Anal intercourse after anal cancer treatment

Hi Sammy, 

It’s Megan here from Macmillan’s Online Community team. I saw your post and wanted to offer some support whilst you are waiting for other group members to reply. You may also want to consider connecting with others in our Anal cancer forum. 

With you having questions about sex, you may wish to chat with our nurses here at Macmillan. They can provide trusted information and reassurance, alongside talking through your concerns. To get in touch with the Nurses, you can post a question in our Ask an expert section on the Community or contact the Macmillan Support Line.

The Support Line is open from 8am to 8pm every day and to get in touch, please call 0808 808 00 00. There’s also the options to send an email or use live webchat during the opening hours.

When you get in touch with the Support Line there will be options to speak to the Information Nurse Specialists and Support Advisers alongside the Money and Work teams. If you need a listening ear, then the teams are here for this too as sometimes it can be helpful to talk to someone who is there to listen.

We have also recently published the 'Sex and cancer uncovered' blog which includes support information and higlights some personal experiences which may be helpful for you to read. 

I’m sure others who feel comfortable sharing their personal experiences will reply soon. In the meantime I hope the above information can be useful. 

If you have any questions about the above, or ever need any additional support, please don’t hesitate to get back in touch. You can email community@macmillan.org.uk or send a private message to the Moderator account.

Best wishes, 

Megan
Macmillan's Online Community team

Hi Sammy

I’m a gay man, who like you, has come through the horrible experience of Chemoradiotherapy for anal cancer- my last check-up at 1 year post-treatment was fine but I have some residual scaring of the rectum. As someone who used to enjoy anal penetration sexually before this all kicked off, I too have started to become curious to know how this might get back to normal for me.

During the diagnosis and treatment period my libido completely disappeared, however after about six months or so I started to become more sexual again. However, because of my bad memories of the painful and uncomfortable anal symptoms and side effects, my anus seemed to have lost its erotic appeal!

One of the ongoing side- effects for me from the treatment has been a post-radiation irritable bowel syndrome which means I have to open my bowels 3 or 4 times a day instead of just once- it’s gradually getting better but it’s something I discuss with my oncologist at our 3 monthly appointments. Interestingly, he asks me every time how my erections are but has never enquired about any problems I might be having with receptive anal sex! 
It does surprise me that there seems to be an absence of information out there about this topic, and so I was really pleased to see your post today when I came to the forum. Maybe no one asks about it because of the triple stigma around the subject (stigma1:Cancer/ stigma 2: Gay/ stigma 3: Anal)

I was aware that whenever women undergo pelvic radiotherapy there is a big focus on ensuring that they are able to return to enjoying vaginal penetrative sex, and, because radiation can cause the vaginal walls to shrink and lose their elasticity, they are advised to use a series of gradually increasing sized dildos to gently stretch the tissues.

Anyhoo- I started wondering if it would make sense to do the same for my anus/rectum. I started to speculate that maybe it was because my anus and rectum had started to lose their elasticity, they were more sensitive to the sensation of faeces in the bowel and triggered the desire to open my bowels more often. 
I did have a small dildo designed for prostate stimulation-short with a diameter not much more than a finger which I dusted down and thought to see if my theory was correct…

Unfortunately when I tried to insert it, it wouldn’t go in, it felt uncomfortable and then when I next opened my bowels it was sore and there was bleeding!

So at my next oncology appointment I raised my theory with my doctor. He said that because of the scarring caused by the radiotherapy, the tissue is now much more delicate and will tend to tear and bleed much more easily. However, there is a chance that ‘germ cells’ can migrate to the area and heal the scarring but this is likely to take years rather than months.

So if my desire for anal sex were to return it looks like there might be problems- at least for me in the immediate term.

Your situation might be very different and I’d be really interested to know if you made any further enquiries as suggested by Megan and if you got any useful advice.

I just wanted to share my experience in the interests of attempting to de-stigmatise this important but under-discussed subject.

All the best!

Hi there 

thanks you so much for the long and important message I do really appreciate . 
like you have said this there’re no one is given you clear information about ot . They all concern and have so much information reaction and straight men sex life but this is still no openly raised , and well treated . Is all all confusion ont person tells you things the another another one . 
So far o had some useful information from amazing straight women echo I have taken on board and appreciate them but you are the first gay passive receiver man who has said things clearly as we are facing 3 stigma; Anal cancer️, Gay , passive receiver.. I had taz feeling all the time that is something I look for it is not down to me 

Personally I have no pain no scars no bleeding or nothing is all come back smoother cleaner and even even put lube and put finger all is clean nice my only BIG gear is incontinence. They told clearly if I do have anal intercourse they I will not control anymore my boo which big red flag . I know is frustrating and is very depressing as o can’t enjoy wry anymore. 
I hope some others comes out out with some positive inputs and cheers is a bit 

I am not if I read your name but thank you so much for liking me and I love you back and appreciate you . 
Sammy