Changes in Intimate and Sexual Relationships After Cancer

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Cancer survivors face unique challenges and adjustments in the years following treatment. Whether its returning to work or regaining emotional stability, it takes time to fully get back on track. But rarely do we address intimacy and changes in sexual relationships post cancer. On this episode of Patient Power, Dr. Sylvie Aubin, a clinical psychologist at the Seattle Cancer Care Alliance (SCCA), focuses on some of the common concerns and misconceptions about sex and cancer.

Dr. Aubin begins the discussion by plotting out common issues for cancer patients like body image, sexual desire, and treatment side effects. She offers ways of initiating these discussions among partners and provides suggestions for couples seeking professional counseling. Lastly, Dr. Aubin emphasizes the importance of keeping the lines of communication open at all times.

Join us for an interesting dialogue sure to keep you alert. You’ll hear Dr. Aubin talk about PDE5 inhibitors, like Viagra, Levitra, and Cialis and overall benefits of hormonal therapy. Dr. Aubin also offers detailed strategies for resuming sex and intimacy after a serious illness.

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Andrew Schorr:

Hello, this is Andrew Schorr and welcome to another edition of Patient Power sponsored by the Seattle Cancer Care Alliance where every two weeks we connect you with a leading SCCA expert and talk about issues that are important to cancer survivors and the people who care about them.

In today's discussion we're going to talk about something that I know as a leukemia survivor I certainly thought about as did my wife, and that is the changes in intimate and sexual relationships after cancer, and with us is an expert from the SCCA and a clinical psychologist, Dr. Sylvie Aubin, and she is in the Department of Psychiatry and Behavioral Sciences both at the Seattle Cancer Care Alliance and the University of Washington Medical Center. Dr. Aubin, thank you so much for being with us.

Dr. Aubin:

Oh it's my pleasure.

Andrew Schorr:

All right, well I know you have a support group that you meet with every few weeks. Is it prostate cancer patients and their partners?

Dr. Aubin:

The history of this support group is yes, originally it was a support group for spouses, wives or partners, of men with GU cancers; that is prostate, testicular, or bladder. Then since there is so much need I extended the support group for couples dealing with cancer, any kind of cancer. The support group happens every third Wednesday of the month at SCCA from 1:00 to 2:00.

Andrew Schorr:

Let's talk about that. There's a story, I've interviewed hundreds and maybe even thousands of patients, and I vividly remember the story that I'll share because I think it's representative. This was a woman who had had a mastectomy, and she came home from the hospital. She was taking a shower, and her concern was would her husband still find her attractive? She tells this story of this man she loved very much coming into the shower with her, just getting in the shower, and giving her a big hug, and they actually made love in the shower, and of course that said it all. That was one of her, you know, she was worried, was she a woman anymore, was she attractive, and she felt confident that she could beat the cancer, but she wasn't confident that her relationship could go on in as meaningful and as intimate a way as it had been before. That must be a common concern.

Dr. Aubin:

Absolutely. Actually it's interesting that some do not have body image issues, but if you understand sexuality in women, very often the sense of self and being attractive to your partner is very key and fundamental to your own sexual desire. So the majority of women who come to see me after they've had a procedure, either a lumpectomy or a mastectomy, are extremely concerned.

It's not only about their breasts, but it's also about their overall body image. A lot of them have also been placed on a treatment that will make them gain weight, so yes absolutely a very, very big concern for the majority of women is, 'I feel change in my body image. I don't feel as attractive, and will that impact my partner and his attraction to me?' A lot of women have very vivid concerns of a lot of 'My sexual pleasure and arousal came from my breasts, my nipples, and unfortunately I can't feel anymore some sensation,' especially if a woman has had a double mastectomy. There's a loss of sensation from this area, which for some women is very dramatic. So yes it is an issue that we can discuss.

Andrew Schorr:

We're going to get into some specifics and give people some strategies on how to feel better about themselves and in their relationships, but it's not just women.

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