Body image and sex

Cancer and its treatment can change how you think and feel about your body. You may feel sad, angry or worried about any changes to your body. You may have scarring, weight loss, physical discomfort, numbness or other side effects of treatment that can make you feel self-conscious or affect your confidence. Talking about how you feel can help you cope. You could talk to someone close to you or you could ask your specialist nurse for help. 

If you have a stoma, you may have strong feelings about the sudden and significant change to your body. Over time, and with support from your stoma care nurse specialist, you will learn to adapt to your new body. Getting through the first few weeks can be tough and you may feel like you have a mountain to climb, but remember family, friends and health professionals are there to help you. Talking about how you feel can help you cope.

Until you get used to looking after your stoma, you might worry about smells or leakage. You may worry that other people can see the pouch through your clothes and you may wonder how other people will respond to your new stoma. Your stoma care nurse specialist can help you with any worries you may have. Having a stoma should not stop you doing the things you enjoy. There are companies that sell underwear, swimwear and other products that can help you feel more comfortable. Ask your stoma care nurse specialist for more information.

Sexual function

Cancer and its treatment affects your emotions and relationships. This can lead to problems with intimacy and sex. If you have a stoma, this can add to any anxiety and change the way you see yourself as a sexual person.

If you have a partner, working together and being open about the effect of treatment on your sex life can help you both. Being physically and emotionally close with your partner may help you feel better able to cope with cancer. This doesn’t need to lead to sex, but if you want to be sexually active or want to start a new relationship, there are professionals who can help. Whether or not you have a partner, a psychosexual therapist can also help you to understand and come to terms with any sexual problems.

Many people find it embarrassing to talk about their sex lives but remember that your healthcare team are used to answering questions and talking openly about sexual matters and want to help.

Surgery and radiotherapy for rectal cancer can cause long term problems getting an erection and problems with ejaculation in some men. These problems may get worse a few years after radiotherapy finishes. Possible treatments include tablets that increase blood supply to the penis, injections to help you get an erection, pellets that you insert into the end of the penis, vacuum pumps and penile implants. The success of the treatment will depend on whether the nerves or blood supply to the penis have been affected by the cancer treatment.

In women, surgery and radiotherapy can cause tightening and shortening of the vagina. This can make sex difficult and painful. Radiotherapy can also cause dryness of the vagina but lubricants can help with this. Regular intercourse or using a dilator after you have completed radiotherapy may help reduce the risk of vaginal shortening.

If you feel you need help with any sexual problems, ask your GP or healthcare team to refer you to a sexual health specialist or psychosexual therapist.

More information

Visit our online community to talk about your experiences, share knowledge and get support from other people

The Colostomy UK website has a list of companies that sell products for people with a stoma.

Macmillan Cancer Support provides information on how cancer treatment affects the way your body looks, works or feels. 

Shine Cancer Support offers videos and podcasts with advice on sex and relationships for people living with cancer.

Updated August 2019