July 1st, 2010
Maybe it’s because I had breast cancer. Maybe it’s because my brother, at age 35, had prostate cancer and was treated with Lupron, a drug that shut down all of his male hormones.
I thought it was obvious that cancer patients have to contend with a serious crimp in their sex lives, during and after treatment. But if it’s a subject that is even taboo in France, you know we still have a long way to go toward talking about sex and cancer.
This is a post about sex and treatment. Not about relationships, not about intimacy. I hope that it helps others out there find some resources to help them with this vital issue.
When I was first in chemo, I tried to find information on the subject. It was hard to come by. I started talking to other patients and survivors whom I met through social networks. I culled the few articles I could find and went into a few chatrooms on the topic. I spoke with my oncologist. This post summarizes what I have learned as I sought information on this important and under-discussed topic.
Cancer threatens our identities in many ways. Treatment often alters our physical appearance. We are confronted with our mortality. For many people, sexuality equals vitality. To be robbed of our hair and our body parts is hard enough. But to be granted early menopause or be rendered impotent hurts in a different way.
From my conversations and reading, patients’ libidos are affected differently –– and for different durations –– depending on the kind of cancer they have and how it is treated.
Some cancer treatments shut down sexual organs and functioning for the long term. Women with cervical cancer, for instance, might have several inches of their cervix removed as a part of treatment. Sometimes, radiation in the cervix can leave adhesions that close the vaginal walls, making intercourse painful or impossible. Men with prostate cancer risk permanent erectile dysfunction in the wake of a prostatectomy. These are serious side effects and require special physical therapy or medications. Cure magazine wrote the best article I have found on the subject, although talking to patients, I find that there is still a lot that is left out.
Other cancers effect secondary sexual organs, such as breasts or testicles, leaving patients with altered body images and transformed (or deleted) erogenous zones. The basic sex act is still possible, but patients’ desires may need to be adapted to their altered pleasure zones. While there are sometimes cosmetic fixes for these lost or changed organs, they are often imperfect, leaving people with little tono sensation.
For example, women with breast cancer are sometimes faced with a choice about having single or double mastectomies. Deciding whether to remove a second, unaffected breast forces women to balance cosmetic, medical, and sexual considerations. The latter is often not discussed with women making this choice. Interestingly, I have not met any men with testicular cancer who have considered prophylactic removal of their second testicle. Maybe I have just talked to the wrong men.
Having body parts removed or altered leads to body image concerns for both men and women. The sex therapist advice I have gathered focuses on getting comfortable with new bodies in the bedroom and refocusing sexual expectations. Some patients seem to recover sexual functioning better than others.
The third group of cancer patients do not necessarily have their sexual organs (or secondary sexual organs) directly affected by treatment. Nonetheless, the physical and emotional toll of surgeries, tumors, radiation fatigue, and chemotherapy can dampen libidos, even if only temporarily.
Interestingly, some people find that they have a surge in their libidos either immediately after diagnosis or once their mojo comes back. Facing mortality can do that to a person.
What have been the most helpful resources you have found on the topic of sex and cancer? Did your doctor discuss this with you during your treatment?
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