Sexuality
Sexuality encompasses many aspects of our lives, including our self-image, our relationships with partners, our perceived attractiveness, our ability to experience sensual feelings, and our reproductive capacity.
Treatment for breast cancer can affect your sexuality both physically and emotionally. The diagnosis and the effects of treatment may cause depression, which in turn may affect your sense of self, desirability, and sexuality. Share your feelings of sadness or depression with health team members. They can assess your symptoms and direct you to appropriate resources for help in dealing with these normal feelings.
Chemotherapy treatments can cause temporary or permanent changes in your ovaries, which produce hormones. Changes in those hormone levels can cause premature menopause, hot flashes, vaginal dryness and other problems. Some drugs can irritate the lining of the vagina and reduce the size of the vagina, making intercourse painful. Other side effects of treatment, such as nausea, may lower your desire for sexual intimacy. Radiation therapy does not cause hormonal disruptions, but it can leave your skin somewhat swollen and tender. It can also cause fatigue. You may find also that your particular likes and needs change during and after cancer treatment.
Losing a breast can deeply affect your feelings about your sexuality. Breasts provide an important source of sexual pleasure as well as a sense of femininity and desirability.
With all of these possible changes occurring, it is quite likely that your sexual relationship with your partner will change. Give yourself and your partner time to adjust. Explore new ways to share intimacy, or just focus on cuddling and feeling close for now. If you feel shy or awkward about the changes in your body, consider wearing a flattering negligee. If vaginal dryness is a problem, ask your doctor or pharmacist about lubricants such as Replens®, Astroglide®, or K-Y® jelly. Many women find that reconstructed breasts help them to feel more attractive. Many women, too, soon find that the loss of a breast is not at all important to their partners.
Don't be afraid to ask for help. Talk to your doctor or nurse about the potential side effects of your treatment. If he or she is not familiar with this issue, ask for a referral to a specially-trained nurse or a program at a medical center.
Maintaining emotional intimacy and communication with your partner is the best way to dispel misconceptions about cancer and maintain a satisfying sexual relationship. Share your thoughts and ask your partner to do the same. If you need assistance communicating with your partner about issues of sexuality or fertility, healthcare providers are available to provide information, support, and practical advice.
If you are not currently in a serious relationship, think about when you want to tell dates about your experience with cancer. It's not something that every date needs to know right away, but it's not something that you need to hide either. It's up to you when you want to bring up the subject. One cancer survivor chooses to discuss her treatment during the second or third date. It's a big part of her life, she says, and ignoring it only delays the "getting to know you" process.
There are many secondary issues that may concern patients. Whether it is continued worry about the possibility that the cancer will return, or a change in physical health or psychological and social well-being, most cancer patients face some level of emotional or physical challenge both during and at the end of treatment.
Your first reaction to completing treatment may be joy, but it may be tempered by uncertainty, grief, sadness, or anger. Many cancer survivors report some level of distress following treatment, particularly if their physical side effects are life-altering, they have had other stressful life events, or they have had difficulties coping with stressful events in the past. Uncertainty about relationships can be another source of concern. While family support can be critical in helping to address these emotions, survivors may worry about further imposing on already burdened family and friends. Cancer survivors often seek psychological and educational support through community agencies or healthcare professionals who specialize in cancer and survivor issues. See Resources for listings of organizations that might help.
Anxiety and depression are not unusual in cancer survivors. Your doctors and nurses can provide you with a better understanding of the emotional changes you may experience after treatment ends. Psychiatrists, psychologists, and social workers can be very helpful with problems such as depression, panic attacks, feelings of isolation, and other feelings that concern you. Joining support groups, talking with family members, friends, and other cancer survivors, and listening to music or relaxation tapes may help.
Cancer often disrupts normal family relationships and responsibilities. Traditional roles may be reversed or additional roles taken on, causing stress for everyone. Returning to old roles and routines may take time. Open communication and a sense of humor help. As with other cancer-related difficulties, many professionals can help families work through these problems.
For many patients, months or years of treatment have conditioned them to a "sick role." They may have felt ill and unable to carry on their usual activities. Now, at the end of treatment, they begin to feel better and can slowly resume normal activities. But leaving the "sick role" behind may take more than simply feeling better. Patterns develop, new behaviors take root, and anxiety and fear remain. The transition to the "well role" may take time.
Almost everyone feels a heightened sense of uncertainty and vulnerability after cancer. But many patients say the experience makes them appreciate all the little things they never had time for before. After cancer, they "stop to smell the roses."
The cancer experience causes some patients to feel isolated or to withdraw from social interactions. Sometimes, social supports disappear or are unable to provide the kind of help a patient needs or wants. Sometimes, patients refuse support. Turn to your healthcare professionals for advice.
