How to Deal with the Sexual and Romantic Fallout of a Cancer Diagnosis?


There's no such thing as a good cancer, but breast and ovarian cancers seem particularly cruel. They seize uniquely female body parts and turn them against us. And the treatments that save our lives assault the same organs-- surgeries that cut out our ovaries and all or portions of our breasts, drugs that hurl us into menopause or intensify its symptoms-- is it any wonder that women's romantic and sexual relationships can be profoundly affected by a diagnosis of breast or ovarian cancer? Our helpline volunteers share their experiences—and some helpful tips:

"I wanted passion and intimacy, but there were times when my body was just not into it," says one married volunteer who was diagnosed with breast cancer at the age of 50 and underwent a lumpectomy, eight rounds of chemotherapy, and seven weeks of radiation, and has taken Tamoxifen for the past three years. "I gained weight, and I felt ugly." To ignite the spark in her brain and body (and the brain and body of her husband), she says, "I lit candles and put on soft music, and we drank hot chocolate and made cookies." She and her husband found that intimacy was not just about sex. "It was about holding hands, cuddling, and looking into each other's eyes."

Not everyone finds such satisfaction. Another helpline volunteer had been married for 22 years when she was diagnosed with breast cancer and had a mastectomy and implant reconstruction. Seven years later, she says, "I still have absolutely no interest in having my reconstructed breast touched. In fact, it is repulsive to me. It has been numb ever since surgery. It is not pleasurable. I keep it covered." After she had finished treatment, her kids left for college and jobs and marriage, so she and her husband had more time and privacy. But then came menopause, and that made things worse. "While my husband probably looked forward to this time in our marriage, I lost all interest in sex whatsoever, and it became painful to have intercourse because of vaginal atrophy and dryness. I just wish sex would GO AWAY. It takes extreme effort for me to get to a place of enjoyment." She and her husband have a good relationship in other respects, but she feels sorry for him. "He probably feels this part of our life is over, and some days I have to admit that it may be. Perhaps it is just normal for women over 50 to feel this way—whether they've had cancer or not—but it makes me understand why so many men leave their wives and find younger, more interested women. I'm not condoning it, but I understand it. Men never seem to lose desire."

Another SHARE volunteer had similar difficulties but found solutions that worked for her. Her husband had no trouble accepting her postmastectomy appearance, but she struggled with her self-image. "I've since heard many other women speak of having the same experience," she says. "Their male partners were O.K., but it took the women some time to feel comfortable in the bedroom." To regain that comfort, she wore a pretty camisole when having sex for the first month—"that, and I kept the lights low." She too suffered from vaginal dryness. "It got so bad that sexual intercourse was not possible," she says. "Fortunately, I heard a presentation about this and learned that it was a common reaction after chemo and that there were several things doctors could prescribe that really help." Her primary-care physician gave her a prescription that had her back to normal within two days.

Another SHARE volunteer, whose vulva became so fragile from chemo-intensified menopause that the friction of her underwear caused abrasions and bleeding, spoke to her gynecologist. In her case, the problem was alleviated by a drop of vitamin E oil applied several times a week to the inside of her vagina.

Though popular culture may focus on breasts, not every man does. A male SHARE volunteer who counsels caregivers has had long-term relationships with two women who had breast cancer. After his wife was told she had less than a year to live, he was stunned when she asked him whether he would like her to have reconstruction following her mastectomy. "To me," he says, "a breast is just a clump of fatty-like tissue—a milk-producing gland." He told her that he "really wanted her soul, not her gland." A decade after his wife's death, he fell in love with another woman who had been diagnosed with breast cancer. To treat her stage 2 cancer, her surgeon had to remove part of a nipple. "The fact that this was no big deal to me was of great significance to her," he says. The relationship didn't last, but not because of the missing nipple. Indeed, he says, he feels that as a result of his experiences with breast cancer, "I almost welcome a mate who has been through the 'storm.' It tells me a lot about her character, and that is what I'm looking for in my next date—character and balance. Life is so precious that having or not having breasts seems like a buried footnote."

Mindy Schiffman, a clinical psychologist and sex therapist in New York, believes many men share such attitudes. The good news is that survival rates for gynecological cancers have improved, she says, "so that you can now look beyond just surviving cancer to getting back to improving the quality of your life. Sex and intimacy, of course, are among the most important aspects of our lives." If you're struggling with finding a partner or improving the sexual relationship with the partner you already have, take heart. "Everybody can have a better sex life and more intimacy, but it takes work," she says. "You just have to keep trying." Several months ago, Dr. Schiffman gave a workshop at SHARE in which she provided frank and precise suggestions for enhancing intimacy. You can listen to the full presentation at:  Sexuality and Intimacy after cancer Video with Dr. Mindy R. Schiffman

Have you found strategies that improved the romance and sex in your life? Do tell!