The cancer amputee and sexuality

To the person experiencing amputation, the loss of a limb has a serious psychosexual impact. Whatever the age, the surgical procedure itself, pain, deformity, inability to perform simple customary acts, economic threat, and many other problems impose on the person facing the loss of their limb. Commonly, concentration is focused on functional abilities during and after prosthetic rehabilitation, and care taken to preserve the person's sexuality is often omitted. Major limb amputation can cause a decrease in self-esteem and body image due to perceived mutation, and this in turn can create emotional hurdles for both the patient and partner. Several potential problems such as the mechanics of body positioning during sex play, balance and movement, and phantom pain sensations can alter sexual function. Added difficulties include chemotherapy-induced neuropathies and enforced isolation because of limited mobility. Although these various disabling maladies may require alterations in a sexual relationship, sex drive and desire usually remain intact. Specific assessment techniques and interventions must be made available to enable the nurse to discuss sexual concerns at all stages of cancer and its treatment. As well, we must not fail to see alternatives to stereotypical behavior and acknowledge each patient's unique sexual identify.