After Cancer
A loving environment all day long sets the stage for good sex, and the pleasure of sex is heightened by feelings of love and intimacy. Both partners should be in the mood, bring high emotional content into the physical interaction, have intensity, and be creative.
Sex is possible without these things. But good sex happens when all these factors come together. Making love is no different than playing a sport, singing, or performing on a musical instrument. If everything is just right, it can be great. When one partner is out of sorts, tired, or distracted by a crisis, sex can feel just so-so. It can prompt the question, “Why did we bother?” If this happens merely once in a while, it is not a problem. But if it happens most of the time or all the time, it is a serious issue.
A cancer diagnosis may alter a woman’s self-image and often changes the balance between partners. After working through the battery of cancer tests and determining her therapy, a woman may wonder if she will still be desirable. She might even wonder, “Will I still be a woman?”
The assault of cancer treatment often leaves a woman with physical changes, and almost surely leaves her psychologically affected. As a result, some women shy away from sexually connecting with their partner. On the other hand, some women, like Christie, believe their partner needs to be taken care of and put sex on their schedule regardless of their personal desire. Christie said that she thought she would address her own sexual needs after she completed her chemotherapy. But for her, making sure her husband’s needs were met was a priority even throughout her therapy. He showed his appreciation by being caring and considerate during loving - and in everyday life. This mutually supportive relationship enabled them to keep their sexual relationship alive even during treatment.
As they go through therapy, many women take steps to redefine their future. They shape their world by initiating changes in their relationships and in the face they present to the outside world. Throwing away their wigs, as Janice did, says “This is me,” and “Here I am.”
A diagnosis of cancer may reveal tensions that have existed in a relationship for a long time. Often, the relationship was not satisfying before cancer entered the couples’ world. Many women who were interviewed or participated in our focus groups showed an emotional strength that surprised even them. Some women did not recognize they were changing until they did something that surprised them, such as dismissing an unsupportive partner. During her course of chemotherapy, Elizabeth told her partner, “You haven’t been supportive since I was diagnosed. What do I need you for now?” With that pronouncement, she showed him the door.
A feeling of mortality changes the sick partner’s perspective. A well-functioning couple rewrites the old rules, to allow the ill partner to explore opportunities outside the boundaries of life before cancer, opportunities that she feels were left unexplored before because of the trade-offs couples always make.
Edith is a breast cancer survivor who told her executive husband that she felt he did not support her enough. She then outlined what had to be done to get their marriage back on track. Edith's cancer experience prompted her to express key issues that had developed over many years of living together. She saw it as an opportunity to improve the relationship. Her husband agreed, and they made changes to their relationship to meet both parties’ needs.
"I’m Still Sexy!” or “Am I Still Sexy?”
Betty’s husband often tells her she is sexy. To which she replies, “I’m glad you think so.” But to her, his comment is just a confirmation of how she feels: “I don’t have the perfect body - but it’s the only one I’ve got, and it gives me and my husband a lot of pleasure. Am I still sexy? You bet! You don’t have to be a Victoria’s Secret model to be smokin’!”
Christine was asked what makes her feel sexy. She answered by explaining how her boyfriend evaluates her appearance each morning. “When he says that I look sexy, that’s one of my sexy days.” When asked a question about her subjective experience, about her knowledge of how she feels, she replies from a position as the object of her boyfriend’s judgment. That is, she sees herself as sexy if she is the object of male desire.
A confident woman in a sexually equal relationship enjoys better health, longevity, better bonding with her partner, and less stress. The benefits are even greater if she doesn’t rely only on her partner for affirmation that she is sexy, but relies on her own sense of attractiveness.
After cancer is treated or cured, a woman has an opportunity to reflect on what she has done up to that point in her life, dreams that have been realized, dreams that have been forgotten or pushed to the side, choices that have been made, and her degree of fulfillment. Her relationship with her partner is part of these thoughts, and sex is a key ingredient of the relationship.
Intimacy and sexuality sit at the tip of an iceberg with a massive foundation. The base consists of knowing and feeling good about oneself, living in a loving environment, having a sense of humor, and introducing a creative flavor to her activities and sex. Many women with cancer see themselves on a path to self-renewal, moving forward toward a new and better version of themselves.
We have found women who truly discovered themselves only after they went through cancer treatment. After a life-changing event, some people live much as they did before. Some make small adjustments, and some make dramatic changes. Every woman decides for herself how far she wants to go in making changes.
Many women have demonstrated a unifying philosophy that speaks of revitalization in the New Woman phase of their lives. Denise speaks of the support she received during her breast cancer experience. Filled with emotion and appreciation, and endowed with a capacity for going beyond her former executive self, she started the SOS breast cancer support program for women in a number of cities in central Maryland. With the same ingenuity and dedication she had applied to her responsibilities as an executive, she developed a successful program for women with breast cancer. Like Denise, a large percentage of women with cancer demonstrate their capacity for self-renewal.
If you are in a relationship, the self-renewal may extend to your partner. The changes brought about by cancer prompt many couples to reinvigorate their relationship and their sex life. This process takes time and is both scary and exciting. Something may have been lost: the familiar way you have made love for months, years, or even decades. Yet something very precious may be gained: greater closeness and intimacy, a rediscovery of each other, and a deeply satisfying sexual relationship.
Chapter 2
Cancer and Female Sexual Function
In light of the changes induced by cancer therapy, many women are not sure whether their sexual difficulties are due to the procedures they have had or to something else. Understanding the normal sexual response cycle, the possible changes caused by cancer therapy, and common female sexual disorders, can help in renewing their intimacy.
The Woman’s Sexual Response Cycle
During our numerous individual and group interviews, many women indicated their lack of knowledge concerning the woman’s sexual response cycle. They did not know what was happening or should happen during a sexual encounter.
In talking about sexual problems, many women said that they missed having any desire for sex since their chemotherapy. A number of women also said that they had never had an orgasm, or were not sure whether they had ever had an orgasm. And now they fear that the cancer treatment will prevent them from ever having one. They are concerned and anxious about having cancer, and the fear of adverse consequences relative to their sexuality makes them even more apprehensive.
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