Whenever someone has an illness that is affecting their loving, romantic, or sexual life, it is helpful to think about what their relationship was like before.

A relationship that was poor before a cancer is discovered probably won’t be any better after the diagnosis. However, some couples come to a new understanding and love for one another as a result of coping with a shared challenge such as cancer.

Cancer, or its treatment, usually changes a person’s role in their family. While having treatment or after surgery, you may not have the physical energy to do all the things around the house that you did before.

Relatives and neighbours may get involved in lending a hand and sometimes this can leave the person with cancer with a sense of not being needed, or not having control over their lives. People often feel that they have lost their place. For some people, fulfilling their role as a mum, dad or breadwinner, or leading an independent life has been part of their sexual self-esteem.

Future plans may also have to be changed as a result of cancer and its treatments. Couples may have made all kinds of plans, spoken or unspoken, to enrich their relationship or sex life. Some look forward to their children leaving home so that they have more time, money and privacy for their relationship. A cancer at this stage of life cheats them of this opportunity. It is very normal to grieve for this kind of loss.

Not everyone has a partner to share these things with, or to have sex with. If you are single, you can still find support from friends and others who love you.

If you want to start a new relationship, it can be very difficult to decide what to tell a new partner about your cancer, and also when to tell them. There is no simple answer that will work well for everyone. To help you decide, it may be useful to consider how safe you feel in this new relationship, and perhaps to talk through any fears. This is particularly relevant if you have a hidden body image change and you are anxious about it being discovered.

You may find that your relationships with friends change. Some friends may not be able to deal with your cancer and you may find that you lose touch with them. Sometimes this can feel like a rejection, which can lower your self-esteem. It is important to focus on friends who are able to support and listen to you. You can also contact some of the support organisations listed in our database.

Many gay and lesbian relationships involve a flexible and varied sex life. This flexibility can be helpful when trying to cope with the changes that cancer and its treatment can cause. Getting pleasure from different forms of sexual stimulation and not always having to rely upon penetrative sex, or the need to have a full erection, can be helpful if this is too painful or just not possible for a while.

However, if sex is a very important part of your life, the loss of some sexual function may be very difficult to accept. Changes in physical appearance due to surgery or other cancer treatments can take time to deal with. Fertility can also be an important issue for some gay men and lesbian women, and it may be devastating if the ability to have children is lost through treatment.

If you are having difficulty coping with the loss of sexual function or a changed body image, you may find it helpful to talk things through with your partner or close friends. It may also be useful to talk to your doctor, a counsellor or the nurses on our helpline.

You may feel more comfortable talking with someone who has a greater understanding about gay lifestyles. GaysCan or the London Lesbian and Gay Switchboard can discuss these issues with you.