“Scary to talk about”: Changing discussions around breast cancer and sex
As one of the most common cancers in Australian women, the challenges of breast cancer are experienced by thousands of women each year.
But one of the areas some say isn’t talked about enough is the impact of breast cancer on women’s sex lives and body image.
“Health professionals are comfortable and used to talking about the side effects of chemotherapy like nausea and vomiting to patients, but many do not feel comfortable discussing the other side effects of treatment, and how these may impact intimate relationships,” says Kate White, a professor of cancer nursing from the University of Sydney Nursing School.
“[Doctors] often wait for the patient to bring it up, rather than proactively explaining it as another potential side effect.”
Medical oncologist Dr Belinda Kiely agrees that changes in the conversations around breast cancer and sex need to come from doctors.
“We, as doctors, are very good at asking people about their pain, or their nausea or their constipation, but another line of questions should be ‘what’s happening with your sex life?’ or something along those lines,” she says.
“I think we could do a better job of bringing it up and not relying on women to bring it up when it is a bit scary to talk about.”
Dr Kiely also points out that changes in physical and mental symptoms can impact the sex lives of patients in various ways.
Professor Fran Boyle agrees, noting that issues surrounding intimacy can arise when any serious illness is diagnosed.
But, there are some issues unique to breast cancer patients when it comes to getting intimate with a partner, such as hormonal changes due to breast cancer treatment.
“Breast cancer also affects a part of the body which is important for many women for arousal as well as body image, and, when sore or numb post-surgery, women may not wish to be touched on the breasts,” she says.
“Hair loss from chemotherapy can also affect body image and relationships.”
Other issues can include low libido, vaginal dryness or soreness, as well as hot flashes and sleeping problems, which Professor Boyle says can have an “impact on the desire for closeness”.
A gap in the discussion
Rebecca Angus was diagnosed with breast cancer at 33, and her eventual journey to recovery impacted her life in countless ways.
In her experience, Rebecca found that discussions around sex with medical practitioners focused on medical aspects, leaving the effects on mental health unspoken.
“Sex is explored at the beginning of chemotherapy education. However, it mainly focuses on fertility preservation, ovarian suppression and contraception during treatment,” Rebecca says.
As Rebecca recovered, fatigue from treatment and medical restrictions on how she could engage in sexual activity had dramatic effects on her sex life.
“You’ve got this cancer in your body that has tried to kill you, so you don’t have the best relationship with your body at that stage,” she says.
“There are a lot of rules around when and how you can have sex as well. Your body for a while is not your own, it belongs to health professionals.”
Though her experience may not be universal, Rebecca says, “Having a good sex life within a relationship is so valuable for anyone with cancer”.
She also hopes to normalise conversations around these more sensitive topics so that women can obtain the help they need.
“You can get help from your psychologists, gynaecologists and oncologists - your specialists are there to help you.”
Professors White and Boyle will be appearing alongside Dr Kiely and Rebecca Angus for a Q&A all about breast cancer and sex on Thursday, September 30.
Let’s Talk About Sex is a free Q&A session run by The Breast Cancer Trials and moderated by journalist Annabel Crabb that offers the chance for anyone to ask questions about this important issue.
The online event will take place between 5pm and 6.30pm, and attendees can register here.
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