It’s Breast Cancer—Not the End of the World: Continuing to be Intimate and Sexual

By Jen Sinclair, LPC, Program Director, Cancer Support Community of the Greater Lehigh Valley

It’s a shock that resonates far beyond the questions about treatment and mortality. It can infringe on a woman’s self image, creating fears about intimacy, sexuality and changes to relationships. The diagnosis is breast cancer, and the waves of distress can keep on coming.

Many women have caring support from their partners.  Through diagnosis and treatment, some have grown closer to their loved ones as they find ways to cope together.  However, for some, the experience can be isolating and frightening as they adjust to the changes that affect their mind, body and spirit.  “How can I have sex?  Who will want me?”  will echo through the minds of many women.

Distress is the most common side effect of a cancer diagnosis—and for a woman with breast cancer, distress can carry into all aspects of her life, manifesting itself as vulnerability, sadness, anger, depression, anxiety or panic.

Crying often, under the weather, over-tired, jittery or irritable? Distress. Over-reacting, eating and sleeping differently? Distress.  Avoiding  people and activities? Afraid to have an intimate or sexual relationship? Distress.

All of these emotions are normal, but they don’t have to last, and they don’t have to rule a life.  Emotional and physical intimacy—that sense of having a secure and close relationship with someone—is critical to restoring self-esteem, confidence, and peace for a woman with breast cancer.

Nevertheless, both physical and emotion concerns can thwart a woman’s desire for intimacy and sex. She is facing surgery, chemotherapy, hormonal therapies, pain, premature menopause, and fatigue. She worries about her partner’s reaction, and may feel depressed, guilty or fearful of the unknown.  Even myths might haunt her: is cancer is contagious through sex; are partners at risk for radiation exposure; will sex cause harmful increases in estrogen; should sex always happen spontaneously.

A woman can master these fears, control her anxieties, and move ahead—just differently.

A woman with breast cancer must first reconnect with herself as she adjusts to this “new normal” in order to reconnect with a partner.  By asking questions about what is personally important while giving her time to mend, she is offering herself the kind of nurturing attitude that can eventually build her self-esteem.  Even though it is often a taboo subject, masturbation and self-exploration can be a helpful way for the woman to discover how her body may be reacting differently to touch and sensations after treatment. Another useful, less intimidating exercise is the “Mirror Exercise,” where women privately assess and emotionally integrate the physical changes.

Sex may change, but it’s important for couples to remember the benefits of physical closeness by discovering new ways to express sexuality that may not involve intercourse, but instead may involve new positions, gentle massage—and above all, communication.

It is often hard to work through these issues without help and support;  but there are many options such as certified sex therapists (aasect.org), books, and online resources that can provide information and guidance.

Cancer Support Community offers free programs that help people and families affected by cancer regain a sense of hope and control, reduce stress, manage their care through education, and lessen their sense of isolation.  Some of our programs that are relevant to couples facing breast cancer together are couples retreats, survivor retreats, and support groups for couples to validate with others their difficulties.

Some groups focus on specific kinds of cancer, or needs that are specific to demographics.  Thus, a 36-year-old woman with breast cancer with a husband and two children can attend a monthly group for breast cancer survivors and a monthly group for Young Adults, while her husband participates in a Caregiver Group.

It is important to find resources that meet a woman’s needs to ensure the best psychological, social, and emotional support.    Along with the local resources from hospitals, other non-profits, and clinical professionals, Cancer Support Community can be a valuable asset in the field of psychosocial oncology…so that no one has to face cancer alone.

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