If you would like more help, you may want to seek out a sex therapist or counselor. Our sexuality counseling services are available through our non-profit organization, The Center for Intimacy After Cancer Therapy Inc. (C-I-ACT), www.renewintimacy.org.
We hope you will find this book helpful and that you will tell others about it, as well as write a review on our and other websites. Your comments and questions are important to us, and are very welcome. Note that there is a feedback form on the website. Also, please consider a tax-deductible donation to C-I-ACT, Inc. (P.O. Box 34 1388, Bethesda, MD 20827-1388) so that we can continue developing materials and programs for patients and cancer couples.
Thank you, and best wishes for a happy and healthy life!
Ralph and Barbara Alterowitz
Potomac, Maryland
March 2011
Chapter 1
Cancer and “The New Woman”
My hair was my crowning glory. The first thing people often mentioned after they met me was that I had beautiful hair. So you can understand how freaked out I was when I saw a big clump in my hand while showering. This was the moment I had dreaded. I had gotten somewhat complacent because it had not happened after so much therapy. Other women in the support group kept saying it would happen.
But I was prepared. After the first clump came out, I bought two wigs. It didn’t make me feel better about losing my hair, but I was determined to look good, hair or no hair.
Feeling good about how I looked with my wig lasted for a few days. The wigs were uncomfortable and hot. I was suffering while trying to look cool, as the kids would say. Before the breast cancer, summer temperatures in Virginia had forced me to run for air conditioning whenever I could. Now with this rug on my head, and that’s what it felt like, I was perspiring all the time.
It suddenly hit me that I was doing this for others, not for myself. I felt good about me. That’s what mattered. I was respected in the work world, had a loving family, and so on. So, even though I had said that I would never let anyone see me bald, I tossed the wigs in the closet. I felt freer than ever in my life. With the wigs went a lot of fears. I saw the breast cancer as a sort of signal, the beginning of an open road. It was an opportunity to reshape my life. I began to think about things that I’d never done. It’s like opening a new life book. I’ve gotten the message to give myself the freedom to do new things even if there are some risks that they won’t work out. What a feeling!
Janice (the names of all women quoted about their personal experience as cancer survivors have been changed to protect privacy)
The “New Normal.” Some call it a mantra, but the phrase seems to aptly characterize many women’s post-cancer-therapy phase of life. Life will never be exactly as it was before, and many aspects of themselves and their lives now need to be redrawn, revised, or even created anew. While some of these women have not even completed their treatment - usually chemotherapy - their declaration of “I am not the same as I was” is a notice to the world to be prepared for dealing with a changed and often renewed person.
The New Normal can come at any time. Thoughts and feelings, and just things going on around her, can prompt a woman to notice that although many aspects of her life seem to be the same as before cancer, there are distinct differences. The Old Normal and the New Normal now need to be meshed to form a new and different whole.
The experience of cancer creates an opportunity for a woman to stop and think about her objectives and her needs, about what she expects her future quality of life to be. Cancer means change, and change can be both frightening and invigorating. As they go through the experience of cancer diagnosis and treatment, many women feel that they get to know themselves much better. They have a reason to step back and think about their lives and how they would like to reshape them.
Hundreds of thousands of women annually go through the shock of receiving a diagnosis of cancer. Suddenly, they must make decisions about therapy, and then fight to achieve a desired quality of life. Cancer therapy affects everything.
Where do intimacy and sexuality, key components of quality of life, fit in? Part of a woman’s cancer journey consists of rebuilding her love life. And energizing or reviving intimacy and sexuality in a relationship requires the partners to work together.
According to Barry McCarthy, Ph.D., Professor of Psychology at American University, when sexuality functions well, it is a positive and significant part of a relationship. Sexuality energizes, strengthens, and makes the marriage bond special. However, when sexuality is dysfunctional, it has a powerful negative effect, robbing the relationship of vitality, closeness, and intimacy. Intimacy is especially crucial for couples dealing with cancer, and merits special attention.
Both intimacy and sex involve people opening themselves to others, presenting themselves through their thoughts, ideas, and behaviors. The total person appears, which is the basis for intimacy. Intimacy may evolve into its sexual dimension to provide satisfaction and a sensation of physical and emotional connection. Sharing sexuality is the most intimate experience two people can have.
Sexuality reflects and is a part of a person’s total health and quality of life. Sex expresses both partners’ emotional states, the health of the partners, their physical environment, each partner’s view of her- or himself, the nature of their relationship, and the quality of the relationship. Cancer treatment changes sexuality in many ways. It can change mental orientation and the way the body functions as it concerns sex, and can create physical changes that may affect the way a woman makes love.
A good sex experience is complex. Even healthy couples that are madly in love can’t expect a great experience every time they make love. When cancer is added to the mix, in addition to the physical effects of therapy, the entire experience changes.
Relationships After Cancer
A loving environment all day long sets the stage for good sex, and the pleasure of sex is heightened by feelings of love and intimacy. Both partners should be in the mood, bring high emotional content into the physical interaction, have intensity, and be creative.
Sex is possible without these things. But good sex happens when all these factors come together. Making love is no different than playing a sport, singing, or performing on a musical instrument. If everything is just right, it can be great. When one partner is out of sorts, tired, or distracted by a crisis, sex can feel just so-so. It can prompt the question, “Why did we bother?” If this happens merely once in a while, it is not a problem. But if it happens most of the time or all the time, it is a serious issue.
A cancer diagnosis may alter a woman’s self-image and often changes the balance between partners. After working through the battery of cancer tests and determining her therapy, a woman may wonder if she will still be desirable. She might even wonder, “Will I still be a woman?”
The assault of cancer treatment often leaves a woman with physical changes, and almost surely leaves her psychologically affected. As a result, some women shy away from sexually connecting with their partner. On the other hand, some women, like Christie, believe their partner needs to be taken care of and put sex on their schedule regardless of their personal desire. Christie said that she thought she would address her own sexual needs after she completed her chemotherapy. But for her, making sure her husband’s needs were met was a priority even throughout her therapy. He showed his appreciation by being caring and considerate during loving - and in everyday life. This mutually supportive relationship enabled them to keep their sexual relationship alive even during treatment.
As they go through therapy, many women take steps to redefine their future. They shape their world by initiating changes in their relationships and in the face they present to the outside world. Throwing