Breast cancer is the second most common form of cancer, despite the fact that it effects only one male for every 100 females. This makes it by far the leading cancer in women.
Although it becomes more common as women grow older, it is being discovered in increasing numbers among younger women, as young as their 20′s. When cancer is discovered at an early stage, treatment is simpler and more breast tissue can be saved, allowing shape to be maximally retained and breast feeding to be possible.
Women who survive breast cancer, and this is the majority or those diagnosed, need to learn to live with all or some of the following challenges: body image changes, mastectomies (removal of the breast tissue), reconstruction of the breast or breasts and fear that this life-giving and erotic area has turned into a focus of danger.
Support from friends, family and other survivors is helpful in reintegrating the sense of capability and optimism to face the future, but support from a lover and open communication about feelings and needs is vital for restoring intimacy, especially after cancer has attacked such an erotically symbolic part of the body.
The vigorous demands that breast cancer brings on the body and the self can shake the foundations of any relationship. It has from time to time broken up unstable partnerships, but has also been able to restore and strengthen those who have good and willing relationships. It is perhaps the fact that it is the breasts, a symbol and active participant in gender relations, intimacy and motherhood, that makes this the a disease that changes people and their surroundings in such a profound and existential way.
- Chemotherapy is very tough on its patients bodies and their sex life may be the last of their concerns at his time, but it is something that becomes an issue for their sense of self and their relationship as the long (and sometimes recurring) process advances. Chemo tends to cause fatigue, nausea and weight gain. Chemo also weakens the immune system. This may bring on vaginal ulcers, genital herpes, thrush and other painful manifestations that prevent sex, even if there was some desire for it.
- Some forms of chemotherapy bring on “medical menopause” because they cause the ovaries to stop producing hormones. This is more common among women in their 40′s and 50′s, but also happens with women in their 30′s. Unlike with natural menopause, sometimes medical menopause can be reversed when treatment is over, and a woman’s period can return within a few months. Menopause can bring on various changes that will affect one’s sexuality, such as vaginal dryness and libidinal changes.
- Hormonal changes brought on by chemotherapy mean that arousal tends to be slow and laborious and orgasm can be more difficult than usual to achieve. Women and their partners should be aware that there is great value to sexual and intimate behaviour, even if orgasm is improbable. But it is not important at all costs, namely at the cost of pain and great discomfort. These are symptoms of the treatment and do not denote the end of sexual pleasure.
- Some forms of breast cancer are related to estrogen, and treatment with drugs such as tamoxifen (an anti-estrogenic drug) are called for. This can cause or strengthen hot flushes and temperament changes. Tamoxifen does not bring on menopause but can mimic the process.
- Depression is a common response to receiving the diagnosis of breast cancer, but it is also a result of the medication in some women. Depression reduces the libido and it sabotages the process of recovery of the body, the spirit and the intimacy. Depression responds well to drug therapy, such as Prozac, but can also be kept at bay with strong support from friends and from cancer support groups.
- Radiation therapy causes hair loss which some women find depressing and unappealing. Beautiful women such as Sinead O’Connor and Demi Moore have shown us that a shaved head isn’t unfeminine. In any case, once radiation is over, the hair will be back as lustrous as ever.
- Unattached women who are interested in forming a romantic relationship may experience stress related to exposing their history of cancer and their scars or modified breasts to potential new partners. Some advise that these women should make sure they create trust and friendship before increasing the intimacy. Others would argue that they should be empowered to act according to their natural senses; for some this may involve sexual expression that does not necessarily need commitment but which shows the survivor that she can return to her integral body, even if it is scarred and changed, and she can relearn to love the way it looks and the way it makes her feel.
- After recovery, it is important to restore one’s relationship with the affected breast/s. Stroking and stimulation of the breasts and scar tissue is in no way dangerous, as long as there is no pain involved; it can even help bring back pleasurable feeling, when done by oneself or one’s partner.