Sex in Breast Cancer Life

Cancerland is a place where, as the late Christopher Hitchens put it, “there seems to be
almost no talk of sex.” In the case of breast cancer, he was right. Now I don’t want to get
all cancer competitive on you, but the discussion of prostate cancer is often accompanied
by concerns about its impact on a man’s sex life. With breast cancer, if there is any
discussion of sex at all, it is likely to be if you are of childbearing age, and it is more likely
to be about fertility than it is about sexuality. Your sex life doesn’t come up much.
If this is not an issue for you, I applaud you and recommend you move on to “T Is for
Therapy.”

If this is an issue for you, let’s talk about it. As you’ve gleaned from the preceding pages,
when the complete embodiment of your womanhood—your breasts—becomes diseased,
this is not an easy thing to deal with. In fact, sex is so far from your mind that you might be
asking yourself, Why is she bringing this up at all? The National Cancer Institute reports,
“About half of women who have long-term treatment for breast and reproductive organ
cancers … report long-term sexual problems.” So if you are going through any sexual
challenges during treatment, you are in good company. But every year, hundreds of
thousands of women are treated for breast cancer and come out the other side. While sex
may be on hiatus during treatment, it doesn’t have to stop forever.

Lots of things can affect your sex drive when you are diagnosed with breast cancer.
First, you’ve been diagnosed with breast cancer (see “A Is for Anxiety” )! There is nothing
that can prepare you for the number that does on you mentally. This is news that you need
time to cope with, and really, all your attention can be focused on that for as long as you
need.

Second, if you have breast surgery, you hurt. You hurt physically because some or all of
your breast or breasts have been removed. That is a whole lot of hurt (see “M Is for
Mastectomy”), not to mention bandages and drains and general yuckiness. I’ve tried to
think of any way to interpret this immediate post-surgical period as sexy, but I really can’t.
Please let me know if I am wrong. You hurt emotionally too. Not only are you in mourning
for the previously healthy you, but you are in mourning for a part of your body that may
have helped define your sexiness, appeal, attractiveness. It is really hard to get aroused
when you are in that kind of state.

Third, you might have to undergo chemotherapy and/or radiation. How do I begin to
describe the unsexiness of that? Your body is being pumped with toxic chemicals and
countless other drugs to counter the effects of the toxic chemicals. Here are some of the
side effects that were possible from the particular chemo that I was taking:

• Fluid retention with weight gain, swelling of the ankles or abdominal area
• Peripheral neuropathy (numbness in your fingers and toes)
• Nausea
• Diarrhea
• Mouth sores
• Hair loss
• Fatigue and weakness
• Infection
• Nail changes, including in extreme cases nails falling off

Nothing sexy about any of that list!
So you go through the weeks and months of surgery and recovery, followed by
chemotherapy and recovery, maybe followed by radiation and recovery. During that time
you will want to be loved and hugged and calmed and comforted, and maybe you will want
to have sex. But maybe you won’t. This is where the U Is for Understanding (see “U Is for
Un-”) comes in on the part of your partner. Your partner may not feel that you are
deformed or unsexy or unattractive. In fact your partner may be working hard to convince
you of the exact opposite, that you are as beautiful and lovely as you were when love first
struck, that a surgery like this, and the resultant nine-inch scar across your chest, and your
baldness and your bloating, changes none of that. Your partner means it. You just might
not be in a condition to hear any of it.

One of my doctors did bring it up with me actually.
DOCTOR: How is your sex life?
ME: Um, nonexistent.
DOCTOR: I know it’s hard but…
ME: It’s really hard, I feel like crap.
DOCTOR: I know, but it’s like a muscle, you have to keep using it!

There you have it, the view from a medical professional. So while not many people talk
about it, a lot of the cancer literature will deal with the question of intimacy. It’s important
enough that the National Cancer Institute lists intimacy as one of the parts of your life that
can be severely affected by a diagnosis of cancer. And that is the first step, recognizing that
your sex life, sort of like your taste buds and your energy level and your hair, is affected by
your treatment. Like all of those things, it comes back. It just comes back on its own
timetable. And I speak from experience.

Sex in Breast Cancer Life