June 7 is National Cancer Survivors Day, which reminds me of my own bout with breast cancer back in 2001; and is also a reminder of the many people who have a difficult time with the transition to intimacy following disfigurement. When we think of transformation, we usually think of emotional or psychological change, but just as often, it can refer to physical transformation — which can be elective, such as plastic surgery — that we choose as a result of an accident, or an illness such as cancer.
Women who’ve had breast cancer often deal with self-image issues, and because of the particular type of treatment and the time it takes to heal, they’re often not ready to be intimate immediately after surgery. Women need a great deal of reassurance about their appearance, and according to Vladimir Lange, M.D., in his book Be a Survivor, preoccupation with cancer and its treatment usually decreases interest in sexual intimacy, but there are things couples can do to rekindle interest, such as hugging, cuddling, kissing, dimming the lights, showering together, watching an erotic movie, and trying comfortable positions.
This year marks the 16th anniversary of my mastectomy and reconstruction as a result of DCIS (Ductal Carcinoma in Situ), the most common form of noninvasive breast cancer. Often, when physicians explain surgery to patients, they focus on the physical changes to expect afterward; but more often than not, they neglect to share the psychological manifestations. Fortunately, my surgeon disclosed the physical and psychological changes to expect.
As I prepared psychologically for my surgery, I had my emotional ups and downs, but I had no idea what the actual effects would be afterward. My feelings of melancholy and shock led to a complete disinterest in intimacy, which my surgeon only hinted at pre-operatively. What I’ve known for years, and what a good partner also understands, is that the largest sex organ is the brain, and what is said to a woman is as important as what is done.
In 2010, The Journal of Sexual Medicine reported that 70 percent of women diagnosed with breast cancer encounter sexual dysfunction two years after their diagnosis. The author of the study, Mary Panjari, from Australia, said that 83 percent of these women had a good sex life before surgery but noticed a decline afterward. This doesn’t have to happen if the partner in a woman’s life makes an effort to make her feel better. I was blessed to have a husband who did.
I was also blessed to have a surgeon who offered individualized care; he knew and understood my passion for writing and told me to journal my breast-cancer journey. Much of my writings dealt with my disfigurement. Not only did these jottings lead to my second memoir, Healing with Words: A Writer’s Cancer Journey, but writing was very cathartic for me. Even more cathartic was my surgeon asking me to share my journal with him because he had a deep interest in what women were undergoing during this process.
During my first postoperative visit, my surgeon scanned my journal notes and thanked me for sharing. Even though I’d been already been married for a few decades, he understood that the glue of a solid long-term relationship lies in intimacy. He also understood how breast cancer changes a woman’s view of herself. During that appointment, he said, “As soon as possible, I want you to wear provocative clothes — first at home and then out.” I still had my drainage tubes hanging from my mastectomy site, and that bit of homework seemed insurmountable; however, I did take careful note of his advice.
Soon after the tubes were removed, I treated myself to a new (sexy) wardrobe. It was amazing how wonderful this made me feel. Intimacy had always been an important part of my life, and there was no reason to change that. While it’s important for a partner to remind a woman who’s had a mastectomy that she’s as sexy as she was before, it’s equally important to tell her partner what makes her feel good. A woman’s changed body landscape can be very awkward for one’s partner, who might ignore the mastectomy site because the woman doesn’t have sensations there. But in ignoring that side, a woman might feel her partner isn’t acknowledging her breast-cancer journey. In honoring the mastectomy side, the woman’s partner is offering a message that she’s a survivor.
For some time after my surgery, I felt disconnected from my breast. It was as if someone had pasted it on. It became a reminder that the landscape of my body would never again be the same. Each time I looked in the mirror, tears rolled down my face. But I decided to turn those feelings around. With meditation and journaling, I transformed those tears of sadness into tears of joy, which reminded me that I had survived, and was alive — a great cause for celebration. While the loss of sensation on the mastectomy side continues to be a constant reminder of my past, I work hard to keep it from affecting me, as it did in the earlier days. Life goes on, and I continue to grow and change on many levels.
Lange, V. (1999). Be a Survivor: Your Guide to Breast Cancer Treatment. Los Angeles, CA: Lange Productions.
Panjari, M. (2010). “Sexual Function After Breast Cancer.” The Journal of Sexual Medicine. Vol. 8. Issue 1. pp. 294–302.
Raab, D. (2010). Healing With Words: A Writer’s Cancer Journey. Ann Arbor, MI: Loving Healing Press.
Originally published at www.psychologytoday.com.