Elephants and Tea - March 2020 - 18

Sexuality

INTIMATE ISSUES WITH MARLOE

the tumor (called brachytherapy). In this case, you should receive specific instructions from your radiation
oncologist regarding close contact with your partner and others, because as long as the radioactive substance
or seed is implanted, there is an exposure risk.
COULD I ACCIDENTALLY GIVE MY PARTNER CANCER?
Nope! You do not have to worry that your partner will become infected with your cancer cells or "catch" cancer
because of close contact, including sexual contact9. However, it is true that some STIs can increase a person's risk
of developing cancer at a later time.
One example is the human papillomavirus, or HPV. Certain strains of HPV cause the vast majority of
all cervical cancers, and can also cause vulvar, vaginal, penile, and anal cancers as well as cancers of the
mouth and throat1. You can protect yourself by using barrier methods during sexual activity and getting
vaccinated. The vaccine for HPV is safe and effective, and it drastically reduces HPV infection and its associated cancer risk (up to 90%!). Learn more from the American Cancer Society's website.
WHEN MIGHT SEXUAL ACTIVITY IMPAIR HEALING?
You may be asked to abstain from sexual activities that include penetration if your tumor is located in your pelvic
area (such as your bladder, cervix, or rectum) and is at risk for bleeding, or if you are actively undergoing pelvic
radiation that has caused your skin or tissues to be damaged. If you are physically healing from a surgery, intercourse may be just one of the many more physical activities you are asked to avoid for a specified amount of time2,9.
Your provider may also advise you to avoid penetration if your platelets are low, because this puts you
at a greater risk for bleeding7. Just like going through chemo or a stem cell or bone marrow transplant can
decrease your WBC counts, these treatments can also decrease your platelet counts. If you notice bleeding
after sex, notify your provider. If it is excessive or does not stop, seek urgent care.
SO, WHAT CAN MY PARTNER AND I DO TOGETHER?
If you have been instructed to hold off on activities that include penetration or have the potential for bodily fluid
contact to mucous membranes (such as oral sex), that doesn't mean you have to avoid all contact with your partner!
Engaging in snuggles, hand-holding, skin-kissing, or other forms of loving touch is an important part of maintaining connection and closeness at a time when certain types of sexual intimacy may be temporarily on hold9.
Ask your provider what activities are safe to participate
in right now, and when you can begin to engage in others.
REFERENCES:
1.	 American Cancer Society. HPV and Cancer. https://www.cancer.org/cancer/
cancer-causes/infectious-agents/hpv/hpv-and-cancer-info.html, accessed
12/30/19.
2.	 American Cancer Society. Fertility and Sexual Side Effects in People with
Cancer. https://www.cancer.org/treatment/treatments-and-side-effects/
physical-side-effects/fertility-and-sexual-side-effects.html, accessed 7/8/19.
3.	 Center for Disease Control and Prevention (CDC). How to Use Condoms and
Other Barriers, accessed 1/9/20.
4.	 Green, Laci. (2018) Sex Plus. New York, NY: HarperCollins Publishers.
5.	 Katz, Anne. (2014) This Should Not Be Happening: Young Adults with Cancer.
Pittsburg, PA: Hygeia Media.
6.	 Kelvin, J.F., Steed, R., Jarrett, J. (2014). Discussing safe sexual practices
during cancer treatment. Clinical Journal of Oncology Nursing 18(4): 449-453.
7.	 Macmillan Cancer Support. (2017). Sex and Relationships, accessed 1/9/20.
8.	 Memorial Sloan Kettering Cancer Center. Sexual Health and Intimacy,
accessed 7/8/19.
9.	 Schover, Leslie R. (1997). Sexuality and Fertility after Cancer. New York, NY:
John Wiley & Sons, Inc.

WHAT IF I HAVE MORE QUESTIONS?
I've said it before and I'll say it again - talk with your
healthcare provider. Don't be afraid to bring up your
questions about specific sexual activities, and if you have
a regular partner, he or she may also have questions for
your care team. Taking the initiative to discuss this sensitive subject can take guts, but it's an important part of
getting the information you need to make safe, healthy
decisions for you and your partner. You won't be the first
person that has inquired about sex, believe me. Just ask! l

THE BARRIER
METHOD
BREAK-DOWN:
As the name implies,
barrier methods
create a barrier
between you and
your partner, blocking
direct contact with
each other's mucous
membranes and bodily
fluids. But they only
provide protection if
they are used correctly and consistently3,4!
Check out the Center
for Disease Control
and Prevention (CDC)
website to learn how.
MALE CONDOM
Used for: vaginal or
anal intercourse,
performing oral sex on
a person with a penis
FEMALE
CONDOM
Used for: vaginal or
anal intercourse
DENTAL DAM
Used for: performing
oral sex on a person
with a vulva or anus
(Hint: you can make
your own easily and
inexpensively by using
a male condom!)

M A R L OE E S C H, R N, B SN, ONC OL O GY C E RT I F I E D N U R SE (O C N), A N D YOU NG A DU LT C A NC E R
SU RV I VOR , GR A DUAT E D F ROM T H E U N I V E R SI T Y OF W IS C ONSI N - M A DIS ON S C HO OL
OF N U R SI NG (G O BA D GE R S!) I N 2 0 0 8 . SH E E N JOYS E DUC AT I NG B OT H SU RV I VOR S A N D
H E A LT HC A R E PROF E S SIONA L S ON T H E TOPIC OF C A NC E R A N D SE X UA L I T Y, A N D H A S
PR E SE N T E D FOR T H E YOU NG SU RV I VA L C OA L I T ION, T H E ONC OL O GY N U R SI NG S O C I E T Y,
A N D PL A N N E D PA R E N T HO OD OF W I, A MONG OT H E R S . SH E HOL DS A C E RT I F IC AT E F ROM T H E
SE X UA L H E A LT H C E RT I F IC AT E PRO GR A M T H ROUGH T H E U N I V E R SI T Y OF M IC H IG A N A N D IS
C U R R E N T LY PU R SU I NG H E R D O C TOR OF N U R SI NG PR AC T IC E (DN P) AT T H E U N I V E R SI T Y OF
W IS C ONSI N - M I LWAU K E E . A N E N T H USI A S T IC SU PP ORT E R OF SE X UA L H E A LT H A N D W E L L N E S S ,
M A R L OE IS M A K I NG I T H E R M IS SION TO BR I NG SE X I N TO T H E SU RV I VOR SH I P SP OT L IGH T.

18

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MARCH 2020
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Elephants and Tea - March 2020

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