Sexual Dysfunction From Cancer Is Widespread—and Many Don’t Know That Before Treatment, Data Show

If the packed lecture hall during the 50th European Society for Medical Oncology (ESMO) Congress, was a sign, there’s lots of interest in the topic of sexual dysfunction following cancer treatment. On Saturday afternoon, experts on hand said there are too few conversations on sexual health between oncologists and patients, especially before treatment begins.

Erik Briers, PhD | Image: Europa UOMO

The initial focus on survival makes sense, said Erik Briers, PhD, a prostate cancer survivor and advocate with Europa UOMO, a group for men with prostate cancer. But beyond survival, “We have to challenge [physicians] and tell them, I have a problem with my erections,” he said. Instead, “We don't want to make them unhappy saying, “Yes, you cured me, but now I have another problem. Can we talk about that?’”

Briers led off a group of speakers in an ESMO Quality of Life session on confronting sexual dysfunction after cancer care, which included a look at data from Europa UOMO on how treatment affects partners.

If men with prostate cancer are missing information before treatment starts—a finding of an earlier Europa UOMO survey—partners feel even more left out, said André Deschamps, a former Europa UOMO president who presented findings from the EU-ProPER study.1

With watchful waiting an option for some newly diagnosed prostate cancer patients, the report’s most unexpected finding is that “Many partners are simply not receiving the information they need about the impacts of treatment before it begins. This means that the impacts on sex life can come as a shock and make changes harder to adapt to. It can also lead to regrets about having chosen the wrong treatment.”1

Briers said sometimes treatments cannot be avoided to save a person’s life; however, “Even if it is a necessity it has to be explained.”

Results from 1135 respondents to EU-ProPER were gathered over 60 days in the fall of 2023. They showed:

• 48% report their partner is a “changed man” after prostate cancer
• 32% report prostate cancer has had a significant effect on social and family life; 20% say they feel lonely and 19% say they have less participation in family and leisure activities
• 16% of partners feel they should get help with mental health, and 20% say their partner should get help with mental health
• On the positive side, 9 out of 10 said they could talk to their partner about their prostate cancer, and only 13% said communication had become worse
• 59% said most men could talk to their partner about death
• There is some uneveness in talking about sexual needs: 64% said they can talk openly about the man’s needs after prostate cancer treatment, but only 42% of partners found it easy to talk about their own needs
• 65% of partners say they make treatment decisions together, meaning a third are not; 30% said they felt they did not get the information they needed about how prostate cancer treatment would affect their sex life.
• 1 in 3 partners reported being frustrated in their sex life, 1 in 4 said they were satisfied, and 1 in 5 said they no longer need sex.
• Beyond sex itself, the off-limits topic is talking about incontinence, respondents said, According to the survey; 52% said it has affected their sex life and 33% said it’s affected their social life.

Deschamps added, “39% said ‘Nobody apart from me is aware of my partner’s incontinence.”

Although the survey involved partners of men with prostate cancer, Briers said these challenges affect patients with many other types of cancer, in both men and women and their partners. Any treatment with hormone therapy can affect sexual function, for example. “These are the widespread consequences of treating cancer. If you have cancer in your abdomen, an operation for colon cancer—the possibility is that your sexual function will be involved,” he said.

Yet even urologists, whose patients experience erectile dysfunction in the majority of cases, are often not prepared to discuss this or refer patients to specialists who can help patients find solutions, Briers said.

Most of all, he said, “We have to learn to talk to our partners. This is a big taboo.”

“You’re talking about an absolutely important function of our life and the quality of life. We’ve shown it in our surveys, and time and again it is clear that this is the biggest problem in the treatment of this cancer and in other cancers.”

What Can Patients and Partners Do?

Michaela Bayerle-Eder, MD, of the Medical University of Vienna, is an endocrinologist by training who now practices sexual medicine, a discipline she said, “addresses the biological, the psychological and the social factors of sexual function,” all which are extremely important to those who have been treated for cancer.

In treating cancer, she said, “we do a lot of harm to the patient.” Although 80% of sexual dysfunction issues are of “somatic origin,” meaning they are caused by cancer or cardiovascular disease, some of the problems are caused by the treatments. The goal of sexual medicine, Bayerle-Eder said, is to “preserve, restore, and improve sexual function.”

Health systems have not just a goal, but a medical obligation to maintain sexual function as an integral part of overall health, she said. “That’s not just my opinion. That’s also the opinion of the World Health Organization since 2006.”2

Models of what constitutes good sexuality have shifted over time, and much of this is bound up in patients’ self-perception, which Bayerle-Eder said can be quite different for men and women. For women, so much cultural meaning is tied up in the breast—it is also a sexual sign of attractiveness, and the penis holds the same place for men.

Thus, when treatment affects these parts of the body, or creates issues such as dryness, it creates enormous stress as well as actual pain. For some women, “it’s like menopause all at once,” and the resulting depression can be debilitating.

Cancer can harm relationships. The effect of breast cancer, for example, is more pronounced on younger women and those with lower education levels; 14.8% of women with breast cancer end up getting divorced compared with 7.7% of men with prostate cancer, Bayerle-Eder said.

Creating new expectations means writing a new sexual “script,” she said. She encourages patients to speak up about what is causing pain, to try changing positions, or figure out which lubricants will help with dryness. And they definitely should speak openly with their physicians about their sexual health. “What happens when you get cancer?” she said. “There is an adjustment to a new normal.”

Physicians must also re-examine what they assume about patient priorities and initiate these conversations.

“I had my eye opening moment when I talked to a patient [with] an anal cancer, and I talked to her about sexual life after therapy. She was like, ‘Woo-hoo! Somebody's talking to me about something besides death or life-threatening therapy!”

References

1. The Europa UOMO ProPER study. Europa UOMO. December 2024. Accessed October 18, 2025. https://www.europa-uomo.org/who-we-are/quality-of-life-2/eu-proper/
2. Sexual and reproductive health. World Health Organization. Accessed October 18, 2025. https://www.paho.org/en/topics/sexual-and-reproductive-health