptions about sexuality and cancer.

Here are some ways we can all be allies:•    Educate ourselves about cancer and sexuality. By learning about the experiences of people with cancer, we can better understand their needs and challenges when it comes to sexuality.•    Advocate for inclusive cancer care. Cancer care should be inclusive of all aspects of a person’s life, including their sexuality. Healthcare providers should be trained to address sexual concerns and provide resources for managing any sexual changes that may occur.•    Support cancer-inclusive sex toy companies. There are many sex toy companies that offer products specifically designed for people with cancer. By supporting these companies, we can help make sexual exploration more accessible for everyone.•    Challenge negative attitudes towards cancer and sexuality. We can challenge negative stereotypes and assumptions about people with cancer by speaking out against stigma and promoting inclusivity.

Cancer is a life-changing diagnosis that can impact a person’s sexuality. By debunking myths and misconceptions about sexuality and cancer, and becoming allies for people with cancer in their sexual exploration, we can help create a more inclusive and accepting world for all.

Male Breast Cancer

Around 25 men are diagnosed with breast cancer each year in Aotearoa New Zealand. Most information and services offered for breast cancer are based on women’s (biological sex) experiences, but generally, the symptoms, diagnosis, treatment and survival rates of breast cancer are very similar for men and women. A comprehensive framework of how breast cancer is experienced by men is lacking. 

Issues and concerns identified for men with breast cancer include: •    being a mutation carrier •    being in the health care system with contested masculinity and an altered self-image •    significant illness avoidance behaviours •    lack of male breast cancer knowledge •    receiving female-focused treatments and services •    experiencing the stigma of living with a “woman’s disease”

As for women, diagnosis for men can cause worry and concern, so sex might fall on the list of priorities for you and your partner. Treatments can cause nausea, pain, fatigue and loss of libido. You may experience erection problems and orgasm changes. Talk about your diagnosis, treatments and any sexual changes or issues with your oncologist, breast care nurse, GP, counsellor or psychologist. They can give you good information on how you can overcome problems, how long symptoms are likely to last and ways to restore your sexual pleasure and self-esteem. Viagra® (sildenafil) can be helpful in treating erectile dysfunction.

There’s more information on our webpage on men with breast cancer.

Cancer Australia has more detailed information https://breastcancerinmen.canceraustralia.gov.au/ 

The Cancer Society, Te Kahui Matepukupuku o Aotearoa, has information about cancer and men. 

You might want to check out this book written by US breast cancer expert Professor John Boyages MD, PhD 

Resources for LGBTQI+ people

As we say in the intro to this article, all of the information and tips above apply to you, wherever you are on the LGBTQI+ spectrum. 

For further resources check out our webpage here.

Acknowledgments

We’re hugely grateful to sex therapist Edit Horvath, MSocSci Hons Psych, COP (Sex Therapy), for her expert input into this article. For more information or to contact Edit at Active SexLife Solutions Ltd, visit her website here.

Ngā mihi nui hoki ki a Maria Marama (Te Arawa, Ngati Whakaue, Cook Islands) mō tana tautoko tikanga. Many thanks also to BCAC Committee Member Maria Marama (Te Arawa, Ngati Whakaue, Cook Islands) for her cultural support and input.