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Sex and Advanced Cancer

Posted 9/8/2015

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  This is a difficult topic. Of course there are many reasons why someone living with advanced/metastatic cancer still wants and needs an intimate relationship. There are also many reasons why it may be challenging and why others in this situation may not be interested.

  It is far too easy to feel very alone with a serious illness. In the context of a loving relationship, a natural reaction to that feeling is to reach out and be close. Another natural reaction can be to further withdraw and close one's self away. When frank conversation about  illness and fears and sadness is difficult, physical intimacy may be a way to bridge that isolation. We have all experienced the (slightly) greater ease of some conversations in the immediate afterglow of intimacy. From another perspective, however, having a responsive libido may be pretty tough when one is feeling ill from treatments, ill from the cancer itself, and overwhelmed with intense feelings.

I often speak with my patients about other ways to be close: showering together, foot or back rubs, cuddling on the couch or in bed, just holding hands. I remember poignantly hearing from a man whose wife was dying that they went to sleep each night holding hands, something that had not ever been their habit.

  This is an introduction to a good piece from ASCO Connection. Very honestly, I have a lot more to say and will do so another time, but I can't bear to fight the Maine internet any more

Sex in the Face of Metastatic Disease Don S. Dizon, MD - 

Significant psychological distress often accompanies the first diagnosis of cancer, but for most patients, I find the distress fades as the cancer gets treated and ultimately becomes a part of their past. Life resumes a new normalcy, interrupted only by clinical visits for surveillance and, perhaps, the management of ongoing sequelae related to therapy.

For others, though, cancer does not leave them—it persists, recurs, and/or becomes metastatic. I have found that for those living with metastatic disease, life becomes intensely medicalized; appointments to be made, tests to be performed, treatments to be administered. With the focus on treatment—both its effectiveness and toxicity—I worry that some aspects of life may be forgotten, or worse, deemed unimportant. This is especially the case with sexuality. Take the situation of my patient Elaine, who has voluntarily decided to share her story.

Elaine had a prior history of early-stage breast cancer, dating back to 2004. She should have been cured, but in 2013 she developed fluid within her pelvis. Further work-up revealed carcinomatosis involving the abdomen, all of which pointed to a probable diagnosis of ovarian cancer. She had exploratory surgery two days before Thanksgiving in 2013 and after that, her life changed.

- See more at: https://connection.asco.org/commentary/sex-face-metastatic-disease

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