Penile Cancer

Sex and relationships

The impact of penile cancer on a man’s sex life will vary considerably depending on the stage at which the cancer was diagnosed, the extent of the treatment and also how active the man is sexually. It is important to emphasise that a diagnosis of penile cancer does not necessarily mean the end of a sex life.
If a man is in a relationship, it can be a great help for him to talk to his partner about his feelings and concerns about sex. In some relationships, where sex is not openly discussed, this can be difficult. Even where a couple has previously been able to talk about sex easily, this new factor may make the conversation uncomfortable for one or both partners. Some men may find it helpful to discuss their concerns about sex in the company of a specialist nurse or counsellor.
Treatment of the penile cancer is likely to raise many questions, fears and anxieties for both a man and, if he has one, his partner. Some men we interviewed felt that after surgery to remove part of all of their penis, they could no longer satisfy their partner; for Simon, who had had a total penectomy, this was the worst part of the experience; he said he felt sorry for his wife because he was no longer able to have sex.
There are many ways to satisfy partners without engaging in penetrative sex. With time, most couples affected by penile cancer can have fulfilling sex lives. Massage, oral sex and sexual aids, such as vibrators, can provide pleasure for couples. Sex therapists can also provide men, and their partners with advice on how to achieve arousal without the need for full intercourse.
Speaking to partners about concerns and anxieties about sex can be a source of great comfort, and many of the men we spoke to who were in relationships talked about their partners being understanding of the changes that had occurred. Whilst Big D expressed concern about the impact of his treatment on his partner, he said his partner was very considerate and tried to ease his concerns. Some men said that their relationship with their wife or partner had actually become closer as a result of their cancer.
For some men who had part of their penis removed (see ‘Types of surger for penile cancer’), their treatments left them with difficulty in achieving an erection. In some, but not all cases, sensation and function can return after a period of time. Sometimes using drugs such as Viagra can help this problem. The swelling of the penis that follows surgery to the lymph nodes in the groin also makes sex difficult (see ‘Lymphoedema and the impact of lymph node removal’). Tom was concerned that after the swelling had reduced he didn’t have any feeling in his penis and he was unable to achieve an erection. After about a year, his penis began regaining normal function. Jordan had difficulty with sex before his operation about a year ago and has been able to have sex once since; whilst it has not been easy, his wife has been very understanding and he is hopeful of improvement.
For many men, and their partners, sex will be different after they have been treated for penile cancer, however, sex can still be enjoyable for men and their partners. About two months after his operation, Tim and his wife began to cautiously engage in sexual activity. Whilst neither Tim nor his wife found sex as satisfying as it had been before surgery, with some imagination they were still able to enjoy fulfilling sex. Jim also talked about how he and his partner adapted to the changes that occurred and how his sex life has been quite satisfactory as a result.
Some men said that they felt ‘less of a man’ after their surgery. However, the majority of the men interviewed who had had surgery, no matter how invasive, did not feel this way. Most men felt that there was more to being a man than simply having a penis.
Most men were still able to experience sexual pleasure in some form. David’s operation hasn’t impacted on his sense of masculinity and he is able to have a relatively normal sex life.
The majority of men we spoke to were treated with surgery, however some men received radiotherapy, usually in combination with other treatments. Radiotherapy can in some cases result in difficulty achieving an erection (See Cancer Research UK for more details). However, most men who receive radiotherapy are able to have sex afterwards. Some of the men we spoke to who had received radiotherapy told us that they were able to continue their relationships and engage in sexual activity during and after treatment.
The significance of sex for a man can differ considerably between individuals; relationship status, age and life stage are all likely to have a bearing on the role that sex plays in a man’s life. A diagnosis of cancer can also affect how a man (and his partner) views sex and the level of importance which he attaches to it.
Several men felt as though, in the context of their wider lives and current circumstances, sex was not something which was of the utmost importance to them. Some men were currently single or divorced, others were widowed, and others felt that as an older man sex was not as significant to them as it would be to a younger man. Frank (Interview 3) had a healthy sex life before his cancer and as someone now in his 70s he feels it was the best time in his life to have cancer.
As a single man, with two grown up children, Mark did not attach great importance to sex. He talked about needing to focus on getting better, psychologically more than physically. Similarly, Frank Z’s main concern was getting back to normality; he felt that sex was not a priority.

Last reviewed July 2017.
Last updated January 2015.


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