As an oncologist who also specializes in sexual health, I have realized just how essential it can be. I have seen many grapple with the consequences of cancer and its treatment on their own sexual view of themselves (their sexual self-schema) and how it can impact the relationship between partners. For some, the experience draws them closer; for others, it creates more challenges. I have learned that the latter is especially true for those with metastatic disease.
Such was the case with Joanna* and her husband, Scott*. Joanna was in her 30s when she was diagnosed with breast cancer, and by 41, she had been living with metastatic disease. Before her cancer, the couple had enjoyed what they considered a “normal” sex life: fulfilling and enjoyable, even after so many years together. With her first diagnosis, they had held on to their sex life and navigated intercourse through chemotherapy and endocrine treatment.
But, then the cancer spread, and her health had suffered. In recent months, she was hospitalized three times — first for a pulmonary embolus (“It felt like I couldn’t breathe — I thought it was the end,” she told me), then for a severe infection, and more recently because of seizures (due, they would later find, to brain metastases). Each time she made it back home from the hospital, and when she felt well, she was determined to resume some semblance of a normal existence: making dinner (although she hadn’t much of an appetite), reading with her daughter at night, and watching movies with her husband.
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