Facing Cancer’s Impact on Intimacy

The night Eden and her partner planned to celebrate their one-year anniversary turned into an unimaginable ordeal. Instead of a romantic evening, they found themselves in an urgent care clinic, where Eden, a 31-year-old artist just beginning her career, received the horrifying news: she had advanced cancer.

This diagnosis followed five days of unusual fever and abdominal discomfort. “By the fifth day, I thought, why not skip the restaurant and head to urgent care?” Eden recalls. At the clinic, she learned that she had stage 3-4 Hodgkin lymphoma, which meant she would have to exchange her paintbrushes for aggressive treatments and a daily fight for survival.

Then, as if things weren’t complicated enough, a war broke out. A sense of danger and fear pushed the couple to move in together earlier than planned. In the chaos, their relationship shifted painfully from lovers to a caregiver-patient dynamic, with her partner leaving his job to take care of her.

“I felt shattered. I could barely lift myself off the couch,” she shares. “He appointed himself as my main caregiver, always right by my side. On one hand, it was wonderful. But on the flip side, the intimacy we shared, the things that drew us together, faded completely. My illness altered everything in profound ways.”

As treatments began, the once-pleasurable aspects of physical closeness turned fraught with anxiety. Blood thinners led to a fear of injury, making intimacy feel risky. “I was warned that if I got hurt, it could lead to prolonged bleeding. That fear loomed over everything, including sex,” she explains.

The extreme fatigue left little room for any desire. Eden describes moments where she tried to maintain connection for her partner’s sake, even as her own body let her down. “I pushed myself to pleasure him, but that too eventually ceased. It felt impossible to experience pleasure—either giving or receiving—when my body was in rebellion,” she admits.

Months rolled by, and while the cancer retreated, the disconnection from her partner lingered. The dream of things returning to normal was crushed under the weight of reality. A year and a half after the diagnosis, Eden finds herself mourning the loss of the ease and simplicity that once defined their intimacy. What was once comforting has become a challenging task, filled with effort, practice, and constant reminders of her pain.

“The trauma from the treatment has left me acutely sensitive. Every little sensation can feel painful,” she continues. “When we try to be intimate, surprising aches pop up out of nowhere, and my body automatically tenses. That’s where it all stops.”

“We still haven’t established an intimate routine. What used to be fun has now turned into something complicated, laden with anxiety and effort. It’s ironic because it often feels like another battle to fight. I often find myself grieving the loss of what we once had, realizing I need to rediscover myself within this new reality,” she reflects.

Cancer, it seems, doesn’t just attack the body; it challenges the psyche too. The primary fight is, naturally, for survival, but many patients find themselves wrestling with their sexual identities and relationships too—issues often sidelined in the face of medical urgency.

Research indicates that around 60% of women with breast cancer face significant sexual dysfunction, such as dryness and diminished desire, after hormonal shifts and treatments. Men, too, are affected; studies show that about 70% of prostate cancer patients contend with erectile dysfunction after medical interventions.

Yet, it’s not all mechanical or physical. Physical and emotional changes linked to cancer—and things like scarring or altered body image—can build walls that hinder intimacy. When a beloved partner turns caregiver, the romantic spark can dim significantly.

“I opted for mastectomy and reconstruction because I wanted to reclaim my feminine appearance. It was a long and complex process, but ultimately necessary,” shares a breast cancer survivor in her 40s.

“Every evening, my husband changed the dressings, effectively becoming my nurse. The surgical site looked terrible, and while I appreciated his care, I started to feel distant. How can you feel desirable when someone has seen you in that state?” she contemplates.

Her heartbreak intensified when she realized that despite how successful the reconstruction appeared, sensation would never return to her breast. “What was once warm and sensitive became numb—a reminder of what had been. Our love remains strong, but physical expression of that love requires conscious effort,” she says.

For Eyal, a 43-year-old father of two and thriving El Al employee, cancer wasn’t just a medical condition; it threatened the essence of his masculinity. Diagnosed with Hodgkin lymphoma at 37, he faced the illness alongside recollections of losing his mother to cancer at 16. The memory of her fight to maintain a normal appearance haunted him. “She always wanted to appear unaffected. If someone knocked on the door, she’d immediately put on a wig,” Eyal remembers.

When chemotherapy began to alter his looks, old fears resurfaced. “The arrival of the disease was incredibly stressful,” he shares, referring to the insecurities stemming from childhood. “After all this work I’ve done on my self-image, the thought of cancer messing with my appearance was unbearable.”

“One side effect of chemotherapy is hair loss. Forget about the existential fears; suddenly I was worried about losing a key part of how I saw myself. What would I look like? Would anyone still accept or love me?”

The identity crisis hit hardest when he started losing hair. “After my second treatment, I found clumps of hair in my hands. That’s when I decided to shave it all off,” he says.

But hair loss was just the beginning. Steroids and treatments transformed how his body felt, both internally and externally. During the months of treatment, everything related to sexuality felt out of reach. Eyal explains it was a time when both the mind and body were in survival mode, leaving little room for desire.

“Sex wasn’t even on my radar. Early on, doctors advised against any intimate contact due to side effects. Every discomfort and swelling, every sense of fatigue, created a barrier to my libido,” he explains.

For both Eyal and Eden, the true crisis emerged post-treatment, when they were left to face the emotional and physical void left by their illnesses. “After so long being surrounded by medical support, it all suddenly felt empty. Every small ache became a reminder of what I had been through. Recovery didn’t happen overnight; it required rebuilding myself piece by piece,” he mentions.

His journey back to self-awareness was active and intentional. He didn’t wait for recovery to come naturally; he embarked on a rehabilitation process involving exercise and deep relational work with his partner. “I began training towards the end of treatments. I aimed to restore the body I loved, one that didn’t tire during simple tasks,” he remarks.

Yet, rediscovering intimacy was fraught with conflict, as both struggled to relearn the language of their relationship. “It took a while for me to let go of expectations. If my mind is preoccupied, intimacy can’t flow,” he admits.

“My partner adjusted physically to the new situation more quickly, which often led to tensions. We all want to feel desired. But the body retains memories of pain, and when my mind finally let go of fear, it created space for intimacy to begin anew,” he adds.

“We’ve sought guidance and attended workshops to help breath life back into our connection. After 15 years together, attraction may not replicate the raw passion of our earlier days, but we’ve learned to find joy in other facets of connection: touch, scent, and intellect. It’s a gradual return to life,” he notes.

A significant hurdle in coping with the loss of desire during treatment is the silence surrounding the topic within medical circles. Caregivers often overlook these conversations, and patients feel it’s trivial to address intimacy when survival is on the line.

Studies show that patients often feel their sexual needs are seldom discussed during medical consultations, leading to feelings of isolation and guilt. Prof. Gal Markel from the Davidoff Comprehensive Cancer Center acknowledges this gap, attributing it to mutual discomfort. “Patients don’t bring it up, nor do doctors dive into the subject,” he explains.

Markel points out that while medication affects physical health, patients often grapple with deeper existential queries regarding their self-worth and roles. “Many of them ponder: Will I still work? Can I fulfill my role as a partner or parent? These questions about sexuality may arise even if there is no direct physical harm,” he adds.

Addressing sexual health among cancer patients is essential, not just an added bonus. “Our work focuses on treating human beings, not merely diseases. This encompasses the patient and their family,” states Markel. He emphasizes that sexuality is a vital aspect of well-being that should not be sidelined.

How can medical practices translate this understanding into action? Markel argues that individuals who are psychologically secure are more likely to respond positively to treatment. “Survival alone isn’t sufficient; thriving is crucial. The journey of healing is immensely important, and engaging in the discussion around sexuality can build resilience,” he concludes.

This growing understanding of sexuality’s significance has led to the establishment of new services aimed at addressing the issue. In November 2024, Rabin Medical Center launched a sexual therapy clinic to help cancer patients navigate their intimate lives.

This clinic not only provides counseling services but also trains staff on how to engage with patients about sexuality, ensuring it becomes a core part of cancer treatment protocols. Other hospitals have followed suit, and various organizations also offer resources for sexual counseling.

The clinic at Rabin Medical Center was born from a unique collaboration between the hospital and the Stop Cancer nonprofit. The initiative was founded in memory of Tal Yakobson by her parents, who became aware of the unmet needs of young cancer patients, particularly in the realm of sexual health.

Currently, the clinic offers free services to patients, even though sexual therapy isn’t funded by Israel’s public health system. Malca Graucher, a certified sex therapist, leads the clinic, bringing her distinct background and approach to the field.

Graucher, an ultra-Orthodox woman, began in this profession after being approached by a young student seeking help with sexuality issues during her time as a parenting instructor. “I delved deeper into resources to assist him, which eventually led me to train in marital intimacy guidance,” she explains.

The necessity for such a clinic underscores the idea that sexuality remains integral to human vitality, especially during tough times. Graucher believes that discussing intimacy can alleviate some of the isolation felt by patients.