Written By Josh Fernandez, Digital Media Specialist
Stephanie Joseph, 50, tells her doctors everything they need to know to help her maintain her health. When she was diagnosed with stage IIA, HER2-positive breast cancer in 2010, she applied this personal rule to her cancer care team by sharing her sexual orientation with them.
“The oncologist, radiologist, breast surgeon, plastic surgeon and nurses—I don’t think there was anyone on my care team who didn’t know I was a lesbian,” the Washington, D.C. area resident says.
Studies suggest that being overweight, drinking alcohol, not having children, not breast feeding and smoking may increase a woman’s risk of developing breast cancer. Lesbian and bisexual women are more likely to have some of these risk factors, which in turn may increase the risk of developing breast cancer.
Stephanie says she had some of those risk factors, which is why she thought it was important to talk about her sexual orientation when she brought up her full health history.
“It’s part of my care; it’s the overall picture of who I am and where I’ve been,” she says. “This disease was going to affect me a little differently because of who I am.”
Getting Help During and After Treatment
Stephanie’s oncologist told her that she needed a mastectomy of her right breast, followed by treatment with chemotherapy and the targeted therapy trastuzumab (Herceptin).
Her breast surgeon recommended she have someone help her the first week after surgery, while she was recovering.
“I told him I didn’t have a choice—I wasn’t married; I didn’t have a girlfriend and my family wouldn’t be able to help,” Stephanie recalls.
As she worried about the first week of recovery, Stephanie remembered a support program her friend with brain cancer used in the early 1990s. She contacted the Mautner Project, now part of Whitman-Walker Health in Washington, D.C., an organization that helped lesbians, bisexual women and transgender people through advocacy, education, primary medical care and support services. A Mautner volunteer came to Stephanie’s home every day of the week after her surgery. The volunteer helped her with household chores and made sure she rested and didn’t strain herself. Mautner volunteers also helped get her groceries on a weekly basis and drive her to and from the hospital for treatment.
“They cleaned for me, landscaped, put furniture together—if they couldn’t do something, they’d let me know,” Stephanie remembers. “I don’t know what I would have done without them.”
Stephanie sought help for her emotional needs as well. Before she finished breast cancer treatment in 2011, Stephanie began seeing a therapist. that matched her personality. “For me, it’s really important that I click with my therapist, my oncologist, primary care doctor, podiatrist—any healthcare provider,” Stephanie says. “If someone is taking care of you, I think it’s important you feel comfortable with that person, especially when you are dealing with breast cancer.”
Body Image and Dating After Treatment
One of the biggest issues Stephanie and her therapist worked on was Stephanie’s body image concerns after surgery.
In addition to mastectomy, Stephanie had breast reduction surgery on her opposite breast. She was really concerned about how a partner would view her and did not date until she finished taking trastuzumab. She considered getting breast reconstruction.
“I was going to have more surgery, and then I asked myself an important question: Who am I doing this for?” Stephanie recalls.
She asked herself if she wanted reconstruction because she was ashamed of the way she looked, or because she worried nobody would find her attractive. Stephanie says that after enough time and therapy, she realized her breasts do not define her. When she looks at her chest, she now sees the tissue from after her mastectomy as a battle scar.
“I’m almost proud of it in some ways, that I am resilient, and that scar is a sign of that,” Stephanie says.
Stephanie decided not to have breast reconstruction. She will continue to date until she finds the right partner for her.
“If I’m going to be alone for the rest of my life, it’s not going to be because I have one breast,” she says. “It’s going to be because I didn’t meet the right person. I’m convinced of that.”