Sex and Cancer--Why We Need This Book

Dr. Saketh Guntupalli and Maryann Karinch have given us a gift. And this may be a gift that you want to give to yourself or to a friend who is dealing with cancer or who is the caregiver of a partner with cancer.

I've written about "Sex and Cancer" before but I wanted to share it again and to also show this brief Youtube video of Dr. Guntupalli talking about why he wrote this book. He leads with the sad but true story that is more common than we realize about how lives are saved but relationships lost because no one talks about sex.

It's a crime.

As a cancer caregiver--and newlywed wife--I had to fight fiercely to save both John's life and the marriage.

And thank goodness I got mad--the result was crazy, sexy advocacy and this blog and a lot of community education. I was determined that no couple would feel as alone as we did the first time we asked, "So what about sex?" and the oncologist said "Have a nice day" and walked out of the room.

I think today I'd be more bold and follow him down the hall and say, "Hey, buddy, I asked you about sex not suicide.:)))

So years later, hundreds of blog posts, many talks and workshops and panels later, here's the book I wish I'd had back then.

Give a click below to listen to this short Youtube video with Dr. Saketh Guntupalli:

https://youtu.be/Fniygu7ZIGIhttps://youtu.be/Fniygu7ZIGI

Cancer and Sex

So, the silence around sex and cancer was the impetus to this very blog. No one would talk to us. Not a doc or a nurse or a PA...finally a friend got some out of town resources for us, but by then I was so mad, and I started provoking everyone, and I wrote a very mean post about cancer resources folks who think relationships live on the "C" word:  cuddle.

Now there is a little bit more info and I dig for every bit of it and bring it to you right here.

So here is todays offering--a new book, "Sex and Cancer" by Dr. Saketh R. Guntupalli and Maryann Karinch. The link below is to an article in today's New York Times section called Living with Cancer--and Susan Gubar (we love her) writes about the new book.

Take a look, and please share this with family
 and friends who are living in CancerLand--You might save a relationship and a life:

https://nyti.ms/2FMqqPP

The Great Divide: Certain Regrets

When interviewed at or after middle age, both men and women have expressed some profound sexual regrets. But, researchers say, what they regret shows how great gender differences can be.

 It is as you might expect: Women regret sexual experiences they had—one-night stands, or sex with the wrong person, while men regret sexual experiences they missed --opportunities passed up, or not attempted.

According to Marty Haselton, professor of social psychology at UCLA, “When men miss a sexual opportunity it may be a costly loss from an evolutionary perspective.” 

Researchers at The University of Texas agree: “Men are genetically hardwired to seek mates and on some level each missed opportunity to have sex is a missed opportunity to reproduce. 

But for women, who invest more in each offspring—pregnancy, breastfeeding, infant care—“the consequences of casual sex are much higher which is likely to have shaped women's emotional reactions to sexual liaisons even today”, according to the findings reported in The Archives of Sexual Behavior. 

So then, here we are in CancerLand and we wonder about regrets here. Do we, should we make an extra special effort to have more sex and keep our sexual lives, well, alive? Or should we acknowledge that being alive (beating cancer) is the ultimate prize, and go have a great chocolate cake and some champagne?

Does a cancer diagnosis, and surviving cancer (and its treatments), change our regrets, or make us wish for—and still try for—more sex?

Cancer Movies: 50/50

Maybe like me, you have put off watching the 2011 comedy/drama called 50/50. I didn’t watch it for years because I thought it was either a sappy, tearjerker about cancer, or a gross, expletive-filled, Seth Rogen 20-something boy story. I didn’t know, and I didn’t realize, that it could be both.

We watched it last night and we laughed and cried. Yeah, John too. I am glad that I didn’t see this at the movies with friends though. Not because the cancer scenes cut so close to home but because there is one boy-to-boy discussion of their girl friends and certain sex acts that made me blush. If I saw this movie on a first date I’d leave the theater in sunglasses and go right home. (alone.)

But, we’re not dating, we’re married and we’ve done that sex act so I am laughing as as I type this, Ok it’s that funny.

And yes, Seth Rogen is mostly a pig but, a pig with a heart for friendship, good writing and insight into how guys talk and fight and love each other. Yeah, the movie is a love story and –spoiler alert—the love object is not Anna Kendrick. 

I would put 50/50 in my top three cancer movies. Check it out. But please, not on a first date. (And dear God, not with your in-laws.)

Sex and Intimacy and Cancer

It’s been a long time coming but finally I came across an article about how your sex life might be impacted during and after cancer. The article is in CURE Magazine. (Cure is available in your oncologist's office or at any chemo center.)

Written by Lacey Meyer, the article discusses the challenges, feelings, fears and the shame about losing, reclaiming or trying to revive your sex life. Meyer addresses both the patient and the caregiver. The article talks about libido, erectile dysfunction, hormonal changes and the conversations required.

 Yes, she does include the requisite bit on cuddling. Sigh. (The “C” word). But brave Lacey Meyer-- she also talks about masturbation and vibrators and getting pleasure.

An open discussion about orgasms is coming soon!

Surrender to Being a Good Lover

You know that I love reading, and that I love reading –and talking—about sex.

The newest book on my bedside table is called, “The Ecstasy of Surrender” by Judith Orloff, MD. Doctor Orloff is a fascinating physician. From the start of her career she has been practicing a combination of Western, Eastern, Alternative and Energy medicines. She is a clinical professor of psychiatry at UCLA.

This new book promises to be a bestseller just as her first book; “Emotional Freedom” was a New York Times Bestseller for several years. In this new book she is writing about all different types of surrenders we can practice—with family, in the workplace, with communication, aging and yes, as lovers.

In Chapter Eight Orloff offers this list of the Ten Qualities of a Good Lover:

1 You’re a willing learner.

2 You’re playful and passionate.

3 You make your partner feel sexy.

4 You are confidant, not afraid to be vulnerable.

5 You’re adventurous and willing to experiment.

6 You communicate your needs and listen to your partner.

7 You make time and don’t rush.

8 You enjoy giving pleasure as much as you enjoy receiving it.

9 You’re supportive, not judgmental.

10 You’re fully present in the moment with good eye contact and can let go.

Yes, I do think it takes a lifetime to learn all that and to bring it to bed consistently. But hey, what a set of skills to keep practicing. I’m keeping this mini inventory nearby as a reminder to keep surrendering. Before, after and through cancer and illness we can keep sensuality and pleasure alive.

Love, Sex, Intimacy and Affairs

In most literature about cancer and couples you see the words, “love”, “sex” and “intimacy”. Those topics get some attention and ink even though the word intimacy is often used euphemistically for the word, “sex”. And of course you know by now how I feel about “cuddle” as a euphemism for sex or intimacy.

But there is a nodding awareness that a couple dealing with cancer is going to have issues around their intimate lives. What is often not acknowledged is that it’s no so easy to predict where the pressure or initiation for the issue will begin.

The common stereotype is of a woman with breast or gynecological cancer becoming reluctant to have sex with her husband and so the “work” is coaxing her back to the bed and to intercourse. Because of that stereotype a lot of the literature is addressed to men with the admonition to “be patient and to engage in non-sexual intimacy”. Hence the cuddle messages.

But that is not the whole story. And this is why it is crucial for healthcare professionals in Cancer Land to talk openly about sex. In many cases the person with cancer is the one who wants the direct sexual contact but the caregiving partner (male or female) is the reluctant one. And it’s also true that while chemo and repeated surgeries can diminish a patient’s libido, in many cases the stress of caregiving diminishes the libido of the “healthy” partner.

So if you look at those combined dynamics and the unpredictable nature of who wants what when—then you realize that you cannot assume that the “patient” wants less sex and the caregiver wants more. That is also why the word “affair” also has to be included in the “What about our sex life? conversation for the couple.

But I’ve never seen a piece of cancer care literature include a discussion of affairs or “sex outside marriage” –well, until I read “The Caregiving Wife’s Handbook” by Diana Denholm.

The whole book is a breath of fresh air and Denholm can be thanked for her stunning honesty. She writes about all aspects of caregiving and the mostly unmentioned parts like resentment, codependence, finances and sex. Bless her. And she adds a section on affairs to say that sometimes the caregiver is the one who has an affair because their needs are not being met (physical or emotional) but that it is equally true that the person with cancer can be the one who has an affair in order to feel masculine again or feminine again and to have the validation of a new partner—or to play out the anger they feel at having cancer. We know that affairs meet more needs than just the physical and so a couple dealing with cancer has to face the long list of needs being deferred or delayed or lost for both partners.

The subject of adultery or infidelity is so taboo in our society that coupled with the still taboo subject of cancer it’s understandable that no oncologist is saying, “Hey folks, we need to affair-proof your marriage.” But wouldn’t that be a wonderful and compassionate and healthy conversation to begin? 

Don't Use the C Word in CancerLand

Every now and then I start to think that maybe we just had a uniquely bad experience in Cancer Land. I'll see an article about "Remaining Intimate Through Cancer Treatment" and I think, "See you just didn't ask the right questions." Then I read the article and there it is: The C Word...experts in Cancer Land are still thinking that cuddling equals sex.

Now, don't get me wrong--I like cuddling. I like it any old time and I particularly like it after sex..but it's not sex, not all by itself. Cuddling might be sensual and it might express sexuality and it might be a prelude to sex and yes, it might be all you can do when sometimes you can't have any sex, but why not just say that?

This weekend I was at a conference with professionals in the Addictions Treatment industry. I gave a presentation on what happens in longterm recovery and of course one of the many things that happens is aging and along with aging comes the illnesses and disabilities that are unrelated to addiction--and that leads to the topic of caregiving. We were talking about the issues that affect caregivers an I mentioned the challenge for caregivers in talking about sex with cancer care professionals. And the hands shot in the air.

More stories of doctors who won't talk about sex and nurses who refused to talk specifics about sex--and even therapists who avoid talking about sex while trying to help couples communicate about their cancer.

So a ban on The C word in CancerLand. And more info and maybe soon a post about the very specific questions you can pass to your doctor in a note.

Books for Cancer and Sex

Love in the Time of Cancer is all about cancer and love and sex. I started writing this out of frustration in finding medical folks willing to talk openly and specifically about sex in the time of cancer. Since I couldn’t find those others I decided that I’d have to become what I was wishing for—not a bad way to approach many things in life I’ve discovered. So I started writing this blog, which became a book and then a presentation and now a cause.

So I love to share resources for other couples that are facing cancer and who want keep a great sex life. So many forces—medical, religious, cultural and social still think cancer and sex are separable but I—for many reasons believe they are inseparable. I had my first experience with cancer in my twenties when I was just discovering my sexual potential and I was not going to give that up. I got knocked for a loop but—like Rocky—came back stronger. And more passionate—in every sense. And grateful to the women and men that I learn from.

So here are two books and one writer that I highly recommend. The tagline on both books is identical and it says: “Reclaim your sex life after a cancer diagnosis…”

The books are: “Woman Cancer Sex” and “Man Cancer Sex” by Anne Katz, RN, PhD. Katz is an oncology nurse and a sexuality counselor at CancerCare Manitoba and she writes a regular column for The American Journal of Nursing called, “Sexually Speaking”.

Just to give you a sense of how complete and open her writing is, some of the chapter headings in “Woman Cancer Sex” and “Man Cancer Sex” include these topics: Loss of Sexual Desire; Problems with Orgasm; Painful Sex; Lesbians with Cancer; Partners of Patients with Cancer; Sex and Terminal Illness.

Not a lot of euphemisms in these books and no pretending that cuddling is enough.

Both books are paperbacks and can be ordered by your local bookstore.

Women, Cancer and Sexual Pain

When I was growing up my mother loved Ann Landers and Dear Abby. She read them and I learned to read them too. Both writers offered good advice and a picture too of just how dysfunctional families could be. Tolstoy was right.

As a young woman I had a strong reaction to the letters from women of a certain age who wrote to say, “Why doesn’t my husband leave me alone?” They would describe how the man in their life badgered them for sex and they hated it. “Why can’t we just cuddle?” And I would think, “I never want to be one of those women.”

Now that I am woman of a certain age I am more sympathetic but I still don’t want to be “one of those women”. I like sex. But, something that we don't talk about is sexual pain. I wonder now how many of Ann Landers correspondents really meant it when they said that it was a pain to keep having sex?

In today’s New York Times the wonderful Jane Brody writes about women and sexual pain and specifically relates it to cancer treatment and treatment side effects. I thought, “Yes, this is for the Love in the Time of Cancer folks, and it’s also for most women I know –including those who are not dealing with cancer. Chemotherapy wreaks havoc with women’s hormones, as does positive cancer treatments and so do aging, perio-menopause and menopause and post-menopause.

Dryness, tears, pain, no elasticity—and who knew that your vagina could get shorter? All this for women with and without cancer.

But the point Brody makes—the reason I stated writing this blog --is that so few oncologists and medical folks talk to patients and couples about sex, sexual issues and sexual side effects. So thank you Jane Brody!

The article (click below for the link) gives suggestions, recommendations, remedies and references. Hooray!

Here it is: http://well.blogs.nytimes.com/2012/08/06/persistence-is-key-to-treating-vaginal-pain/?smid=pl-share