“Although the conversations, especially in the beginning, were brutally difficult, they helped us in the long run.” -Anonymous
Advanced illness often comes with changes to our sexuality and fertility. We talk about how the side effects of our treatments have affected our innate sense of sexuality and our physical ability to have sex. We discuss how we have found new ways of exploring sexual intimacy and communicating with our partners. We also describe our emotions surrounding fertility and the grief that comes with losing the ability to have children.
Advice from Health Care Providers
Sexuality is a term that is used to describe who we are attracted to and how we see ourselves as sexual beings, as well as how we enact our sexual feelings. It is about more than what we do sexually with or without a partner. We remain sexual beings even close to or at the end of life, even though this is not talked about and remains somewhat of a taboo. Sexuality near or at the end of life is about connection and validation of who we are as individuals and our feelings about a partner, or longing for a partner if single. Acting on these feelings is complicated in part because of symptoms such as pain, weakness and the side effects of medication. There are also logistical barriers to sexual expression including lack of privacy in hospice or home, where family and staff may be ever present. While sexual intercourse may not be possible, there should be no boundaries placed on touch and other erotic activity. Mutual or solo masturbation, oral sex or sensual massage can help to provide comfort and connection, but you have to ask for and be allowed the privacy that you need to maintain this important aspect of who you are, no matter where you are.
Many people imagine that one day they will have children in the future. This does not apply to everyone of course and some people are ‘childless by choice.’ Cancer takes away the choice for some, and this can be devastating. Depending on the age at which you are diagnosed, the need to start treatment on an urgent basis, or because of finances, some people with cancer are not able to bank sperm or eggs. This can cause tremendous sadness and frustration later in life when they are ready to have children. For those facing the end of life, the missed opportunity to have the experience of having a child, or leaving a legacy in the form of a child or children, can be even more distressing. It is important to recognize this distress and to mourn the lost opportunity. There is no easy solution to this longing, and while some may offer platitudes, these do not take away the sense of loss and grief. It can be hard to talk to family and/or friends about this as they may also be feeling very sad, or are not able to find the words that might bring comfort to you. If you are experiencing feelings of sadness or distress at not being able to have a child or more children, it may be helpful to talk about this with a professional.