Dating and Marriage

Even without complications, the period of adolescence to young adulthood is a tough time. During this period, people often struggle with identity and self-esteem, worry more about how they compare to others, and experience increased sexual interest and puberty. As a result, teens and young adults tend to focus more on appearance and body image.

That's why this time period is especially difficult when cancer treatments have changed the way you look. Long-term physical effects, such as weight loss or gain, surgical scars or any change in your physical appearance, may affect your overall self-esteem and make you uncomfortable in a sexual relationship.

It's important to strengthen your self-esteem so that you can form healthy, productive dating relationships. Below are some ideas for creating positive self-esteem:

• Exercise. Not only is exercise part of a healthy lifestyle, it releases chemical endorphins in the body, which lead to feelings of well-being.
• Create your own space. Decorate your room, a box or a journal where you can keep your own belongings, music, books, movies or writings.
• Don't compare yourself to others.
• Find your skills. Whether it is writing, dancing, singing, video games, sports or academic interests, find what it is that makes you happy and do it.
• Say positive things about yourself. It may sound corny, but talking to yourself in a positive way helps boost your self-esteem.
• Surround yourself with positive, supportive people.
• Make a list of your past successes.
• List your future goals and plan on how you will achieve them.
• Learn to laugh at yourself. A good sense of humor and the ability to laugh at yourself increase your enjoyment of life.

Intimacy

You may experience sexual concerns caused by fertility issues and health worries. Your ability to perform sexually might also be affected by depression, guilt, fear or fatigue. Sometimes, low self-esteem leads people to engage in sex less frequently, feel more anxious about sex, have difficulty becoming aroused or deriving pleasure from sex, avoid sex or engage in it too freely or dangerously.

The key to overcoming confusion about sexuality is to be honest--with your partner and your doctor. Discussing reproductive issues and sexual concerns can be embarrassing and scary. However, the benefits of an open discussion far outweigh keeping these concerns unspoken.

Discussing these issues and working to feel good about yourself will help you have healthier and happier relationships.

You may also benefit from seeking professional counseling. It's important to be well informed about possible sexual and/or fertility problems and to be willing to talk about these concerns with your partner, your doctor and, if needed, a counselor. If you need additional help related to sexual issues, you can obtain referrals to a licensed sex therapist or counselor through the American Association of Sex Educators, Counselors and Therapists (www.aasect.org).

Studies show that the marriage rate is generally the same for cancer survivors as for the general public. Working on intimacy can be difficult, but openly addressing these issues and developing positive self-esteem will help you strengthen your relationship.