It takes two to tango: Sexual health and closeness in couples coping with advanced cancer.


Each month, Professor Catherine Walshe, Editor-in-Chief of Palliative Medicine, chooses an article and invites the authors to draw out the key points on the EAPC blog. Focusing on research that is novel, a robust review, from a specific country or just slightly left of field, the ‘Editor’s Choice’ post aims to share experience and stimulate ideas. We hope you’ll read the longer article in Palliative Medicine – EAPC members can access a FREE copy from the EAPC website.

Janneke van Roij introduces the background to the longer article selected as ‘Editor’s Choice’ in the April 2022 issue of Palliative Medicine. Janneke is a Psychologist and researcher with the Netherlands Comprehensive Cancer Organisation (IKNL).

Photo of Janneke van Roij
Janneke van Roij

For me, feeling connected to my partner is most important to me. Especially when times are rough, my partner and I tend to look out for each other by providing emotional support. I can only imagine how patients with advanced cancer may find comfort and support in their connection with their partner. The advanced cancer diagnosis often comes with feelings of uncertainty and even anxiety as the perspective on life changes as death comes into play. Feeling connected to my partner provides me with comfort as it gives the feeling of not being alone but being in it together. It provides strength by the knowledge of being able to carry the burden together.

We are all born with an innate need to feel connected to one another. Sexual health can play an important role in feeling connected to one’s partner. Physical contact gives us a good feeling, for instance because it enhances the release of ‘happy hormones’ and lowers our blood pressure. The act of sex will stimulate processes that makes us feel connected to the other person. However, with advanced cancer, sexual health may become affected as the cancer and its treatment may create sexual dysfunction or sexual problems (for example, feeling less attractive, feeling distressed etc.).

While the partner of patients with advanced cancer obviously plays an important role in the emotional connection and sexual health, they are not always included in research. Studies on sexual health that include couples coping with advanced cancer are even more scarce. In our recent article published in Palliative Medicine, we report on findings from the eQuiPe study, an observational multicenter study about the sexual health and connectedness in 566 couples coping with advanced cancer in the Netherlands.

We were happy to find that most patients with advanced cancer and their partners felt connected to each other in our study. We also found that around half of all patients (male and female) are interested in sex. Of these, male partners experience more interest in sex (73%) compared to females (50%). We found that 25% of the patients and one third of all partners were not satisfied with their sex life but it is not known whether this was the case before the cancer diagnosis. Moreover, about one third of all patients and partners reported sexual problems or problems in their relationship but only a few (<10%) sought professional advice for these problems.

As expected, we found that satisfaction with sex life was related to feelings of connectedness in couples, especially for partners. Satisfaction of the other person in the relationship was also related to own feelings of connectedness. These results suggest that the opinion of the other person in the relationship matters for one’s own feelings of connectedness in the relationship. It really does takes two to tango.

Our study suggests that sexual health is an important topic to discuss with couples coping with advanced cancer. Healthcare professionals caring for people with advanced cancer should be aware that sexual health is for many people an integral part of quality of life, including for people in poor health. Sexual health should be a routine part of clinicians’ assessments of their patients.  It is important to explore both the patient and partner perspectives on sexual health because their experiences regarding sexual health impact each other and they are both the focus of palliative care. When discussing sexual health, it is crucial that health care professionals are aware that sexual activity may change due to advanced cancer and alternative ways to adjust to these changes may be beneficial for couples to feel close to each other while dealing with advanced cancer. Besides the sexual act, it is also important for healthcare professionals to discuss alternative ways to regain and foster connectedness in the relationship. Especially male partners deserve attention from health care professionals as they experience most sexual problems but often do not seek support.

Our study has shown that connection is important between those with an advanced cancer diagnosis and their partners, and sexual health is an element which can support this connection.


This post relates to the longer article “Sexual health and closeness in couples coping with advanced cancer: results of a multicenter observational study (eQuiPe),” by Janneke van Roij, Natasja Raijmakers, Anna Thit Johnsen, Maiken Bang Hansen, Martine Thijs-Visser and Lonneke van de Poll-Franse. Issue published: Volume 36; issue 4; April 2022 

Links and resources

  • Netherlands Cancer Registry: “Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship (PROFILES)” is a registry for the study of the physical and psychosocial impact of cancer and its treatment from a dynamic, growing population-based cohort of both short and long-term cancer survivors. Find out more here
  • Read more about the eQuiPe study on Palliaweb and here.

About the author

Janneke van Roij is a psychologist and works as a researcher at the Netherlands Comprehensive Cancer Organisation (IKNL). She recently finished her PhD study on quality of care and life in patients with advanced cancer and their relatives (the eQuiPe study). She will defend her PhD thesis “In it together: a dyadic approach to care experiences and quality of life of patients with advanced cancer and their loved ones” in May 2022 at Tilburg University, the Netherlands.


If you are currently an Individual or Associate EAPC Member, you have full access to the Members Area of the EAPC website, and the chance to download a free PDF of all ‘Editor’s Choice’ articles, as well as many other membership benefits. Just click here, enter your email address and membership password and choose from the list of journal articles for 2022.

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