Cancer and sexuality

Nurse : Mrs. Martin, the test results show that you have a grade-one breast cancer. It’s in its primary stages.

Patient : Oh God ! But where might this come from ?

Nurse : Actually, a family history of breast cancer and other factors, like the use of specific medicine, radiation therapy, drinking alcohol or obesity, may increase the risk of breast cancer. But it’s sometimes caused by inherited gene mutations.

Patient : Ok. So now what are my options ?

Nurse : Your cancer is in situ, that is it’s not infiltrating. So we need to perform a breast-conservation surgery and maybe chemotherapy and radiation therapy with or without antiestrogen drugs. The oncologist will tell you more about that.

Patient : What are the side effects of such therapy ?

Nurse : Radiation therapy may cause inflammation of the lungs especially when chemotherapy is given at the same time. The late effects of chemotherapy may include heart failure, blood clots, premature menopause and sexual and fertility disorders.

Patient : All right ! Now though it’s tough to talk about such an intimate subject, I need to ask some questions and maybe be reassured about my sexual life.

Nurse : What would you like to know exactly ?

Patient : I fear that the treatment could influence my sexual life negatively. I’m scared about the idea of changes in my body in case of surgery.

Nurse : I know what you mean. The feeling of a changed body may be seen as if the world has crumbled around you.

Patient : I’m afraid this may affect my self-image. I mean losing a breast would make me feel as if I’m no more a sexual individual and that I’m less attractive…

Nurse : I see, but then again women who have undergone a mastectomy resulting from a breast cancer generally regain their sexual self-esteem when they manage to get how to perceive their “new” body and how this body looks, so as to merge into an acceptance of their new situation.

Patient : To be honest, right now I feel vulnerable just by thinking that I’ll go into this treatment-induced menopause.

Nurse : I’d say it’s normal in this case, as the hormonal effects become much greater. Chemotherapy triggers the disruption of the sexual response cycle.

Patient : I don’t get it ! Do you mean that I’ll have no more sexual life at all ?

Nurse : No, but it depends actually. It could be for a short period of time or permanently. But in your case, as your cancer is not aggressive and you would perfectly cope with chemotherapy, chances that you regain your sexual experience are great !

Patient : But what worries me the most is that I’m still young and I still want to have children. And as you’ve just told me, chemotherapy and also radiation therapy have potential harmful effects on fertility.

Nurse : They do actually, but then we have fertility programs specifically designed as a follow-up cancer care.