Dating With a Cancer History

The question that comes up most is when to tell someone. There is no single right answer, and the advice you will get from other people who have had cancer will contradict itself, because they are all describing what suited them.

Three approaches that work, with their trade-offs:

Early — in a profile, or on a first date. Filters fast, and you never carry the secret. The cost is that it front-loads your history into a first impression and invites questions before you know whether you want to answer them.

A few dates in, once you like them. The most common choice. You have enough investment to justify the conversation and enough distance to walk away. The cost is a stretch of waiting for the right moment.

When it becomes physical, or unavoidable. Scars, an ostomy, fatigue, or a port under the skin will raise it anyway. Saying it just beforehand is honest and practical. The cost is doing it while already feeling exposed.

What matters more than the timing is that you choose it, rather than being surprised into it.

Timing and detail are separate decisions. One sentence is a full disclosure: "I had cancer three years ago, I was treated, and I'm well." Or, if it is ongoing: "I'm on treatment for a cancer that's being controlled. It's part of my life, not all of it."

You are not required to supply staging, scan intervals, prognosis, or the history of every drug you have taken. If someone presses, "I'll tell you more when I know you better" is a reasonable boundary and tells you something about how they handle limits.

A note on messaging apps: written disclosure gives the other person room to react privately and gives you the option not to watch their face. Some people much prefer it. It also removes tone, so keep it short and unapologetic.

Cancer treatment changes how people look and how they feel about themselves — scars, weight change, hair regrowth, ostomies, and effects that last long after treatment finishes. It is common not to feel like the same person afterwards.

A few things that help:

• Decide in advance how you will mention a scar or device, so you are not improvising while undressed. Flat and matter-of-fact works: "That's from surgery. It doesn't hurt."
• Treat sexual side effects as medical, not personal. Pain, dryness, erectile difficulty and low libido are common after many treatments and often treatable. Raise them in clinic.
• Pace things. Fatigue is real and unromantic, and a shorter date you can enjoy beats a long one you spend rationing energy.

This is rarely a first-date subject, but it is worth knowing your own position before it becomes relevant. Cancer treatment can affect fertility, sometimes permanently, and it is easier to have the conversation from a position of information than of guesswork. If you have not had a fertility assessment since treatment, ask for a referral.

Some people withdraw. It stings, and it is worth being clear about what it means: it is information about their capacity, not about your desirability. Someone who cannot handle a past illness would not have handled a redundancy or a bereavement either. The one consolation is that it usually surfaces early, before you have spent a year finding out the same thing the slow way.

Others will overcorrect — treating you as fragile, or as an object of admiration. That is also worth naming: "I'd rather you didn't treat me as a special case. I'm just someone you're seeing."

If explaining is exhausting, groups where the context already exists can be easier. Stupid Cancer runs meetups for adolescents and young adults where cancer needs no preamble, and Young Survival Coalition runs peer groups for younger people with breast cancer. Plenty of relationships start in rooms where nobody has to give the speech.

• NCI — Fertility Issues in Girls and Women with Cancer
• NCI — Fertility Issues in Boys and Men with Cancer
• NCI — Survivorship
• Stupid Cancer
• Young Survival Coalition