About this ebook

This ebook is about how cancer and its treatment can affect your sex life. It is for anyone who needs information about this before, during or after cancer treatment.

This information is for you whether or not you are in a relationship or having sex. We hope you find it helpful whatever your sexual orientation or gender.

The ebook explains:

- how your sex life may be affected by cancer and its treatment

- how to get support and treatment that can help.

The ebook is split into sections to help you find what you need. We cannot give advice about your situation. You should talk to your doctor, who knows your medical history.

We have more information on our website about side effects of cancer treatment that may affect sexual well-being.

We also have more booklets you might find useful. These include:

- How are you feeling? The emotional effects of cancer

- Cancer and relationships – Support for partners, families and friends

- Sex and relationships – Support for young people affected by cancer

If you are trans, non-binary or intersex

If you are trans, non-binary or intersex, this ebook is also for you. In some places we use the words ‘male’ and ‘female’ to make it clear which body parts we are talking about. Otherwise we have tried to use inclusive wording. We hope you find the information that is right for you.

If you need more information, a gender identity clinic, GP or sexual health service may be able to help.

For more information

If you have more questions or would like to talk to someone, call the Macmillan Support Line free on 0808 808 00 00, 7 days a week, 8am to 8pm, or visit macmillan.org.uk

If you would prefer to speak to us in another language, interpreters are available. Please tell us, in English, the language you want to use.

If you are deaf or hard of hearing, call us using NGT (Text Relay) on 18001 0808 808 00 00, or use the NGT Lite app.

We have some information in different languages and formats, including audio, eBooks, easy read, Braille, large print and translations. To order these visit macmillan.org.uk/otherformats or call 0808 808 00 00.

Quotes

We have included quotes from people who have chosen to share their story with us. To share your experience, visit macmillan.org.uk/shareyourstory

How cancer may affect your sex life

Sex and cancer

This section is about getting support if you have questions about sex before, during or after cancer treatment. There is information about the different types of support that may be available. We have included tips for how to start a conversation about sex and how to ask for advice.

We know how difficult it can be to talk about sex and relationships. We also know that it is an important part of life for many people. You do not have to be in a relationship or having sex to have questions or to need support.

Cancer and cancer treatment can affect many areas of sexual well-being. They may cause changes that are:

- physical – you may have side effects or symptoms that change how your body works or looks

- emotional – you may be dealing with stress, worry or other difficult feelings

- practical – your usual routines or roles may change.

These areas are often linked. If there is a change in one area, it may affect another.

These changes may affect how you feel about your body. Or they may reduce your sex drive (libido) or make you less interested in sex. They can affect your relationships or how you feel about being intimate with another person. You may worry these changes will affect how attractive you are to other people.

Many changes caused by cancer treatment are temporary and usually get better after treatment. As you recover, you may find your sex life goes back to the way it was. Sometimes people might have to adjust to changes that last longer or that may be permanent.

There can be ways to improve your sexual well-being and to manage any problems. But sometimes this gets forgotten because there are other things to cope with when you have cancer. It may also be ignored because you or your healthcare team feel embarrassed or worried when talking about sex.

Who can help?

If your sexual well-being is affected before, during or after cancer treatment, this does not mean your sex life is over. There may be advice, support or treatments that can help. Your healthcare team is always a good place to start if you are worried. Try not to let embarrassment stop you from asking for help. Your healthcare team are used to talking about sex.

Talk to your GP, cancer doctor or specialist nurse or your local sexual health service. They may offer advice or treatments that can help you. Or they may suggest that you see someone else if you need more help. This might be:

- another healthcare professional in your cancer team

- a clinic that manages changes such as erectile dysfunction or early menopause

- a physiotherapist – a professional who may give you information and exercises that can improve some problems

- a gynaecologist – a doctor who treats female reproductive system problems

- a urologist – a doctor who treats bladder or male reproductive system problems

- an endocrinologist – a doctor who treats hormonal problems such as low testosterone.

Sometimes it helps to talk about sexual problems. Your healthcare team may arrange for you to talk to a counsellor, psychologist, psychiatrist or sex therapist. These professionals all work in slightly different ways. But they can all help you understand and cope with your feelings or any changes. We have more information on our website.

You may find a support group is a good place to talk. Some groups are for anyone affected by cancer or a type of cancer. Some are for anyone of a specific gender or sexual orientation. Some groups meet face to face and others meet online. It can help to talk to people who are in a similar situation or have coped with the same issues.

You may prefer to get support from a helpline or through email or webchat. These can be anonymous, and it might feel easier to talk about sex and ask questions this way.

You can often get support with sexual problems through the NHS. But some services, such as sex therapy, may only be available privately or through another organisation. Your healthcare team can explain what is available in your area.

We have more information about other useful organisations including helplines and support groups.

Or you can call us on 0808 808 00 00 if you need more information or want to talk.

‘I had counselling through a scheme my company has in place and it was extremely beneficial. My self-confidence had taken such a knock.’ Alex

What is sex therapy?

Sex therapists are experts in sexual well-being. They can help with physical, emotional and relationship issues that affect sexual function or well-being. Some sex therapists are also doctors or nurses which can be helpful.

A sex therapist will ask questions to find out:

- what is worrying you

- how they might be able to help.

You do not have to answer any questions you feel uncomfortable with. But remember, therapy is confidential. It can help to talk about any sexual problems or worries you have.

Many people find they need more than one session of therapy to feel comfortable talking to their therapist.

You can talk to a sex therapist about:

- your sex life before cancer and cancer treatment

- any physical sexual difficulties you have

- your thoughts and feelings

- your relationships.

Sex therapy can help you think about any physical changes, and how to adjust to those changes. It can also help you explore different ways of enjoying sex. The therapist may suggest exercises to help you with any problems. Therapists can also help partners. If you have a partner and feel comfortable including them in therapy, this can help you both.

The College of Sexual and Relationship Therapists have a list of professional therapists on their website.

Talking about sex with your healthcare team

It can be difficult to start a conversation about sex with someone from your healthcare team. Some people feel embarrassed or uncomfortable talking about something so personal. But it is important to get the right information when you need it. You can ask your healthcare team about anything before, during or after cancer treatment.

A health professional may not ask about your sexual well-being unless they know you want to talk about it. Tell them if you have questions or are worried about anything. They will understand that these questions are important to you. If you feel embarrassed, you should still ask for information and support. Most health professionals are used to having these conversations.

Some cancer teams use a questionnaire such as a holistic needs assessment. This is usually a tick-box form that you complete before seeing your cancer doctor or specialist nurse. It helps them find out how you are and what worries you have. You can use this to tell them if you have questions about sex or relationships. We have more information you might find useful in our booklet Holistic needs assessment – planning your care and support.

Tips for talking

You may find it helpful to prepare before you talk to a health professional. Here are some tips:

- Think about who you want to talk to. Is there someone in your healthcare team you feel more comfortable with?

- Think about what information you want. For example,

- you may want to know why you have lost interest in sex

- since starting treatment. Will this improve? What might help?

- Write down the questions you want to ask.

- Practise what you want to say.

- At the start of your appointment, tell the health professional you would like some time to ask questions.

- Do not worry about using the right medical words about sex or your body. Use the words you understand.

- If something is not clear, ask the health professional to explain again.

If you identify as LGBT+

Your healthcare team are there to support you and treat you in a way you feel comfortable with. There may be times when it helps them to know how you identify your gender or sexual orientation. It may help you feel better supported. And your healthcare team can give the right information and support to you and your partner if you have one.

The impact of cancer and cancer treatment are often the same whatever your sexual orientation or gender. But you may have some specific questions about how these will affect your sexual well-being. The NHS aims to provide healthcare to everyone. This includes providing care and support on sexual well-being to people of all genders and sexual orientations.

If your healthcare team cannot help, they can refer you to a sex therapist or another specialist who can. If you want to talk things through, you can call the LGBT Foundation on 0345 330 30 30. They can give you confidential advice and support.

‘We faced no real problems in terms of being gay while in hospital. In fact, the nurses were lovely and let my partner stay with me during difficult nights when I was really sick.’ Grant

Many people have good relationships with their healthcare team. But sometimes it can be more complicated. There is support available if you feel you have been treated unfairly or are unhappy with your treatment. The Equality Advisory and Support Service can give advice and support if you are in England, Scotland or Wales. If you are in Northern Ireland, contact the Equality Commission for Northern Ireland.

If you are trans or non-binary

If you are trans or non-binary, talking to a health professional about sex can sometimes be especially difficult and complicated.

Some of the information you need may involve parts of the body that do not reflect your gender identity. You may find this uncomfortable or upsetting to talk about. You may also have specific questions about sex and cancer if you take hormones or have had gender realignment surgeries.

If you do not feel you can talk to your healthcare team, you could talk to:

- your local sexual health service

- a transgender sexual health service

- the LGBT Foundation.

We have more information on how to get in touch with these organisations.

Sex and cancer treatment

Making treatment decisions

Before you decide to have a cancer treatment, a member of your cancer team will explain the possible benefits and risks. They will explain if the treatment is likely to cause physical changes to your sex life. For example, some treatments cause physical changes to the pelvic area. Or they may affect levels of hormones in the body.

Your team will also explain if treatment is likely to affect your fertility (your ability to have children). There may be things that can be done to protect your fertility. It is important to talk to your team about this before your treatment starts. We have more helpful information about cancer and fertility in our booklet Side effects of cancer treatment.

It is important to understand the possible benefits and risks of your treatment. It helps you and your cancer team decide on a treatment plan that is right for you. Everyone has different things that are important to them.

Your sex life during treatment

Some people worry about whether it is safe to have sex after being diagnosed with cancer. It is important to remember that sexual touching, penetration or close physical contact:

- cannot pass cancer on to a partner

- will not affect the cancer

- does not make cancer more likely to come back.

If you feel like having sex then it is usually safe to do so. And some people find they enjoy sex and want to keep their sex life as normal as possible.

But you should not put pressure on yourself to have sex or be intimate with a partner. For many reasons, having cancer treatment can affect your sex drive. You may not feel interested or ready to have sex for a time before, during or after treatment.

Some cancer treatments may directly change how the body works sexually. This may include:

- surgery or radiotherapy to the pelvic area (the area below your tummy and between your hips)

- hormone therapy – this is often used to treat breast or prostate cancer

- chemotherapy if this causes an early menopause

- surgery or radiotherapy to the pituitary gland or brain.

Other treatments cause general side effects that can change how you feel about your body or about having sex. For example, treatment might cause tiredness (fatigue) or pain, or make you feel sick. This may mean you are less interested in sex. Or if your body or appearance changes in some way, this can affect how you feel about your body and sex. We have more information you may find helpful in our booklet Body image and cancer.

Your cancer doctor or nurse will explain what to expect. They will also tell you if you need to make changes to your sex life because of a treatment. For example:

- You may have had surgery or radiotherapy to the pelvic area. Your body may need time to heal properly before you receive vaginal or anal sex.

- You may have had certain types of internal radiotherapy called seed brachytherapy or radioisotope therapy. In this case you may be advised to avoid close physical contact for a short time. This is to protect partners from radiation.

- You may have had high-dose chemotherapy or a stem cell transplant. In this case, you will be advised not to have close physical contact with anyone for a while. This is to protect you from infection. Your cancer doctor or specialist nurse will explain more about this.

Having sex during treatment

If you have sex during cancer treatment, it is important to prevent a pregnancy and to protect yourself and any partners.

Preventing pregnancy

Some cancer treatments can be harmful to an unborn baby. During your treatment and for a time after, it is important to use contraception if you or a partner could become pregnant. Even if your cancer treatment is likely to damage your fertility, you may still be able to start a pregnancy. Your cancer doctor or specialist nurse can tell you more about this.

There are many different types of contraception. Ask your cancer doctor or specialist nurse which type is best for you to use. This will depend on you and the type of cancer treatment you are having. Condoms or caps (diaphragms) can be used whatever type of cancer treatment you have.

Some hormonal contraceptives (such as the pill, patch, injection or implants) may not work during cancer treatment. This can be because of:

- the drugs you are taking

- side effects, such as diarrhoea and vomiting.

Your doctor or nurse can tell you more about what types of contraception are safe for you to use.

Protecting partners

Small amounts of chemotherapy, or other drugs, can get into your body fluids. This includes fluid made in the vagina and the fluid that contains sperm. To protect any partners, your cancer doctor may advise that for a few days after certain drugs

you use:

- a condom for vaginal or anal sex

- a condom (or a latex barrier such as a dental dam) for oral sex.

Your cancer doctor or specialist nurse can give you more information about your treatment. If you use a lubricant, only use a silicon or water-based product with condoms or dental dams.

Protecting yourself

Using condoms and dental dams also helps protect you from sexually transmitted infections (STIs). This is especially important if your cancer treatment affects how your body fights infections. Again, if you use a lubricant, only use a silicon or water-based product with condoms or dental dams.

You should also:

- Avoid giving oral sex if you have cuts or sores in your mouth. There is a risk these could become infected.

- Tell your doctor if you notice any bleeding after sex. If the bleeding does not stop, contact a hospital straight away.

- Use a condom and some silicon or water-based lubricant if you give or receive anal sex. This helps prevent bleeding or infection.

- Never use the same condom for anal then vaginal or oral sex.

- Clean sex toys, dildos or other objects before you use them, or cover them with a condom. If you use one for anal sex, clean it or change the condom before you use it for vaginal sex. If a partner uses it too, clean it or change the condom before you use it again.

Lubricants

Lubricants are gels or liquids that you can use before or during sex. Using lubricant can make penetration or sexual touching feel good. It can also make it feel easier and more comfortable.

Lubricants can be oil, silicon or water-based. Always check the instructions to find out what type you are using. You should only use a silicon or water-based lubricant with a condom, dental dam, latex cap (diaphragm) and latex sex toys. Oil-based lubricant can make condoms, dental dams and latex caps tear and stop them working.

There are many brands of lubricant. Some products are available on the NHS. You can also buy lubricants from a pharmacy or other shop, or online.

Your thoughts and feelings

Your thoughts and feelings have a powerful effect on your sexual well-being. Being diagnosed with cancer can cause strong emotions. You may not feel like sex if you feel depressed or anxious, or if you are worried.

We have more information about coping with your feelings in our booklet How are you feeling? The emotional effects of cancer.

How you feel about yourself sexually may also change if you:

- are feeling less in control

- feel weak or tired

- feel your role has changed at home or work

- have changes to how your body looks or works.

Being less interested in sex is a normal reaction to what you are going through. This can often get better with time as you recover from treatment or get back to everyday activities.

Talking about it

Whatever feelings you have, it can help to talk to someone. You may not need advice. It is often helpful to have someone just listen.

Try to find someone that you trust and feel comfortable talking to. This could be a partner, a family member, a friend or a professional.

Talking to someone who has been through a similar treatment or situation can also help. Sometimes your cancer doctor or specialist nurse can arrange for you to talk to someone

like this. Or you could join a cancer support group such as our Online Community.

Talking to a partner

If you are in a relationship, try to be honest about how you feel. If cancer or treatment has changed how you feel about your body or about sex, tell your partner. This gives them the chance to understand and support you. They may also have questions to ask you. Try to listen to, and answer, each other’s questions and concerns.

Coping with cancer can change relationships. For some people, working through difficulties and facing cancer together makes their relationship stronger. But it is not always like this. Some of the professionals who can help you can also help a partner or both of you as a couple.

We have more information for partners about cancer and relationships in our booklet Cancer and relationships – Support for partners, families and friends.

Starting a new relationship

If you are still having cancer treatment, you may worry a new partner may not understand what you are going through. If you meet someone after you have finished cancer treatment, they may not even know you had cancer.

You might not want to talk about it. Or you may feel it is too soon to tell them. If the cancer has affected your body, sexual well-being or fertility, you may worry about how a new partner will react.

It is your decision how, when and what you tell a new partner. Some people want to be open about their experiences from the start of a relationship. Others prefer to wait. It can help to talk to someone else you trust before deciding what to do.

‘The love of my partner, and her emphasis on the sensual side of sex and the need to “make love,” not just enjoy sex sessions, are of enormous help.’ Alex

Sex and side effects

Side effects and your sex life

Treatment for cancer usually causes some side effects. These can depend on the type of treatment and can be different from person to person. Before you start a treatment, your cancer team will explain what side effects you are most likely to have.

Some side effects affect your general well-being, and this can also affect your sexual well-being. For example, you are less likely to be interested in sex if you feel unwell or tired.

Other side effects can change your appearance and body image. Sometimes this can affect your confidence or how you feel about your body and sex. This might include a visible change, such as scars or losing your hair. It could also be something less visible, such as bladder or bowel problems or having a stoma.

There are also side effects that change how your body and sex organs work during sex. These side effects may happen if a treatment affects your levels of sex hormones. Or they can happen if a treatment damages tissue, nerves or blood vessels in the pelvic area. These side effects may include:

- changes in sexual sensation

- erection or ejaculation problems

- vaginal dryness or other vaginal changes

- anal or rectal changes

- loss of sex drive.

The treatments that are most likely to cause these types of side effect are:

- surgery or radiotherapy to the pelvic area

- surgery or radiotherapy to areas of the brain that make hormones

- drugs that affect hormone levels, for example hormonal therapy drugs for breast or prostate cancer.

‘I didn’t feel like having sex while I was having treatment. For a few months, I felt really unattractive – especially when I looked into the mirror and saw how thin or pale I was. So I didn’t feel very sexual at all. After treatment, I started to gain my confidence again.’ Grant

More information about side effects

We have detailed information on our website about coping with side effects that may affect your sexual well-being. This includes things that might help and information about where to get support. You can also call us on 0808 808 00 00, and we can send you the information you need.

You can also find more general information in our booklets Side effects of cancer treatment, Body image and cancer, Feel more like you and Coping with hair loss.

Your sexual well-being and relationships may also be affected by more than just these physical changes. We can send you our booklets How are you feeling? The emotional effects of cancer and Cancer and relationships – Support for partners, families and friends.

The body and sex

This information is about the parts of the body that are involved in wanting and having sex. It also explains what happens to the body during sex.

If you have had gender realignment surgery or are intersex, your body may be different in some ways to what we describe here. If you cannot find the right information, your GP or sexual health service may be able to help.

What happens to your body during sex

Your body may go through different stages. This is sometimes called the sexual response.

- Arousal – this is when you feel ‘turned on’ and ready for sex.

- Plateau – this is a stage of arousal where your body is very sensitive to touch.

- Orgasm – this is a feeling of intense pleasure that may happen after being aroused. It is also called climax or ‘coming’.

- Resolution – the stage after arousal and orgasm. The physical changes in the body go back to normal.

Sexual response is different for each person. What feels good for you depends on:

- how your brain responds to a physical sensation

- how you feel emotionally

- your memories, beliefs and experiences.

The brain, body and hormones

The brain is one of the most important parts of the body when it comes to sex. The brain tells you what feels good. It also helps control what happens to your body during sex. This includes how the sex organs in your pelvis work when you are aroused or orgasm. The pelvis is the area between your hips and below the tummy-button. If you are female, your sex organs include the vulva, clitoris and vagina. If you are male, your sex organs include the penis, testicles and prostate.

The brain uses nerves and hormones to send and receive messages around the body.

Nerves are cells that make pathways from the brain to other areas of the body. They send the brain information about what is happening in an area. For example, this may be whether something feels painful or good. The nerves also allow the brain to send instructions to that area. For example, this might be an instruction to move the body away from the cause of pain.

Hormones are chemical messengers. The brain uses them to control many body functions. These include your interest in sex (your sex drive or libido).

For males, the main sex hormones are made in the testicles and in areas of the brain such as the pituitary gland. These hormones control sperm production and your ability to get and keep an erection.

For females, the main sex hormones are made in the ovaries and in areas of the brain such as the pituitary gland. These hormones affect your periods menstruation) and ability to get pregnant (fertility).

Eventually the ovaries stop making hormones. This is called the menopause and usually happens between the ages of about 45 and 55. Changing levels of hormones during the menopause can cause symptoms that include lack of interest in sex and vaginal dryness.

We have more information and illustrations on our website about the body and sex.

‘There is life after a cancer diagnosis. Never give up and never give in. We must give ourselves a fighting chance and we can do that if we feel empowered; simply by information, education, making lifestyle changes and having a great support network.’ Lea

Further information

About our information

We provide expert, up-to-date information about cancer. And all our information is free for everyone.

Order what you need

You may want to order some leaflets or booklets, or download more ebooks like this one. Visit be.macmillan.org.uk or call us on 0808 808 00 00.

We have booklets on different cancer types, treatments and side effects. We also have information about work, financial issues, diet, life after cancer and information for carers, family and friends.

All of our information is also available online at macmillan.org.uk/information-and-support There you’ll also find videos featuring real-life stories from people affected by cancer, and information from health and social care professionals.

Other formats

We also provide information in different languages and formats, including:

- audiobooks

- Braille

- British Sign Language

- Easy Read booklets

- large print

- translations.

Find out more at macmillan.org.uk/otherformats If you’d like us to produce information in a different format for you, email us at cancerinformationteam@macmillan.org.uk or call us on 0808 808 00 00.

Help us improve our information

We know that the people who use our information are the real experts. That’s why we always involve them in our work. If you’ve been affected by cancer, you can help us improve our information.

We give you the chance to comment on a variety of information including booklets, leaflets and fact sheets.

If you’d like to hear more about becoming a reviewer, email reviewing@macmillan.org.uk You can get involved from home whenever you like, and we don’t ask for any special skills – just an interest in our cancer information.

Other ways we can help you

At Macmillan, we know how a cancer diagnosis can affect everything, and we’re here to support you. No one should face cancer alone.

Talk to us

If you or someone you know is affected by cancer, talking about how you feel and sharing your concerns can really help.

Macmillan Support Line

Our free, confidential phone line is open Monday–Friday, 9am–8pm. Our cancer support specialists can:

- help with any medical questions you have about your cancer or treatment

- help you access benefits and give you financial advice

- be there to listen if you need someone to talk to

- tell you about services that can help you in your area.

Call us on 0808 808 00 00 or email us via our website, macmillan.org.uk/talktous

Information centres

Our information and support centres are based in hospitals, libraries and mobile centres. There, you can speak with someone face to face.

Visit one to get the information you need, or if you’d like a private chat, most centres have a room where you can speak with someone alone and in confidence.

Find your nearest centre at macmillan.org.uk/informationcentres or call us on 0808 808 00 00.

Talk to others

No one knows more about the impact cancer can have on your life than those who have been through it themselves. That’s why we help to bring people together in their communities and online.

Support groups

Whether you are someone living with cancer or a carer, we can help you find support in your local area, so you can speak face to face with people who understand. Find out about support groups in your area by calling us or by visiting macmillan.org.uk/selfhelpandsupport

Online community

Thousands of people use our online community to make friends, blog about their experiences and join groups to meet other people going through the same things. You can access it any time of day or night. Share your experiences, ask questions, or just read through people’s posts at community.macmillan.org.uk

The Macmillan healthcare team

Our nurses, doctors and other health and social care professionals give expert care and support to individuals and their families. Call us or ask your GP, consultant, district nurse or hospital ward sister if there are any Macmillan professionals near you.

Help with money worries

Having cancer can bring extra costs such as hospital parking, travel fares and higher heating bills. If you’ve been affected in this way, we can help.

Financial guidance

Our financial guidance team can give you advice on mortgages, pensions, insurance, borrowing and savings.

Help accessing benefits

Our benefits advisers can offer advice and information on benefits, tax credits, grants and loans. They can help you work out what financial help you could be entitled to. They can also help you complete your forms and apply for benefits.

Macmillan Grants

Macmillan offers one-off payments to people with cancer. A grant can be for anything from heating bills or extra clothing to a much-needed break.

Call us on 0808 808 00 00 to speak to a financial guide or benefits adviser, or to find out more about Macmillan Grants. We can also tell you about benefits advisers in your area.

Visit macmillan.org.uk/financialsupport to find out more about how we can help you with your finances.

Help with work and cancer

Whether you’re an employee, a carer, an employer or are self-employed, we can provide support and information to help you manage cancer at work. Visit macmillan.org.uk/work

Macmillan Organiser

This includes a records book to write down information such as appointments, medications and contact details. Visit be.macmillan.org.uk or call us on 0808 808 00 00. You can also download the app on IOS or Android.

Other useful organisations

There are lots of other organisations that can give you information or support.

Bladder or bowel changes

Bladder & Bowel Community

Tel 01926 357220

Email help@bladderandbowel.org

www.bladderandbowel.org

Information and support for people living with conditions that affect their bladder or bowel.

Bladder & Bowel UK

Tel 0161 607 8219

Email bladderandboweluk@disabledliving.co.uk

www.bbuk.org.uk

Advice and information on bladder and bowel problems, practical tips on symptom management and solutions to help manage problems to promote quality of life and independent living.

Colostomy UK

24-hour helpline 0800 328 4257

Email info@colostomyuk.org

www.colostomyuk.org

Information and support about living with a stoma.

IA – Ileostomy and Internal Pouch Association

Tel 0800 018 4724

Email info@iasupport.org

www.iasupport.org

Help for anyone who has had, or is about to have, their colon removed and has an ileostomy or internal pouch.

Urostomy Association

Tel 01386 430140

Email info@urostomyassociation.org.uk

www.urostomyassociation.org.uk

Help and support for people who are about to have, or have had, surgery resulting in the diversion or removalof the bladder.

Body image changes

Changing Faces

Info and advice 0300 012 0275

Email support@changingfaces.org.uk

www.changingfaces.org.uk

Advice and support for people with a visible difference: a mark, scar of condition that makes them look different.

Outsiders/Sex and Disability Helpline

Helpline 07770 884 985

Email sexdis@outsiders.org.uk

www.outsiders.org.uk

A social, peer support and dating club, run by and for socially and physically disabled people. Offers support on relationships, sexuality, dating and sexual services including a helpline.

Counselling and sex therapy

College of Sexual and Relationship Therapists (COSRT)

Email info@cosrt.org.uk

www.cosrt.org.uk

Online information about sexual wellbeing, including having therapy and finding a therapist. Website provides a list of professional therapists.

The Institute of Psychosexual Medicine

www.ipm.org.uk

Online information about sexual difficulties including list of doctors who are trained in psychosexual medicine.

Pink Therapy

Tel 07971 205 323

Email admin@pinktherapy.com

www.pinktherapy.com

Aims to promote high quality therapy and training services for people who are lesbian, gay, bisexual and transgender and others who identify as being gender or sexual diversities. Provides an online list of qualified therapists who adopt a sexuality-affirmative stance and do not see sexual or gender variation as a sickness.

Relate

www.relate.org.uk

Offers a range of online, face-to-face or phone services to help with relationships

LGBT+ support

LGBT Foundation

Helpline 03453 303030

Email helpline@lgbt.foundation

www.lgbt.foundation

Advice, support and information for lesbian, gay, bi and trans people.

Switchboard LGBT+ Helpline

Helpline 0300 330 0630

Email chris@switchboard.lgbt

www.switchboard.lgbt

Provide a safe space for anyone to discuss anything, including sexuality, gender identity, sexual health and emotional wellbeing.

Prostate cancer support

Prostate Cancer UK

Helpline 0800 074 8383

Email info@prostatecanceruk.org

www.prostatecanceruk.org

Information and support for people affected by prostate cancer.

‘Out’ with Prostate Cancer

Tel 07764741366

www.outwithprostatecancer.org.uk

Prostate cancer support group for gay and bisexual men.

Gynae cancer support

The Eve Appeal

Tel 08088020019

Email nurse@eveappeal.org.uk

eveappeal.org.uk

Jo’s Trust

Helpline 0808 802 8000

Email info@jostrust.org.uk

www.jostrust.org.uk

Information and support for people affected by cervical cancer.

Ovacome

Helpline 0800 008 7054

Email ovacome@ovacome.org.uk

www.ovacome.org.uk

A national support group for everyone involved with ovarian cancer, including patients, carers, families, friends and healthcare professionals.

Menopause support

The Daisy Network

Email info@daisynetwork.org.uk

www.daisynetwork.org.uk

A support group for women who have an early menopause.

Sexual health services

Local sexual health services

Your local sexual health service can give you free and confidential information about: contraception, sex and relationships, sexually transmitted infections, and your health and well-being.

To find your nearest service:

England

National Sexual Health Helpline 0300 123 7123

www.nhs.uk/service-search

Scotland

Information Line 0800 22 44 88

www.sexualhealthscotland.co.uk

Wales

Sexual Health Helpline 0800 567123

www.nhsdirect.wales.nhs.uk/LocalServices

Northern Ireland

www.sexualhealthni.info

Transgender sexual health services

Local sexual health services aim to provide support to people of all gender identities. Some areashave separate clinics and waiting areas for men or for women. Some areas have a clinic for trans people.

If you are not comfortable going to any of these clinics, it may help to call first and ask for advice.

The LGBT Foundation also provides information and resources for trans people on their website.

Equal rights advice

Equality Advisory and Support Service (EASS)

Tel 0808 800 0082

www.equalityadvisoryservice.com

Free advice and assistance about equality and human rights issues for people in England, Scotland and Wales.

Equality Commission for Northern Ireland

Tel 02890 500 600

www.equalityni.org

Free advice and assistance for people in Northern Ireland who feel they have been discriminated against.

Disclaimer, thanks and sources

Disclaimer

We make every effort to ensure that the information we provide is accurate and up to date but it should not be relied upon as a substitute for specialist professional advice tailored to your situation. So far as is permitted by law, Macmillan does not accept liability in relation to the use of any information contained in this publication, or third-party information or websites included or referred to in it. Some photos are of models

Thanks

This ebook has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been approved by our Chief Medical Editor, Prof Tim Iveson, Macmillan Consultant Medical Oncologist.

With thanks to: Lynn Buckley, Gynae-oncology Clinical Nurse Specialist; Louisa Fleure, Lead Urology Clinical Nurse Specialist/Prostate Cancer Advanced Nurse Practitioner; Joy Hall, Lecturer and Researcher in Sexual Health; Ben Heyworth, Macmillan Survivorship Network Manager/ Macmillan LGBT Strategy Manager; Dr Rhian Noble-Jones, Lecturer; Chris O’Sullivan, Therapy Radiographer and Lecturer; and Dr Martin Steggall, Researcher in Men’s Sexual Health and Erectile Dysfunction, Dean of Faculty of Life Sciences and Education.

Thanks also to the people affected by cancer who reviewed this edition, and to those who shared their stories.

We welcome feedback on our information. If you have any, please contact cancerinformationteam@macmillan.org.uk

Can you do something to help?

We hope this ebook has been useful to you. It’s just one of our many publications that are available free to anyone affected by cancer. They’re produced by our cancer information specialists who, along with our nurses, benefits advisers, campaigners and volunteers, are part of the Macmillan team. When people are facing the toughest fight of their lives, we’re there to support them every step of the way.

We want to make sure no one has to go through cancer alone, so we need more people to help us. When the time is right for you, here are some ways in which you can become a part of our team.

Share your cancer experience

Support people living with cancer by telling your story, online, in the media or face to face.

Campaign for change

We need your help to make sure everyone gets the right support. Take an action, big or small, for better cancer care.

Help someone in your community

A lift to an appointment. Help with the shopping. Or just a cup of tea and a chat. Could you lend a hand?

Raise money

Whatever you like doing you can raise money to help. Take part in one of our events or create your own.

Give money

Big or small, every penny helps.

Call us to find out more 0300 1000 200

macmillan.org.uk/getinvolved