When Liz came to the sexology clinic to see me, she had been off sex for three years following a breast cancer diagnosis.
“I feel hollow and lonely. I am frustrated. My husband isn’t interested in me. Maybe I should just have died of this cancer,” she lamented.
Liz was 45 years old. She had been married for 11 years. She had two children, the last one being five years old. Trouble started when, at the age of 42, she developed a painless lump in her right breast. The breast then started discharging blood-like fluid. She underwent tests and ended up with a diagnosis of breast cancer.
“Doctors were in a hurry to cut off my breast before the cancer spread to other organs,” she explained. “Things happened very fast and within a month I was left with one breast and was undergoing chemotherapy.”
Nobody talked to Liz or her husband about their sex lives, which is an injustice. Doctors dealing with cancer rarely bring up the topic of sex.
In one study such doctors, the oncologists, were asked why they neglect the sexual aspect of their patients’ lives. Many said that they were not trained to handle sexual health. Others said that they thought someone else would do it even though they never referred the patients to a sexologist. Further still, many doctors said that the patients did not ask about sex and they felt that they would annoy them if they brought up the topic.
Most annoying are the doctors who believed that cancer treatment is an issue of life and death, and that patients should be happy to be alive instead thinking about sex.
It is important to note that both quantity and quality of life are important. It is inhuman and unethical to prolong a cancer patient’s life without adding quality to it. “Yes! That is what I mean when I say that I should have been left to die of the cancer!” Liz exclaimed.
Cancer – and its treatment – can make one too sick to think of sex. The weight loss, hair loss, body disfigurement and general sickness can make patients lose their self-confidence. They begin to hate their bodies.
Sexual function is totally affected by these experiences. Libido goes down. It becomes hard to get sexually stimulated. In some cases, sex becomes painful. Orgasm becomes a dream.
The other thing that people never realise is that the partner of the cancer patient is also affected. They have to deal with the psychological stress of supporting their partner. Money also becomes an issue, adding to the stress. Overall, the partner of a cancer patient is likely to also lose sex feelings.
“So what can we do?” Liz asked.
The most stressful phase is during the intensive phase of treatment. Sooner or later, one gets well, especially if the cancer was discovered early and treatment has led to complete resolution. It is important to look forward to this day. Keeping hope alive gives us the motivation to maintain some level of intimacy albeit minimal.
The team of doctors treating cancer also need to incorporate a sexual health expert. Quality of life includes a satisfying sex life and sexual satisfaction is something that can be achieved even in illness. Denying cancer patients their right to sex is unacceptable.
Once cancer treatment is completed, the couple must undergo sex coaching. It is important to realise that sex may not happen the same way as before.
Liz and her husband underwent sex coaching and were back on course with their sex lives three months later.
As we go through this month of breast cancer awareness, I hope that sexual health will be an important consideration for care in patients undergoing cancer care because we all deserve the right to a fulfilling sex life, cancer or no cancer.