When it comes to difficulty attaining intimacy after a cancer diagnosis, most people think immediately of breast cancer. But the truth is, any type of cancer diagnosis can affect your sex life—man or woman—in ways both obvious and quietly insidious.

Cancer is the second leading cause of death in the United States. In 2008, it was estimated that there were more than 1.4 million new cases of cancer in the United States and, in 2004, it was determined that there were over 10.8 million Americans with a history of cancer living in the U.S.

Based on those numbers, it’s not surprising that recent show that 40 to 100 percent of men and women who have been treated for cancer have experienced some level of sexual dysfunction.

Recently, a study published in the Journal of the American Medical Association showed that sexual performance can be adversely affected in the cases of men who have undergone treatment for prostate cancer. Although the effects vary greatly depending upon a number of variables - age, the severity of the cancer and the quality of the man’s sex life before treatment - the majority of participants in the study reported continued issues with erectile dysfunction and other intimacy-related issues after treatment.

Prostate cancer —the most common cancer among men in the United States — is located in the prostate gland, where semen production occurs. In its early stages, this type of cancer can have no symptoms, but some men do experience weak or interrupted urine flow (the urethra runs directly through the prostate gland), unusually frequent urination, difficulty starting or holding back urine, pain or burning during urination, blood in the urine or semen, inability to urinate, or painful ejaculation. Treatments include surgery, radiation therapy, and chemotherapy. One type of surgery, employed in an attempt to cure the disease, is a radical prostatectomy, which involves the removal of the entire prostate and some surrounding tissues. This major operation, however, can cause permanent incontinence, and frequently results in irreversible impotence, or erectile dysfunction. Not what we’d consider a win-win situation.

A transurethral resection of the prostate, on the other hand, is used to relieve common symptoms of prostate cancer, but it can also cause retrograde ejaculation. Radiation therapy, meanwhile, can cause impotence. In advanced cases of prostate cancer, you could also try hormonal or other drug therapies.

Unfortunately, hormonal therapies almost always result in impotence, and can also lower your sex drive.

Orchiectomies (the removal of one or both testicles) are also sometimes employed in advanced cases of prostate cancer, but this can be an unattractive prospect for most men.

In the end, all of these treatments can cause depression, low self-esteem and problems with body image.

These, in turn, can cause a general lack of interest in sexual activities.

So what can you do?

Rebuild Your Sex Life Around Other Forms of Intimacy
But part of enjoying sex post-cancer requires redefining what sex is. And there are plenty of ways to have fun without intercourse.

Try a New Position
Having sex while lying on your side can help with some of your physical challenges.

Mix Up Your Routine
If you always have sex in the evening, you may want to consider mixing things up a bit. If you are feeling a little frisky in the a.m., go for it.

Not only will this provide more opportunity for sexy time, but the added spontaneity could give the both of you an extra libido boost.

Do Movie Night
Watch a sexy film together, one that could get you in the mood. And watching one together could allow you and your partner to open up a fruitful dialogue about fantasy.

Get a Prescription
Drugs like Viagra, Cialis and Levitra can help. Beyond this, you could also get a testosterone boost from patches, creams or injections. Talk to your doctor about your options.

Talk to a Professional
Of course, if the issue you're grappling with is psychological, it can help to talk to a counselor... especially one who specializes in erectile dysfunction-related angst.

For more tips on dealing with intimacy post-cancer, please check out our new book, Sexy Ever After: Intimacy Post-Cancer, available at goodinbed.com.

Just because sex is different for you post-treatment doesn't mean it can't be good. Just remember that redefining sex requires an open mind, constant communication, a little bit of effort and some creativity.

Patty Brisben is the CEO and founder of Pure Romance, which specializes in relationship enhancement products, intimacy education and sexual health awareness. Through Pure Romance's sexual health education department, Patty assists women in recapturing their sensual and sexual selves following cancer diagnosis and treatment. Dr. Keri Peterson obtained her bachelor degree from Cornell University and received her medical degree from Mount Sinai School of Medicine. Dr. Peterson has been in private practice with a prominent medical group on the Upper East Side of Manhattan since 1999.
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