On Thursdays, during my hospital shift in Oncology, sometimes I swing by the resource library to pick up material for the patients and, more than once, I sat, riveted, reading about anything from end of life care to financial assistance. Buried, among the brochures and leaflets, I also found a thick booklet on Cancer and Sexuality.
Of all the kind and amazing doctors I saw and am still seeing after my close encounter with breast cancer not a single one mentioned the side effects that either surgery or medications can have on self-image or sexuality. Granted, I underwent a lumpectomy that removed a very tiny portion of my breast tissues and, nine months later, the end result is that my small breasts look very much alike: the right one is still tanned from radiation but there is no scarring (the incision is made around the nipple) and nothing much seems to be amiss.
Nonetheless, when you wake up from surgery, you find yourself with a small, clear bandage and a velcro-fastened pale pink, soft bra that comes in useful for the first week. Then, you are on your own. The breast that underwent surgery is swollen and it takes weeks for the swelling to abate completely and about six months for the tissues to rearrange themselves and give in to gravity. It’s a bit disconcerting to look in the mirror and see your breast a couple of inches higher than its twin.I can’t even fathom what dealing with a mastectomy must be like.
Obviously, emphasis is placed on getting well and, as a patient, it often feels out of place to worry about aesthetics. But I am still a woman and whatever visual reminder was going to live with me forever more, I wished it to be as minimized as possible (and I am grateful to my female surgeon who understands such subtleties).
Sexuality and self-image are often wrapped up together in the same bundle and, while every serious disease will affect our self-perception, one that involves our feminine organs even more so. Yet, doctors don’t talk about it – at least not according to my very informal chats with friends and patients I have come across on my shifts. Plenty of classes are available to chemo patients on how to ameliorate one’s self-appearance but nothing on topics that are more personal and less visible.
It becomes a word of mouth chain among those who have been through it, who have seen their libido dip once they start taking certain estrogen suppressants, or experience a crippling vaginismus, and sometimes imperfect information is spread around.
Because I am curious, big-mouthed and unself-conscious in matters of sex, I prodded all my doctors for information on possible side-effects of medications on sexuality: I got fairly scant answers. “It’s unlikely. Very few patients report them. You can buy a lubricant” were some of the unhelpful answers I got. The booklet I discovered in the hospital library was much more helpful and prompted me to do my own research that culminated in a very informative lecture by a doctor that specializes in such problems.
In the end, I haven’t experienced any of the possible side-effects. Still, I went in able to deal with anything that could come up, without being blindsided. Just because we should be grateful to have emerged from the tunnel of disease fairly unscathed, we shouldn’t be made to feel as if our concerns for sex and appearance don’t matter.
Now I am waging a different type of battle: I push my doctors to come up with better answers; to give patients an opening in case they want to talk about it; and I am working with the hospital case manager to make this type of information more readily available. Because word of mouth and girlfriends’ networks are wonderful but when it comes to medical information we should have access to what is relevant, scientific and true without having to dig.
IN MATTERS OF BRAS POST SURGERY
I transitioned from the hospital issued bra to a sports one, zipped in the front and fairly sturdy.
At the beginning, it’s easier to use bras that open in the front because the arm on the side of the surgery is pretty useless. You want soft and supportive.
Subsequently, anything very soft and clingy is your best bet – Uniqlo was one of my better finds. If a large chunk of tissue was removed, bras that have removable padding might be your best option for an even look.
During radiation, at times a bra was out of the question: too excruciating on the burnt skin so I resorted to wearing camisoles or tank tops.
Underwire bras are impossible for the first six months.
The offerings on sites that specialize in garments for breast cancer patients are pretty sad-looking. This is an entrepreneurial woman who understood the problem and is trying to do something about it.
If you wish to know more on how to obtain information on how medication or surgery can affect your sexuality, feel free to write me privately and I will point you in a few directions that were helpful to me (use the contact form or firstname.lastname@example.org).