Navigating Romantic Relationships and Sexual Intimacy: Challenges and Opportunities for Adolescents and Young Adults With Cancer - A Literature Review of Qualitative Studies.

Objective: This review explores the impact of cancer on adolescents' and young adults' (AYAs) romantic and sexual relationships, examining both challenges and opportunities.

Methods: Qualitative studies on AYAs with cancer and/or their partners were searched based on a sub-set of studies identified in a previous literature review within the EU Horizon STRONG-AYA project, and supplemented with an additional search on romantic/sexual relationships. Articles were screened, reviewed in Rayyan and data extracted using a structured framework. Study quality was appraised, and findings were synthesised thematically.

Results: Twenty studies were included. Findings revealed how cancer altered AYAs' sense of self, affecting the navigation of romantic relationships and sexual intimacy across four themes: (1) Romantic relationship development-connection, isolation and changing priorities: Disrupted romantic trajectories and fears of being undesirable hindered relationship formation, though some re-evaluated priorities, deepening emotional connections, (2) The disclosure dance: Finding the right time and way: AYAs struggled with when and how to disclose their diagnosis, with anxiety about burdening partners or altering dynamics. Open and honest communication fostered intimacy, (3) Body image, sexuality, intimacy, and fertility: Challenges in these areas impacted self-worth, but also led to sexual empowerment and adapted intimacy, (4) Partnerships and social support during cancer: Unsupportive partners heightened isolation, while supportive partners reinforced self-worth. Many AYAs experienced growth, resilience and a deeper understanding of themselves/their relationships.

Conclusion: Results may inform age-appropriate interventions to adequately address the unique challenges AYAs with cancer face in navigating romantic relationships and sexual intimacy.