well it's time for a long discussion basically your choices are therapy for both of you or divorce cuz otherwise you're just going to live miserably for the rest of your life

That's one long headache!

I have a friend in basically the same boat. He’s a great guy, but things have always been strained in the “romantic department” in their marriage and now it’s threatening his marriage. I’m sorry, I feel for you OP. You patiently took care of her for so long and now she’s not returning the favor now that things are better.

Perhaps it may be time to look into alternative types of partnerships? My husband and I are polyamorous, meaning we have other partners, because he is much more reserved sexually. I am decidedly not. He is my main partner, and he has say so if he doesn't like any of my partners. Same with me. Becoming poly saved our relationship. That being said, it is definitely not for everyone, and needs a lot of thought and discussion and trust. Go to therapy with your wife and separate. And to the people saying "oh, he took care of her, now she's obligated to take care of him"... That's simply not true. If op took care of her simply for the return of sex, that would make op kind of a jerk. You never take care of someone expecting for a reciprocation, especially physically, you take care of them because you can. If reciprocation doesn't happen naturally, then discussion needs to happen. No one "owes" anyone anything.

Yeah, I know how this goes. Everyone supports her decision of course and she's empowered, but if you'd left her when she was sick, you would have been the asshole.

If she cheats on you, get proof, document everything and take her to the cleaners in the divorce.