Cancer and Intimacy

Cancer and Intimacy

Sexuality plays an important role in society, facilitates reproduction, and helps us to feel connected to our partner as well as to ourselves. When you are told that you have cancer, it can affect the desire of either or both partners. For some people, desire decreases (as they are distracted and not in the mood), while for others physical intimacy may sooth or provide welcome distraction.

Cancer therapies can affect sexuality in many ways. Qualitatively, your routine sexual act may need to be adapted due to anatomical changes (e.g. pelvic or breast surgeries) or functional changes (e.g. erectile dysfunction, vaginal dryness or scarring). Quantitatively, the frequency and duration of sexual acts may change, usually lessening. Reasons for the latter can be due to the experience of pain, discomfort, shame, or guilt, but also because one’s desire may be decreased when going through premature menopause/andropause, anxiety, or depression.

Oftentimes, I see couples, whether in brand-new or long-lasting relationships, in which I sense that both partners are longing for a connection but are not communicating about this out of concern for disrespecting or hurting the other. Finding a safe environment for this communication may help healing to begin. Also, it may encourage a cancer survivor to feel confident enough to talk with a health care provider to find if there is anything that can be done to improve matters.

There are medications and devices that can improve, if not resolve, anatomic/functional deficits. (As a gentle reminder, hormone replacement therapy is not an option for those who are survivors of tumors that are fueled by hormones.) Talk- and/or pill-therapy can emotionally support partners.

However, at the end of the day some things may not be fully restored to the pre-diagnostic state. Some emotional and physical scarring may be permanent. In these situations, partners may have to work harder and be more creative in finding ways to connect with each other in ways that are enjoyable, pleasurable, and satisfying for both. In addition to intimacy, identity and security can also be altered by cancer. Therefore, even couples who have been together for a long time may need to reset and rekindle their relationships. Keep in mind that sexuality is one form of physical intimacy. You may want to explore other forms of physical intimacy, such as sensuality and eroticism.

There are many other ways of being intimate that can enhance or compensate for the impaired ability to connect physically. Examples of these alternative forms of intimacy are emotional (connecting with someone else in spoken or unspoken ways that express your love), intellectual (participating in communication about a topic that both parties are passionate about), and experiential (sharing activities and making memories together).

Enjoy connecting!

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Learn & Think, Live & Feel:

My family decided to go all in. For years we have held ourselves back due to various issues including active or anticipated medical issues. Recently, we decided to get some more love in our house. A month ago, we expanded our family to include our beloved cat, Melky. In another month, we will be expanding again with a dog, Cookie. We are fully aware that having a pet may bring more responsibilities, worries, and expenses, so we have backup plans in place, but we do not want to miss out anymore on the therapeutic joy pets can bring. Stay tuned for our adventures!

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(In)fertility after Cancer

(In)fertility after Cancer

Hello, Fellow Travelers!

When I was younger, I dreamed of having a large family, with lots of children – likely because I grew up in a small nuclear family, or because I am strongly maternal. (Some people call me Mother Duck.) Regardless, the scenario I had dreamed about needed to be rewritten. When our first child was three months old, my husband was told he needed to be placed on the organ transplant list for autoimmune disease-related organ damage. My husband’s and my health issues made having more children impossible. 

I have heard too many tragic stories. Patients who were diagnosed at a young age and time or resources or medical knowledge did not allow for sperm/egg harvesting. A couple who didn’t meet until later in life and only had a limited fertility window remaining when cancer hit. A mother diagnosed with cancer while pregnant.

When fertility is maintained throughout cancer therapies, many cancer survivors become concerned with how pregnancy will affect their health and if their genes or previously-received cancer therapies could affect their offspring. Pregnancy will be fine for the majority of cancer survivors and their offspring, but you should discuss your desire to become pregnant in advance to allow evaluation and optimal support throughout the journey from conception through postpartum phase. Despite the many medical advancements for saving one’s fertility when diagnosed with cancer, success cannot be guaranteed. Cancer can either prevent the ability to have and carry your own biological child or put a couple through the incredibly difficult choice of choosing between the life of the child or the mother.

Sadly, cancer may force us to change our dreams and life stories as we grieve what will never be, such as having our own children or grandchildren. I hear so many people say that people who are not suited to having kids continue to get them, and those who have the potential to provide loving homes cannot have them. Then there are mixed feelings when someone close to us gets pregnant. We often suffer in silence, trying to be happy for them while feeling that immense pain inside that it will never happen for us. It can feel so unfair. 

Denial, repression, avoidance, and anger are a subset of the feelings and thoughts you may experience in reaction to this hurt. You cannot control or fix this. It truly happened to you. Some people may attribute it to bad luck, faith, or fate. Some people may even wonder if they are being punished. Your mind may become your worst enemy in response to the absence of a thing so essential to life for many – reproduction. You may feel helpless. Ashamed. Embarrassed.

Friends, colleagues or family members may repetitively ask you seemingly innocent, yet painful, questions – “When will it be your turn? When will you get pregnant?” For some of your loved ones, like your parents, your inability to produce children may alter their hopes and dreams, too. I can still remember our child, when he was younger, asking repeatedly when he would get a sibling like his friends had. I tried to deflect and when he was older explain. I don’t know if he was in denial or not mature enough to grasp it yet. For me, that was the most painful part of it all – seeing my child’s longing and sadness about not having a sibling.

There are a growing number of alternative options to try to have a child which might be challenging and costly. Your cancer center may have resources available that can guide you and support you (grant support, fertility experts, behavioral health etc).

But at the end of the day, I hope you will feel defined by more than your (in)ability to reproduce an heir. Your maternal/paternal instincts may be rerouted towards healthier coping styles that may facilitate your sense of purpose or meaning, such as:

  • Transformation. Not needing to spend time and energy on raising your biological kids, you may be able to channel your love into socially acceptable alternatives, e.g. adopting a child or pet, babysitting, volunteering to work with kids.
  • Altruism. Helping others (not at the expense of self-care) may distract you from your own pain.
  • Humor. This is a tricky one. You will have to find your own comfort level of dignity and respect. For example, if you’re not ready to discuss your infertility, you may find your own funny reply to deflect the question, “When will you become pregnant?”
  • Suppress your pain by consciously deciding not to devote energy to related thoughts and feelings. Suppression is different from denial and repression, which are defense mechanisms that keep your pain and grief in your unconscious. You might say, “What’s the harm in that?” Denial and repression make it so that you cannot control negative emotions and they can wreak havoc by popping up at random times and causing discomfort for seemingly unknown reasons (e.g. anxiety, nightmares, panic attacks, depression). Suppression allows you to be aware of your grief and pain, while trying to reduce it. Some methods to try are:
    • Stop method. Tell yourself to STOP going down that rabbit hole.
    • Set a limit. Allow yourself a certain amount of time per day, e.g. 15 minutes, t allow yourself to ruminate about your infertility, but when the alarm goes off,  stop and don’t allow yourself to do this again until the next day. If thoughts and feelings should arise throughout the remainder of the day, you can write them down for the next day’s session.

Only you know if at any point along the journey you hit a wall and need to talk with someone professionally who can help you rewrite your story and legacy. Please be kind to you!

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Live and Feel:

“Families are like pieces of art. You can make them from almost anything, any kind of material. And sometimes they look like you, and sometimes they don’t. Sometimes they come from your DNA and sometimes they don’t. And the only ingredient you need to make a family is love. Unconditional love. 

Mitch Albom on CBS News.

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