Some of you may be fans of the cable television series, "The Big C. In its second season, it tells the story of Cathy Jamison, a woman in her 40s who's diagnosed with stage IV melanoma. Cancer turns her from a staid, conventional woman into a free spirit, getting the most from each day, even though she's often sad and afraid.
In a recent episode titled "Sexual Healing," the show explored the relationship between Cathy and her husband, Paul. She's about to enter a clinical trial and is feeling exhausted. Paul keeps busy giving her shots and preparing healthy, but inedible food. Meanwhile, their sex life is headed out the window.
Paul tells Cathy that he doesn't miss sex, but the next day catches him masturbating while looking at a lingerie catalog. The truth comes out -- Paul is feeling very sexually frustrated.
Cathy's solution is to make up a sexual fantasy for Paul, only to turn herself on. They end up having a great mutual encounter.
The storyline does a good job of showing how partners can slip into a nurse/patient relationship that makes it very difficult to feel like lovers. Another realistic theme is the extra effort it takes, both in terms of making time and sometimes trying something new together, to find intimacy in the midst of feeling tired, scared and sick.
Finding the feeling
For many years, my colleagues and I at MD Anderson have urged people going through cancer treatment to continue to make time for intimacy. Sometimes, that may mean exchanging back rubs or cuddling on the couch, or just taking a walk while holding hands.
Sexual problems caused by cancer treatment can easily turn lovemaking into work. A man feels anxious and ashamed that he can't get or keep a firm erection. A woman is surprised when her usual sexual routine leaves her vagina dry, so that having intercourse is painful rather than pleasant.
We can often improve those sexual problems with a pill, shot or the right combination of vaginal moisturizers and lubricants. However, too few of the men and women we treat for cancer get the information that could help them stay sexually active, rather than giving up.
Why does intimacy matter now?
Why is it important to keep your sex life going during and after cancer treatment? Sexual pleasure reminds us that we're alive and vital. It also helps a couple feel emotionally close at a time when illness can divide them.
There's also growing evidence that our sexual organs stay healthier if they get some exercise. When men have radical surgery for prostate cancer, they're more likely to recover firm erections if they use a medical treatment to get an erection every few days. The tissue inside the penis needs fresh oxygen so that the tiny blood vessels can stay healthy and the spongy tissue in the shaft can keep its ability to stretch as blood fills it during erection. Men who aren't sexually active after surgery may be more likely to notice a loss of penis size.
We don't know if a similar process happens in women, but it would not be surprising. When women get sexually excited, the vagina gets as much as one-third deeper, and the cells lining it produce the clear fluid that makes sex comfortable. These processes, like an erection, are triggered as blood rushes into the genital area.
So, don't forget your sexual healing as you recover from your cancer treatment. Rather than worrying about erections or orgasms, set the goal of having good feelings in your body and giving pleasure to your partner.