Cancer and Sex

Don S. Dizon, MD, FACP, regularly blogs on ASCO Connection, where this post originally appeared. Learn more about sex and intimacy after a breast cancer diagnosis during our Twitter Chat, Tweets from the Sheets, on Wednesday, June 24.

dizon_don 2012As an oncologist who also runs a sexual health clinic for women treated (or under treatment), I am discovering that my perspective on both issues of cancer treatment (and survival) and life after cancer (and quality of life) is somewhat unique. I am conscious of how difficult it is to bring up cancer therapy and survivorship (let alone sexual health) within the same discussion, yet I have gained a heightened sensitivity of the importance of looking beyond treatment even while we are discussing what to do now. I have benefitted greatly from colleagues in the field of sexual health, such as Michael Krychman, at UC Irvine, and Anne Katz, in Canada, both of whom I have been privileged enough to count as colleagues, co-authors, and contemporaries.

I am even more fortunate that one of my friends here in Boston also shares my interest in women’s health. Sandy Falk is a gynecologist and sees cancer survivors for women’s health issues at the Dana Farber Cancer Institute. In our practices, we both see the adverse effects of therapy that patients have to cope with. However, far from the arthralgias of aromatase inhibitors and neuropathy of some of our chemotherapeutic agents (two symptoms which we as oncologists are comfortable discussing), sexual health is often compromised.

There are common complaints encountered by those of us who cover sexual health. They include:

  • “I’m done with treatment, but now I can’t have sex. It is too painful and my sexual desire is completely gone.”
  • “Why didn’t my oncologist warn me about this? Maybe if I had known my partner and I could have worked on this early on. But now, so much time has passed now and my partner and I have lost patience.”
  • “I’m not sure how to go on with my relationship.”

Those may be extreme examples, and I hope for most oncologists that they are. However, what I do know is that these perceptions do exist—inside and outside of medicine. When the paper on AI treatment was picked up by several sites, I had read some comments posted and was disheartened to see that some of the thoughts above were reflected: “A woman should be lucky to be alive,” one stated; another said, “You can’t have sex if you’re dead.”

I believe most oncologists do not discuss sexual health with their patients and as an oncologist, I understand why. Most clinicians reading this might think (perhaps unconsciously) that the patient is “lucky to be alive.” And of course, she is. And we also know that she probably wouldn’t have had the ability to hear detailed information about sexual health during the diagnosis and treatment planning process—there were much bigger priorities then. Continue reading

The Spirit of Pageantry

Natalie Gamble is back on our blog with a post about supporting her daughter while in treatment for breast cancer, pageants and being honored with the “Spirit of Pageantry” Award.

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Life doesn’t stop because of a breast cancer diagnosis – it goes on. How you decide to approach that life is up to you. Me personally, I never missed a step.

After deciding on a treatment plan and scheduling my surgery I was on my way to Virginia Beach with my daughter for the International Junior Miss. Some background information about this trip: My daughter Mikayla is my hero and one of the strongest, most driven individuals I know. I tease her all the time that I want to be just like her when I grow up. At the tender age of 9 she announced she wanted to be a microbiologist and will be attending U.C. Berkeley to earn her degree, and here is the kicker – she wants to pay for it herself!  Since those words left her mouth, Mikayla, now 14, has made it her mission to do just that. Besides maintaining a A/B average in school, she competes in natural pageants to earn scholarships, pageants like International Junior Miss.

As a pageant mom, I wear many hats: tailor, beautician, coach, travel agent and cheerleader to name a few. Needless to say, my cancer diagnosis was a huge hiccup in my role as her support system. Monetheless, I was determined to work around it.  On our way back from an exhausting week of competitions, I received a phone call from my daughter’s new pageant director Christina Sacha Grooms, who introduced herself to us and updated us about the rest of my daughter’s reign.  I informed her of my diagnosis and told her that no matter what I would get my daughter where she needed to be.

While I was fighting the good fight in treatment, my daughter was reigning as International Junior Miss’ Colorado Preteen 2014. And as promised she was at every event, photo shoot, and appearance as scheduled. Our pageant family was just as supportive as our immediate family and to this day, I thank God for these incredible people. Every time we saw each other it was a family reunion and it touched my heart to know they read and looked forward to my Facebook posts. Every day I tried to share my feelings and thoughts with my family and friends.  Continue reading

Changing The Way I Viewed Stage IV: How I Learned I’m Not Alone

Sheila Johnson-Glover is back on the LBBC blog to talk about the Annual Conference for Women Living with Metastatic Breast Cancer, how it changed the way she saw her diagnosis and connected her with a community of support. Learn about our Ninth Annual Conference for Women Living with Metastatic Breast Cancer, taking place April 11-12, 2015 in Philadelphia.

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Motivating, exciting, empowering, community building, love, strength, laughter and unity – these are the words that describe how I felt during and after I attended my first Annual Conference for Women Living with Metastatic Breast Cancer. For me, this conference was a game changer on how I viewed my diagnosis. The event gave me a new hope and a new beginning. I determined then that I would fight and continue to fight and to encourage other’s to attend this conference so they too can make lifelong friendships and get all the updates on research, treatment and support for people living with a stage IV breast cancer diagnosis.

I was diagnosed with HER2-positive metastatic breast cancer in December 2009. I had to ask my doctor, “Well how many stages are there?” My doctor responded, “Sheila you have the worst one.” As you can imagine, my heart felt like it had exploded and my whole body went numb. I needed to know more about metastatic breast cancer and meet women like myself who were living with this diagnosis, and learn if they felt the same way I did emotionally and physically. I was a total wreck when I learned I had stage IV breast cancer. I knew nothing about stage IV and I didn’t have anyone I could relate to.

Living Beyond Breast Cancer has been a true blessing in my life. I was introduced to LBBC by my support group, the Young Women’s Breast Cancer Program in St Louis, Missouri, and what a joy it’s been! I soon learned about the amazing conferences LBBC hosted, and I thought attending one would be a great opportunity to meet those who understood the same battle that I faced every day. I wanted to ask other people living with stage IV breast cancer questions like how they deal with side effects and what questions I should ask my oncologist. I would later learn that every cancer treatment plan is different but still, I needed to hear from others who understood what I was going through.  Continue reading

TNBC Aware: How Being Diagnosed With Triple-Negative Breast Cancer Connected Me To My Roots

Speaker and Integrative Cancer Care and Wellness Coach Eileen Fuentes on how triple-negative breast cancer connected her to her cultural roots. Eileen also included a recipe below!

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Wellness and healthy living has become very trendy. It seems as if everyone is sipping on smoothies and doing yoga. While I have always been health-conscious, the messages I was receiving in the media confused me about what to eat and how to live. Like many women, I thought low-fat anything, artificial sweeteners, and highly processed foods were good for me.

It wasn’t until I was diagnosed with triple negative breast cancer (TNBC) at 34 years old that I made it a point to really understand how to eat and live in order to reduce my risk of recurrence. What makes TNBC unique is that there are no targeted therapies to treat it and it has a poorer prognosis as compared to other breast cancer subtypes. While I’d agree with you that this cancer is definitely “negative”, the name actually refers to the fact that the cancer is estrogen receptor negative (ER-), progesterone receptor negative (ER-), and HER2/neu negative. This disease also disproportionally affects premenopausal women and those of African-American and Latino heritage.

The fact that I fit into both categories and had no family history motivated me to look closer at what I could do given my limited medical options. Below are 5 lifestyle changes that I made that were beneficial:

  1. No matter how I felt, I always exercised regularly including simple movements like walking or more vigorous activities like qigong.
  2. I began my spiritual journey to learn more about myself, my purpose, and to seek guidance on my post-cancer life.
  3. I maintained a journal, which later turned into a newsletter for my loved ones, and ultimately a blog.
  4. I stopped using toxic products on my body and reduced the toxic thoughts I allowed to entire my mind.
  5. I used to food to reduce the side-effects of cancer treatment and to connect me to family/caregivers.

Continue reading

TNBC Aware: Meaningful Action in Honor of Her Shero

Triple Step Toward the Cure founder and CEO Lori Flowers contributed this TNBC Aware blog post about her late sister, Sheryl, who inspired her to start the triple-negative breast cancer nonprofit to educate, encourage, and empower women diagnosed with the disease.

Sheryl (right) with her sister, Triple Step Toward the Cure founder and CEO, Lori Flowers (left).

Sheryl (left) with her sister, Triple Step Toward the Cure founder and CEO, Lori Flowers (right).

Cancer does not run in my family.  But general health and longevity do. Both sets of my great-grandmothers lived to be almost 100 and were largely independent even into their last days. My grandmother is 97 and sharper than many half her age and both she and my mother look younger than their years. I always attributed this to our Caribbean heritage.  So naturally I expected that genetics along with the salsa dancing and the patacones we grew up eating would help carry my sister, Sheryl, and I into ripe-old age.  However, that legacy was not enough to protect my beautiful and brilliant sister who was diagnosed with triple negative breast cancer in January 2008 at age 40.

I had no idea what was required of me but I immediately went into action mode, and assumed a role that was a constant mix of caregiver, therapist, comedian, and cheerleader.  Despite the circumstances, there were many wonderful moments and lessons learned.  As the eternal “little sister,” I now had an opportunity to step up for my shero. Continue reading

I Wasn’t Broken or Fragile…I Just Had Cancer

20141011_123702Today, LBBC blogger and friend Natalie is here to share what it was like for her to hear the words “You have breast cancer” and how her and her family reacted.

My name is Natalie Gamble, I am 43 years old and in May of 2014 one phone call changed my life forever. ” Your biopsy came back positive, Natalie I’m so sorry but you have cancer.” Cancer? My first reaction of course was tears. I cried in my husband’s arms afraid of the unknown because while an enlarged lymph node was positive for cancer my mammogram and ultrasound had shown nothing but benign cysts. My first thoughts after my crying jag were: “The Devil is a Lie!” Cue my second reaction, I got mad, I mean fighting mad and decided right then and there no matter what I was faced with I was going to fight and I was going to win. The next few days were a blur of appointments, procedures and tests I never even knew existed. After it was all said and done I was diagnosed with Triple Negative Breast Cancer, Stage II. Continue reading

Growing Initiatives for Metastatic Disease and LGB People Diagnosed with Breast Cancer

Catherine-Ormerod 1Catherine L. Ormerod, MSS, MLSP, LBBC’s Vice President of Programs and Partnerships, blogs about new resources and programs we developed for people living with metastatic breast cancer and LGB people affected by the disease.

This month, LBBC introduces two new initiatives to provide our brand of trusted information and support to two underserved populations in the breast cancer community: people living with metastatic breast cancer (MBC) and lesbian, gay and bisexual people diagnosed with breast cancer.

LBBC’s Hear My Voice Outreach Program will train 25 individuals from around the country and who are living with metastatic disease to connect others with resources, information and support for coping with stage IV breast cancer. Original LBBC research, confirmed by subsequent surveys, revealed that those living with MBC feel isolated, misunderstood and often unaware of programs and resources tailored to their experience. Other studies show that participation in peer outreach programs improves emotional health and well-being.

I see the power of connection at every one of LBBC’s conferences and thus I am very excited to begin the Hear My Voice Outreach Program at LBBC’s Annual Conference for Women Living with Metastatic Breast Cancer in April. We have already received many applications for the first Hear My Voice, so we know we have tapped into a large, unmet need.

Our second initiative centers on original content we developed to assist lesbian, gay and bisexual people living with breast cancer get the quality of care they need and deserve. For many, coming out to members of their healthcare team can be difficult or scary. The guide, which is the first of its kind for people with breast cancer, provides information, support and resources to help make having these conversations easier. Continue reading