Intimacy after the big C: Book offers tips for women

FARGO - Since the day Deborah was diagnosed with breast cancer, her husband hasn’t touched her.

Without my breasts, Naomi wondered, who am I? She feared no one would want her.

Carol’s drug therapy for melanoma “knocked the wind out of my sex life.”

Those women’s problems following cancer treatment are among the examples by husband-and-wife counselors who’ve written a book to help women cancer survivors rekindle their love lives.

Ironically, “The Lovin’ Ain’t Over for Women with Cancer” evolved from a husband and wife, Ralph and Barabara Alterowitz, dealing with the sexual aftermath of his prostate cancer.

The couple found themselves thrust into a world of support groups. Before long, they were being asked to make appearances at other support groups around Potomac, Md.

Everywhere they went, the Alterowitzes heard from women and girlfriends of men recovering from prostate cancer: What about us? We have to deal with cancer and relationships, too.

The couple, certified sex counselors at the nonprofit Center for Intimacy After Cancer Therapy, decided to write a book after discovering no one else had written about it in the same way.

The book is intended as a reference for women recovering from cancer and confronting issues of intimacy or sexuality.

It addresses topics including female sexual function and cancer, how to talk to your partner, how to redefine yourself after cancer, reinventing loving, and the single woman and cancer.

The book is frank and detailed. It has charts, for example, listing the sex-related physiological and psychological effects of different cancers and their treatments.

The emotional and psychological pitfalls for a woman recovering from cancer are many.

Depression occurs in about one in four women with cancer. That’s double the rate of the general population. Also, depression or anxiety can be a side effect of some drug treatments, such as interferon.

Other drugs, including some chemotherapy regimes that can last for several years, can diminish a woman’s libido.

The fear of rejection, especially for women who have had disfiguring surgery such as a mastectomy, is a common dilemma.

A woman’s body is often central to her identity and self-image – a concept many women recuperating from cancer must reconstruct.

The problem is only magnified if the woman and her partner are afraid to discuss it. Men, who often feel it is a sign of weakness, shy away from talking about intimacy or emotions. Or fearing they will say the wrong thing, they say nothing.

As a result, the woman is left feeling isolated and without an empathetic, supportive partner.

“You really have to talk about it or you can lose your sexual relationship,” Barbara Alterowitz said. “What can happen when you lose your sexual relationship – you can lose the rest of your relationship.”

On the other hand, when it comes to re-establishing a physical relationship, men should let women take the lead, the Alterowitzes write.

“Successful resumption of meaningful intimacy does not come easily,” they write, “and it may not come at all.”

Although difficult and stressful, women and their partners should remember that the work of restoring intimacy after cancer is worthwhile.

People who make love are happier and even live longer, the Alterowitzes note.

The reality for many couples dealing with cancer, however, is that their sex lives never will be the same.

Surprisingly, many discover that with work and ingenuity, their sex lives are more than satisfactory, the Alterowitzes say. In certain ways, the woman and her partner are rediscovering each other.

“They can find that it deepens their relationship,” Barbara Alterowitz said. “This was an ‘aha moment’ for them. It actually opened the door to a lot of creativity because you have to find new ways of doing things.”

For a relationship to be healthy, the two partners must feel equal to each other, Ralph Alterowitz said. And that requires “a better sense of self.”

For some women, a battle with cancer is the first time they look around and decide it’s time to devote more time to themselves.

It’s important for women to know that help is available, including counselors and support groups, Barbara Alterowitz said.

“You are not alone,” she said. “A lot of people think they are all alone,” but that doesn’t have to be the case.

Medical providers, whose first concern is curing the cancer, have not always dealt with issues women have involving sexuality and intimacy.

But that is improving. The Alterowitzes have been invited to speak to medical students at George Washington University, and recently the first conference in the United States devoted to cancer and sexuality brought together doctors, therapists and counselors.

“There are hopeful signs,” Barbara Alterowitz said.

Ten ways to create a loving environment

Start each day with a wake-up kiss, and end with a goodnight kiss. Say, “I love you.”

Touch in a loving way that is soft and gentle. Try to keep that soft tone throughout the day.

Make a date to watch the sunrise or sunset together.

Go to a movie or play and then for coffee afterward so you can talk about what you saw.

Take a walk in the park.

Feed each other your favorite foods.

Read to each other in bed.

Put lotion on each other after you shower.

Kiss when your car is stopped at red traffic lights.

Give each other “affection” or “love” coupons as credit for something kind the other one has done.

Source: “The Lovin’ Ain’t Over for Women with Cancer”

Readers can reach Forum reporter Patrick Springer at (701) 241-5522

Tags: shesays, health