Sex and anal cancer

Soreness of the skin and general tiredness are very common side effects of chemoradiation. Radiotherapy can make the skin around the anus and genital area very sore. So until your skin heals up, sexual intercourse is unlikely to be possible. Most people do not feel like sex while they are having treatment anyway.

Radiotherapy and chemotherapy treatment for anal cancer can have long term side effects. For women, these side effects may include having an early menopause, and dryness and narrowing of the vagina. Your doctor or nurse is likely to give you vaginal dilators to use after your treatment to help stretch your vagina. Your doctor may also discuss using hormone replacement therapy if you have an early menopause. There is more information about using vaginal dilators in the radiotherapy section.

Men may find they have difficulty in getting an erection after treatment. Again there is information about coping with erectile difficulties in the radiotherapy section.

Our section on sex and sexuality has more detailed information for men and women about how to cope with the effects that cancer and its treatment have on your sex life.

You will need time to get over surgery before having sex again. You should not have sex for at least 6 weeks after major surgery.

Occasionally, an operation to remove the anus and the rectum can affect the nerves to the sex organs. A man may not be able to get, or keep, an erection. Women may find that their vagina shrinks slightly and begins to get a bit narrower. Using vaginal dilators after treatment may help prevent this happening.

If you have had surgery to remove your anus and rectum and you used to have anal sex, this of course will no longer be possible. Remember there are other ways to enjoy a fulfilling sex life. Sharing how you are feeling and talking openly about your thoughts and feelings with your partner can help you achieve this.

If you have had a colostomy you may also feel self conscious about the change in your body. You are bound to worry about how the colostomy will affect your relationships, whether these are with friends or a sexual partner. There can be practical worries about the stoma bag being noticeable, or smelling. Or you might have emotional worries about your friends or partner rejecting you.

Stoma appliances these days are very well designed. They cannot be seen through your clothes and should not smell. If you do notice any smell, talk to your stoma nurse. Your stoma bag may not fit perfectly and the nurse may recommend a different type.

Many people find that if they talk openly to close family and friends their fears of rejection disappear. Most people are only too willing to try to understand and help if they can.

It often helps to talk things over with your partner, and explain how you feel. It will take time for both of you to come to terms with all that has happened to you. But sharing how you feel helps more than bottling everything up.

Your doctor and specialist nurse are also there to help you and want you to feel well supported. Your side effects may get better over time. But occasionally, they can be permanent. If you are worried, talk to your doctor or nurse. It’s normal to feel embarrassed when talking about sexual problems. Your doctor or nurse will appreciate and understand this.

But talking about your problems often helps in itself, as it is the first step towards facing and dealing with them. Your doctor or nurse may be able to offer treatments that can help your particular situation. Or they may suggest referring you to a specialist such as a counsellor or sex therapist for further support. You may decide that you want to talk to a specialist counsellor either alone, or with your partner if you have one.

There are also support organisations for people facing problems with sex and relationships. You may find these useful.