Perrin Romine, MD, is a senior research fellow at the University of Washington Fred Hutchinson Cancer Research Center. Dr. Romine’s interest lies in optimizing care delivery for people with head and neck cancer, with a focus on rarer subtypes of head and neck cancer. Kedar Kirtane, MD, is an assistant member and medical oncologist at Moffitt Cancer Center, with a focused interest in the treatment of head, neck, and endocrine cancers. Dr. Kirtane is also a Cancer.Net Specialty Editor for Head and Neck Cancers. Dr. Kirtane’s disclosure information can be found in his biography linked to in the previous sentence. Dr. Romine has no relevant relationships to disclose.

Being diagnosed with cancer can be a life-altering event, regardless of the type of cancer someone may have. This is because cancer can impact every aspect of a person’s life, including family life, work life, and intimate relationships. The majority of people treated for cancer suffer from sexual health issues at some point during their cancer experience, including people with head and neck cancer.

In people with head and neck cancer, the cancer itself often causes physical changes. Because of this, people with head and neck cancer are more likely to have body image concerns, which can have a huge impact on their sexuality. People with head and neck cancer are also more likely to have difficulty with speaking, tasting, making facial expressions (such as smiling and laughing), and moving their neck. These challenges can affect a person’s ability to express their sexuality. Finally, the emotional impact of having head and neck cancer or going through treatment are very real, and people with cancer often experience anxiety and depression. These feelings can, in turn, also impact sexuality.

Here, learn how treatment for head and neck cancer can impact your sexual health and how you can get help with managing sexual health concerns.

How can treatment for head and neck cancer impact a person’s sexual health?

People with head and neck cancer will often receive different forms of treatment that may involve a combination of surgery, radiation therapy, and/or chemotherapy. This treatment often leaves people exhausted, making it difficult to maintain the energy for or interest in sex. In addition, recovery from these treatments can be long and have long-lasting effects on a person’s ability to speak, produce saliva, and taste, all of which can affect sexuality.

Some of the common sexual side effects seen in the treatment and recovery from head and neck cancer include:

• Decreased sexual desire, also called libido

• Impaired sexual function

• Challenges associated with oral sex practices

• Feelings of depression

• Decreased sense of self-image or self-worth

Because every person is unique and treatment is not the same for everyone, it is important to ask your health care team about the impact of your specific treatment plan on your sexual health, both in the short term and in the long term. 

Why is the human papillomavirus (HPV) a concern for people with head and neck cancer?

HPV is a sexually transmitted infection. Most of the time, the infection goes away on its own. But for some people, the infection can persist and eventually lead to cancer.

HPV is now known to be a cause for certain types of head and neck cancer, most commonly with cancers in the base of the tongue or tonsils. This area is called the oropharynx, and the majority of oropharyngeal cancers in the United States are caused by HPV. HPV is also known to cause other types of cancers, such as anal cancer, cervical cancer, and penile cancer. People with an HPV-associated cancer are usually exposed to HPV many years before the cancer develops.

If you have been diagnosed with HPV, using condoms or dental dams can help lower the chance of spreading HPV to your sexual partners. The HPV vaccine can also help lower the risk of getting an HPV infection. Talk with your doctor about how you can prevent getting or spreading HPV.

How can people with head and neck cancer get help for their sexual health concerns?

Ask any question that comes to mind about your sexual health when you speak with your health care team. It is important to ask your team how each cancer treatment may affect your sexual health, both in the short term and the long term. Different treatments may have different effects on sexual desire or on sexual function, so it’s important to ask these questions before starting a treatment plan. Your health care team is the best resource to ask about managing any sexual health concerns before, during, and after your treatment.

Above all, know that there are several things that can be done to help address your sexual health. You should feel empowered to ask your health care team for help. Because every person is unique and has their own set of concerns, your health care team will be able to provide the tailored advice and support you need.

Managing sexual health concerns may include taking medications that specifically treat sexual side effects. There are medications available that can help treat side effects such as erectile dysfunction or depression; medications for pain management; liquids to help with inflammation or sores on the lining of the mouth or throat; creams or ointments for managing rashes; and medications to help with secretion control. Talk with your doctor about what medications might be helpful for you.

It is also very common for people with head and neck cancer to need additional emotional support for feelings of sadness, anger, self-consciousness, or worthlessness. This support often takes the form of therapy, medications, and/or patient-led support groups.

If you are concerned about sexual side effects during head and neck cancer, below are some questions to help you start the discussion with your doctor:

1. How might my treatment impact my short-term sexual health?

2. Am I going to be able to remain sexually active during my cancer treatment?

3. Are there any safety precautions that I need to take for myself or for my partner?

4. How will my cancer treatment or the cancer itself impact my long-term sexual health?

5. What supportive treatments are available to help improve my sexual health?

6. If I am struggling with maintaining my sex life, who can I turn to on my care team for help?

Cancer.Net also has several resources that provide information on sexual health concerns. Learn more about managing sexual health concerns.