The emotions involved in dealing with a cancer diagnosis are exhausting. When faced with our own mortality, we learn valuable lessons about what is important in our life, regrets we may have, and changes we wish to make. When it comes to breast cancer, the psychological effects are compounded by the changes to our sexuality, both physical and mental.
According to experts, many breast cancer survivors will experience "fear of recurrence, changes in body image and sexuality," as well as physical difficulties caused by adjuvant therapy. Further, researchers discovered a "high prevalence of depression and anxiety in breast cancer patients" and "poor self-image and quality of life is associated with all types of treatments."
This means surviving breast cancer is just one step towards living past it - the physical aspect - but returning to a healthy, active sexual lifestyle involves more than the physical. It involves utilizing healthy coping skills to emotionally and mentally return to a place of acceptance and self-love.
The CDC reports that the relative five-year survival rate of women diagnosed with breast cancer is 89 percent. These women are learning to navigate the complex emotions and, for some, physical changes involved in recovering their sex lives after breast cancer treatment.
How Breast Cancer Treatments Affect Sexuality
There are a number of ways cancer treatments affect our bodies. In the case of breast cancer, sexual effects vary, depending on the type of treatment. Not all, but some breast cancer patients will receive continued chemo treatment to ensure any hidden cancer cells are killed, reducing the risk of recurrence.
Often the first thing we think of when we hear the word cancer, chemotherapy is a common treatment for breast cancer, involving anti-cancer chemicals administered either orally or intravenously.
The side effects of chemo vary from person to person and depend on the drugs used. A universal side effect is fatigue which can certainly interfere with sexuality but physical changes such as hair loss, nausea, weight gain/loss, and nail changes can also affect how a woman feels, sexually.
Hormonal changes can also occur in certain types of chemotherapy, resulting in lower libido.
Fatigue and skin changes are the most common side effects of radiation therapy. However, hair loss, nausea, and breast tenderness can all contribute to a lower sex drive.
With hormone therapy, patients are likely to experience symptoms of menopause, including "hot flashes, menstrual cycle changes, and vaginal dryness."
Also known as targeted therapy, this treatment sometimes results in feeling generally unwell and sick.
In some cases, breast cancer is treated by removing either a part (BCS or breast-conserving surgery) of the breast, or all of it (mastectomy). Aside from obvious physical changes, a woman's breasts are an important part of her overall sexuality, due to their connections to the brain and sexual stimulation. Additionally, surgery is often followed by radiation therapy.
The loss of some or part of a breast results in insecurity on many levels, based on the significant value that individuals and society as a whole put on breasts.
From Remission to Acceptance
The hardest part of breast cancer is over: You've survived.
One often-cited important aspect of recovering from breast cancer treatment is quality of life, and our sexuality is a natural human part of having a good quality of life.
Now, it's time to jump back into life and take control of your sexuality. Whatever is holding you back from being sexual, there are ways you can begin to enjoy sex and intimacy again, even after breast cancer treatment.
Have a Confidante
Discussing sexuality can feel uncomfortable under normal circumstances, much less when our bodies have gone through the stresses of cancer treatment. Surviving breast cancer is one thing but thriving afterward involves a more comprehensive approach.
Connect with your doctor so you feel comfortable discussing the physical aspects of your sexuality. Often, there are things your doctor can prescribe to remedy physical discomforts associated with cancer treatment side effects. Whether you discuss these things with your physician, partner, friend, support group, or professional, it helps to have someone you can talk to openly to help you define the things that are holding you back.
Communication Is Key
As with any relationship, communicating with your partner will help you get back to your pre-cancer self. Research has shown overwhelmingly that communication is directly related to sexual satisfaction in relationships. Specifically, sexually satisfying relationships included open communication and relationships lacking it resulted in dissatisfaction and sexual dysfunction.
You may feel uncomfortable opening up about the physical changes you are experiencing, but remember although you are the one experiencing these things, your partner is also eager to be a part of your healing (and get back into the good stuff). It helps them to help you when they understand the things that feel good, things that hurt, and things you are afraid of.
Sex is not the only way to experience intimacy and the fact is, you may not be physically ready to engage in active intercourse. That's why it is important to take your time - it's okay - and slowly evolve into a healthy, active sex life. Do simple things to increase the emotional connection between you and your partner. Sharing experiences, holding hands, massage, kissing, and touching are simple ways to gradually become more comfortable with your sexuality.
Get Plenty of Rest
Since fatigue is overwhelmingly a side effect of breast cancer treatment, make sure to set aside enough time for you to rejuvenate and re-energize. It doesn't have to be sleep. It can be as simple as taking time out to unplug, meditate, and simply relax.
Incorporate New Things
Let's face it: things are different now. So why not incorporate new things to your new you? If you are experiencing vaginal dryness - a common side effect of breast cancer treatments - consider using vaginal lubes to remedy this, or massage oils to increase intimacy. You can also use technology to stimulate your sex life with apps like Mystery Vibe or a vibrator like the Crescendo by MysteryVibe. There are many things you can do to learn new ways to be intimate.
Draw On Your Experience
Surviving breast cancer means you have a unique perspective on how fragile life really is. This can create a sense of intensity with your intimacy, increasing the satisfaction you can get from something as simple as a kiss. It also allows you to be more open to curiosity and explore new ways to experience intimacy and sexuality.
How Can Breast Cancer Survivors' Partners Help?
Of course, it is difficult and frightening to see your partner going through such a painful experience as breast cancer. This in itself can cause partners a lot of anxiety and their own set of emotions.
Perhaps the most important thing for partners of those with breast cancer to do is to educate themselves. Learn as much as possible about your partner's type of cancer and treatment, including the side effects. When it comes to returning to a healthy sex life, here are some things that partners can do to accommodate their loved ones as they shift back into sexuality.
This doesn't mean just about sex talk. Be patient as your partner navigates this unfamiliar journey and actively listen to everything they say. This means paying attention without distractions and asking questions to get clarification. Discussing cancer-related issues is critical to having a close relationship. Remember, this is likely your partner's first time experiencing this, just as it is yours. By asking questions and listening carefully, you will learn more about what they are going through, and also help them feel important, valued, loved, and accepted.
Intimacy goes beyond sex. It includes sharing emotions, experiences, thoughts, hopes, and dreams. Your partner is likely feeling vulnerable - possibly self-conscious - and you can help them overcome these things by being intimate with them. Share your own vulnerabilities and comfort their fears. Show affection with touches, kisses, or caresses that increase the level of intimacy you share.
Surviving cancer is incredibly emotionally, physically, and mentally exhausting. It may sound cliche, but being patient as your partner recovers is essential to helping them feel comfortable as they recover and accept this new person they've become.
Remind Them of Their Beauty
Your partner has gone through a dramatic experience, so it helps to remind them of the things about them that you love and admire. Remind them that their physical changes have not altered the things you most love about them. Affirm for them the specific personality traits or talents you've always loved about them. This helps them accept that they are more than just their physical changes.
Take Care of Yourself
Having someone outside of the relationship that you can talk to will help you release some of your frustration and confusion. Make sure you give yourself the care you need, too. Eat healthy, get enough rest, and exercise as you need to.
Your sexual frustration may build up so you could benefit from pleasuring yourself to alleviate the physical frustrations you are experiencing. This will provide you a little more space to be patient as they work through their remission.