Yes, this is cheeky innuendo, and yes, this post is about sexuality and how the impact of cancer interventions put you into compromising positions regarding the long term side effects.

No one lines up at menopause’s or castration’s table and says “Ooo Ooo… pick me, pick me!”.

However, if you are positive for the  BRCA 1 or 2 gene mutation, this is the life changing decision that we have the privilege of making preventatively; unlike our ovarian, prostate, and testicular cancer brothers and sisters.

I know that after being diagnosed with breast cancer, I certainly wrestled with the fact that I did not get tested for genetic mutations. I had learned I was a candidate for testing at 30, but the thought that the only clear answer would be knowing I had a mutation terrified me.  Having lost my mom to breast cancer in my 20s, I was already struggling with whether or not I should have children, and that knowledge would have made it worse.  I know I am so lucky to have had the chance to become a mom.

However, while I wish I could have prevented myself from having breast cancer in the first place, I knew that I needed to take steps to prevent ovarian cancer. I underwent an oophorectomy (removal of the ovaries and fallopian tubes) the same day that I got my new boobs. I had to preserve some sense of femininity, plus decrease the number of times that I would have to cope with anesthesia brain- which is just like chemo brain.

Whether you are a pre-vivor or survivor of cancer, once you move out of the phase of doing everything you can to save your life, you tumble into the phase of having to deal with the long term effects of the decisions you had to make. This phase is further complicated by recognizing that yet again you are in a place of privilege, because not everyone makes it that far. And if you also have a sexual trauma history, that adds another layer into the mix.

Our sexuality has the potential to be the silver lining of our lives- bringing joy, intimacy, excitement, and pleasure. It can be something that keeps us going in hard times, something that stokes our fires of hope and resiliency.

Yet, so often our sexual functioning and wellness is not even broached by our treatment teams. Likely this is a combo of the taboo nature of sex and sexuality, in addition to lack of time, proper training, and understanding of resources. When our treatment team fails to check in with us, it can have a silencing effect, impacting our capacity to self advocate for information, support and intervention.

While we may never fully return to our sexual prowess because of the hormonal changes or treatment side effects, we can likely find ways of greatly improving our sexual lives. Our definition of sexual activity may need to shift and change.

The other important component of healing is our identity as a sexual being. We may feel less feminine or masculine, our fantasy world might cause us to face over and over again how our bodies have been altered. Most grapple with the fear that their partner will not find them attractive anymore, and if you are single or in a toxic relationship this fear may be amplified.

At the heart of this turmoil related to our sexual identity, is the grieving we need to do related to what we have been through and the profound vulnerabilty that we face as we test the strengths of our partners ability to accept us (current and/or future). It is one of the biggest trust falls that we face.

If you find yourself in need of addressing your sexuality and sexual well being, here is a list of professionals who will hopefully able to help you. It begins with a conversation with your providers, and hopefully ends with finding guidance that helps you reclaim your sexuality:

  • Physical therapists- pelvic floor rehab
  • OBGYN- learning how to maintain healthy tissue
  • Urologists- our male OBGYN counterpart
  • Therapists and counselors who specialize in cancer and sex therapy
  • Relaxation experts, such as meditation teachers  and yoga instructors (who can also help with flexibility, naturally)

And so forth… the point being with a supportive recovery team, we can improve our lives.  Given the fact that we are tribal in nature, making connection with other cancer survivors and taking risks to openly discuss these issues, we decrease our sense of isolation and fear that somehow we are the only ones.  Of course, once we start making those connections, they often help us find the resources we need.

 every gesture, every caress, every touch, every glance, every last bit of the body has its secret, which brings happiness to the person who knows how to wake it

-Hermann Hesse, Siddharta

– Stephanie McLeod-Estevez, LCPC, is an art therapist and breast cancer survivor, and a former oncology counselor at the Dempsey Center. She began Creative Transformations to help others who are healing from a life threatening illness or injury. Through Creative Transformations, Stephanie works with people in person and online to offer cancer coaching, a DIY Individual Art Therapy program to enhance any healing work you are undertaking; workshops; and this weekly blog. Sign up today so you never miss one by visiting our website, Creative Transformations, where you will also find the links to our Facebook, Twitter and Instagram pages.