Fertility, Sexual Health & Wellbeing After Cancer: What You Need to Know

Being diagnosed with cancer is overwhelming, especially when you’re young and facing concerns not just about survival — but about your future. One of the most common and difficult questions many patients under 50 have is: Will I still be able to have children?

Good News and Challenges

Cancer rates are rising among people under 50, but there's a silver lining: treatment has improved dramatically. More people are surviving cancer and living full, healthy lives afterward. However, some cancer therapies, like chemotherapy, hormone treatments or radiation, can affect fertility or make it harder to have children later on.

You Have Options

If you’re facing cancer, it’s important to know that you have options to preserve your fertility before treatment begins — and there are paths to grow your family after treatment ends.

We discuss fertility preservation with patients right from the start. During your initial consultation, we’ll talk about your options and involve your care partner and oncologist in shared decision-making. If you’re interested in fertility preservation, we will provide a referral to a fertility specialist immediately. These specialists in our community are incredibly responsive and typically schedule appointments within a few days, ensuring there’s no delay in starting your cancer treatment.

Choosing Your Path

Not every patient will choose fertility preservation, and that’s completely okay. Every path is different.

In some cases, chemotherapy may temporarily “shut down” the ovaries during treatment. For young women with estrogen-sensitive breast cancer who haven’t gone through menopause, ovarian function suppression (OFS) may be recommended. Later, if you’re ready to start or expand your family, we’ll revisit your care plan and discuss the timing of safely discontinuing OFS. For men, sperm banking is the main way to preserve fertility. It provides a better chance of fathering a child after cancer treatment.

And yes — pregnancy after cancer is absolutely possible.

Pregnancy During a Cancer Diagnosis

We understand that being pregnant while facing cancer brings a unique set of emotional and medical challenges. Most cancer treatments are not started during pregnancy, especially early on. However, in some cases — particularly later in pregnancy — surgery may be safely performed. These decisions are deeply personal, and our role is to provide you with up-to-date, honest information about the timing, risks and safety of different treatment options during and after pregnancy.

It’s also worth noting that certain diagnostic tests, like CT scans, aren’t safe during pregnancy, which can limit how we assess the cancer early on. Postpartum treatment often begins around 2–4 weeks after delivery, depending on your situation.

Sex and Intimacy After Cancer

This isn’t always an easy topic to bring up — but it matters.

Cancer and its treatments can change your relationship with your body and affect intimacy. That might mean physical changes or emotional ones — or both. Here’s what to know:

• Testicular cancer (often in younger men): May involve removal of one or both testicles.
• Prostate cancer (more common in older men): Treatments can affect erectile function.
• Breast cancer: Mastectomy, radiation and hormone therapies (like estrogen blockers) may lead to menopause-like symptoms such as hot flashes, vaginal dryness, weight gain and mood shifts. There are plenty of options to help with these issues.
• Colorectal cancer: May involve a colostomy bag; sexual activity might require adjusting positions for comfort.
• Gynecological cancers: Pelvic radiation can cause discomfort during intercourse.

There are solutions — we’re here to help. From medications to manage symptoms, to helpful tools and strategies, such as using condoms for a few days after treatment — we can work with you to improve sexual well-being. Open communication with your partner and care team is key.

Caring for Yourself

While it may feel like “doom and gloom” at times, there are tools and support systems to help you navigate this journey:

• Talk openly with your care team and loved ones.
• Acknowledge your emotions — they are valid and real.
• Stay healthy: Eat well, move your body when you can.
• Find support: Counseling, journaling and programs like Bayhealth's Survivorship Program.
• Be your own advocate: Speak up about side effects so we can help.
• Join support groups: Learn from others who have walked this road, including Bayhealth’s Survivorship Program and Cancer Support Community Delaware.
• Avoid “Dr. Google”: Everyone’s cancer is different. Ask your oncologist or use trusted sources like the American Cancer Society.

You’re Not Alone

Coping with cancer and recovery isn’t easy. Whether you're worried about fertility, sexuality or just figuring out how to feel like yourself again — we're here to walk with you every step of the way.

Visit Bayhealth.org/Cancer-Institute to learn about the comprehensive services provided at the Bayhealth Cancer Institute.

Written by Bayhealth Family Nurse Practitioner Sandra Voss, FNP-C, AOCNP, who cares for patients at the Bayhealth Cancer Institute.