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Coping with Cancer > Sexuality & Fertility > General Information
Meeting Sexuality Needs of Women With Breast Cancer
Linda Bloom
Meniscus Health Care Communications
Published by permission of the publisher
Innovations in Oncology Nursing Vol. 10, No. 2, pp.29,46-51, 1994
Copyright ©, 1994.
When a woman is diagnosed with breast cancer, the initial priority is to treat the disease. This treatment may include lumpectomy, radiation therapy, mastectomy, with or without reconstruction, chemotherapy, hormonal therapy, or a combination of these. However, during the search for an appropriate treatment option, the woman must also be informed about many other issues, often in a short period of time. One issue that is frequently overlooked is the sexuality needs of a woman before and after
treatment.
Following are interviews with five women who were diagnosed with breast cancer and underwent different cancer treatments at various stages of life. They share their experiences of diagnosis and treatment and their changes in sexuality. As much as possible, the responses of the interviewees were unchanged during editing.
The Interviewees
Linda Dackman was diagnosed with in situ disease 9 years ago at age 34. She had a mastectomy and 3 months later had reconstruction with a silicone breast implant. Linda is single and has written books and lectured about her breast cancer experience.
Cynthia Moorhead was diagnosed in 1985 at age 38. At diagnosis she had no lymph node involvement. She had a mastectomy and 6 months later had a prophylactic mastectomy of the other breast. She had reconstruction with implants at the time of her second mastectomy. She did not have chemotherapy, because at that time it was not recommended for women who had no lymph node involvement. Cynthia is married and has three children. One of her children was conceived after her cancer diagnosis and treatment.
Cindy Supnick was diagnosed with stage II breast cancer 13 years ago at age 29. She had bilateral mastectomies 6 months apart followed by reconstruction with implants. The first breast was reconstructed 3 months after her first mastectomy, and the other breast at the time of the second mastectomy. She did not elect to have chemotherapy or radiation, but rather a more holistic therapy of diet and positive thinking. She also underwent tubal ligation because her doctors felt her high estrogen level would make it dangerous for her to become pregnant. Cindy was newly married at the time of her breast cancer diagnosis and has since divorced. She is currently pursuing a master's degree in social work as a result of her experience.
Lydia Buonaguro was diagnosed 7 years ago at age 39. She had a lumpectomy, removal of lymph nodes, and radiation therapy. One year later she had another lump in the same breast and had a mastectomy. She also developed lumps in the opposite breast and opted to have a rophylactic mastectomy. One year later she had reconstruction of both breasts, including nipple reconstruction. The diagnosis, treatment, and reconstruction (with saline implants) spanned a period of 3 years. Lydia is married and has 2 children.
Linda Bloom was diagnosed in March 1991 at age 44. Her therapy consisted of adriamycin and cyclophosphamide for four cycles, a lumpectomy, and 33 radiation treatments. Linda is married. Since her breast cancer experience, she has initiated efforts to study the loss of sexual desire in women related to androgen deficiency that may be stimulated by chemotherapy.
L. Dackman
I experienced anxiety about trying to initiate a relationship, because l was single.Following my surgery I dealt with the psychological pain of confronting the change in my body and the loss. I deferred sexual relations until I had reconstruction.
C. Moorhead
I had no long-term physical side effects, but l had definite emotional side effects, which are just as difficult sexually. Anything that impinges on the way that you feel about yourself-if you feel angry or sad or you don't like the way you look-affects your sexuality.I felt like my body failed me because I had cancer and also because I had a miscarriage a few months before my cancer diagnosis. My self-image and body image paid the price. l didn't want to permit myself to feel good about myself or about my sexuality. Even when I had reconstruction, I wasn't happy with the results. For some time l even contemplated having the implants removed. They were no substitute what I had.
C. Supnick
There was an issue of reproduction because I had a tubal ligation that I found out later was not necessary.I also had physical changes in terms of touch and sensation in the area of my breasts. I also experienced many complications. Skin grafting was required, so I had nipples made from my ear- lobes, and I had grafting from my thigh. My entire body was affected. I had no problems after my first implant was placed. However, the implant on the second mastectomy site collapsed, had to be removed, and was replaced. This second implant traveled and collapsed and is still in my body.
Psychologically, l experienced feelings of anger and victimization from my physical complications, and l was disappointed with the outcome of the surgery.
I had concerns about going out in public. I was conscious of people always looking at my breasts first and my face second. I also had to reorient my center of sexuality away from my breasts, where it had always been.
L. Buonaguro
When I had the lumpectomy, l didn't have any sexual side effects. The most traumatic time was after the prophylactic mastectomy. At that point everyone was understandably thrilled that I didn't have cancer again, that they didn't think they needed to worry about me anymore. So that support system disappeared. However, I was still facing having had cancer, having no breasts, depression, and a change in body image and femininity. Psychosocial effects are just incredible, but women with breast cancer may not be able to pinpoint what their problem is or acknowledge it.
L. Bloom
The sexual changes that l experienced immediately after the chemotherapy were loss of desire, diminished arousal, and weakened orgasm.I went through the radiation therapy very easily, with minimal fatigue and "sunburn" to the irradiated breast. l was, however, very sick with the chemotherapy. l wasn't too alarmed about the sexual problems at first, because l felt so horrible. It was months after that-when I had my vigor back, was working out in an aerobics class, and was strong again but still had the same symptoms-that I was really certain that something was hormonally wrong with me. I continued to report these symptoms throughout the months after my treatments ended. The doctors continued to tell me, "Give it time." After I knew that I had given it time, I began to realize that l had sustained some type of physical damage. None of the doctors ever validated that.