“ I felt unwanted.” .

“I wondered if I would ever be attractive again”

“I thought it was no longer enough for my partner” .

“I was dry, it hurt.”

“My goal was to survive.”

These are all phrases that are repeated over and over again among people who have undergone cancer treatments of all kinds. But there is one that keeps repeating itself:

“ Nobody ever told me.”

Patricia Araya he is now 48 years old. In 2008, they discovered colon cancer. A year later, pulmonary metastasis. When they told her about the chemotherapy treatment, they warned her that she would have nausea, vomiting and that her hair might fall out. What they never told him was that he would also have issues with his sexuality.

First, he didn’t want to make love because all his energy was devoted to surviving. He felt bad, he was weak. “I just slept and threw up” , remember. Their children at the time were three and a half years old, so there was no desire to think about sex. “I just wanted to survive” , he points out. Then he started to lose his hair and the drugs caused him to have acne and weak skin, so it was tearing and he was still scarring and bleeding. “It made me feel ugly and unappetizing” , points out. And she says it didn’t occur to her to look for her partner because she thought he might feel a little disgusted by her appearance.

Gradually, she began to realize that the effects were not only those, she also had vaginal dryness and pain. “I did not feel pleasure” Patricia said. And although today she is separated from the man who accompanied her at that time, she says that they were very close during the illness. And although she clarifies that on the road to cancer she goes through very bad times, where she didn’t even want to be looked at, she also says that she has gone through others where she wants to continue to maintain a normal life and for people forget the disease. For the same reason, she shares her testimony, so that other people do not have to experience it like this. “Just as there are drugs for cancer, there are also drugs to make things easier sexually” points out.

Maria Luisa Marquez she was diagnosed with breast cancer in July 2021 and November 2022. Like Patricia, she points out that no one ever told her that having cancer would affect her sexuality.

“With cancer the couple unites or moves away” said Marie-Louise. And that is why he feels that it is very necessary for doctors to explain what is happening in this sense, in order to prepare patients, and “That one knows there won’t be any sex for a long time, or at least for the duration of the treatment.”

Maria Luisa She has been married for 14 years and before that she flirted with her current husband for eight years. When they discovered cancer, as a couple, they turned to making a plan, to see how they were doing with their children, how they were going to pay, among other things. “Sex has moved to the eighth level” ensures.

Then comes the problem of dryness and pain which, in practice, makes it difficult to continue having sex. But not only that, chemotherapy also generates a series of physical aspects that affect people, such as swelling. And this, without contemplating the self-image. “When I was bald, my safety, my self-esteem, my image, everything affected me too much. What hurt me the most in life was that nothing happened to my husband when I was naked”. And that is that as she says she looked different and felt like another person, then she saw that her husband no longer felt the same attraction towards her. “It was heavy. In the end, everything is discussed and we were very united emotionally, because as far as physical contact, at that time, he took more care of me than being the usual partner “ said.

Roxana Pincheira, who likes to call herself Ro, is 33 and was diagnosed with breast cancer at 31. At first she was in a relationship and today she is single. He recognizes that sexuality has been altered in many aspects, both emotional and physical, and in this way no doctor has ever approached the subject.

“If you are in a relationship, you are afraid of losing the person you love because of the changes that this disease brings to your state of mind, in your daily life and also physically. . If you’re single, you also feel insecure if you’ll truly continue to be attractive or if you’ll be able to meet certain expectations that are expected in relationships,” she says.

Ro underwent chemotherapy and struggled with hair loss, extreme exhaustion, pain, nausea and diarrhea. He looked in the mirror and didn’t recognize himself, but gradually he adapted to his new physical appearance, along with other side effects. She points out that since sexuality is not discussed, when you start having it, you start to realize vaginal dryness, pain, difficulty in penetration, among others. “And all of that makes you feel worse than you already think because of the physical changes. And in my case there is the added fact that at 30, when you’re supposed to be a sexually active person, you isn’t anymore and we start not to feel enough . Every day your self-esteem starts to drop even more,” he acknowledges.

In her case, of all the doctors she consulted, only one approached the subject of sexuality and she did so from the point of view of reproduction: seeing the possibility of extracting eggs before treatment.

Ro admits that at first all this affected him a lot. The physical change involved hair loss, swelling, yellow walking, chafing and scarring. However, he says that every day he is handling the situation better. “Over time, you realize that you’re still here, you’re still alive and having fun. And that’s the only thing that matters” points out.

Ro acknowledges that cancer has taught him a lot and that those lessons have reflected in his sexuality, which now goes beyond just sex. “The simple fact of being with the person you love, of accompanying him, a simple caress, are acts of love sometimes far superior to the sexual relationship itself” , he comments, adding that even without penetration, you can show love and show desire for the person next to you. He says it’s not an easy process, but little by little you learn to love in other ways and realize that in reality you haven’t changed, because your essence remains the same.

Over the years, and given the better quality of cancer treatments but also the improvement in early detection of the disease, the survival of patients with this disease has increased considerably. It is therefore increasingly important to worry about quality of life and rehabilitation problems. One of them is sexuality.

According to information shared by Dr. Karen Junemann, mastologist gynecologist at the German clinic and graduate in clinical sexology 74% of cancer survivors believe their GP should ask them regularly about sexual issues, but 64% say their doctor never did.

He Dr. Badir Chahuán, Head of Oncological and Reconstructive Breast Surgery of the Arturo López Pérez Foundation (FALP) , recognizes that from oncology they approach the sexual question in a very superficial way. He explains that the consultations are short and that in general they focus more on oncology, medicines, surgeries, among others. “Often we don’t have time and patients don’t ask us” , said. And he explains that often when they bring the issue to the table, they do so out of reproductive issues.

He stresses that it is very important to visualize the problem so that, on the one hand, the doctors take the time to treat it, but also so that the patients consult. “There are solutions, there are things we can do to solve or alleviate these problems,” he says.

Dr. Junemann explains that the question of sexuality does not only involve the sexual relationship itself, but multifactorial aspects such as intimacy, desire, arousal, orgasm, satisfaction, reproduction, l body image, affection, communication, respect, among others. There are also physical and psychological issues that affect sexual functioning. He explains that there are multiple tools and treatments to manage these issues, but because it is a multifaceted problem, it requires multidisciplinary management. For this reason, he suggests that patients ask questions so they can refer them in a timely manner.

Studies estimate that between 40% and 100% of cancer patients will experience alterations in their sexuality. This, contrary to popular belief, regardless of the location of the tumor.

This thus indicates Daniela Paz Rojas, psycho-oncologist and executive director of Yo Mujer Corporation which emphasizes that the sexual life of cancer patients is affected in multiple dimensions and that physiological, emotional, relational and socio-cultural aspects interfere.

Today’s society is centered on coitus, he explains, and in addition, the issue of cancer is also influenced by the meanings and beliefs that are associated with this disease, in addition to those associated with sexuality. This means that it is often seen as a matter of secondary or grosser importance to the purpose of survival, which creates a great challenge.

Added to all this and to the side effects of the treatments, which also affect sexual life -such as orgasmic capacity, the possibility of an erection, lubrication, desire, among others-, there are also psycho-affective problems or relationships that have to do with how much I accept and love myself in the new situation,” she explains.

“It shapes a dynamic that is encapsulated by silence, since one of the social mandates is to make life as similar as possible to what it was before cancer,” he says. All this, and the impossibility of talking about it in general within the couple, generates more problems. The same thing happens with people who are not in a relationship, who fall into a series of fantasies about what will happen when they have a partner, or if there will be the possibility of having a partner.

The sexual question is often considered to be part of the private sphere of patients, so it is not studied further. However, the psycho-oncologist indicates that this is a problem that always appears over time, even in older patients. Likewise, he points out that, when approached, the sexual condition of patients is also not studied, and these particularities are also very important to take into account so that people can feel that there are answers to their concerns.

“It’s a world we don’t talk about, and so if we don’t talk about it, we don’t contain it. If we don’t contain it, we don’t answer the questions, and if we don’t answer the questions, we can’t intervene in these difficulties”, underlines Daniela.