Sexuality in the palliative–terminal phase of cancer

Abstract

The objective of this paper is to increase the knowledge on intimacy and sexuality during the palliative–terminal phase of cancer. For this purpose, qualitative information has been gathered during sexology consultations with surviving partners (usually when attending with a new partner). In the first stages of cancer the major targets are coping with the diagnosis and surviving. In this period most couples practice intimate cuddling. After the treatment stage, the process of recovery starts. Depending on the physical damage, their flexibility and their set of values, couples return to their premorbid levels of sexual functioning or below that. When the patient enters the palliative or the terminal stage other changes takes place. The need for pleasure, grief, love, relaxation, distraction, painkilling, affirmation or anger results in a wide variety of love-making. Some couples quit sex completely, some are satisfied with only petting, but others get into active, desperate and even violent sex. Frequently pain, tiredness, changed physical sensations and disturbed hormone levels interfere with these sexual needs. Listening to the reactions of patients in this terminal phase, sexology can learn some lessons. The variety of sexual reactions clearly shows that sex has many more meanings than only relation, recreation and procreation. Maybe the most impressive message is that sex is not only for the young, the healthy and the beautiful. In this phase quality of life becomes very important; patients, and their partners, deserve sexological care and attention. Since many treatment contraindications have disappeared, quality of life in general and quality of sexual life in particular can be improved by changing treatment interventions.