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Sexuality and Intimacy
Lisa Donley


Lisa Donley has run the Psycho Social Services for Breastlink for
the past 10 years. She has provided huge support and helped
devise useful and practical solutions for our patients and their
partners and families.

"For it was not into my ear you whispered, but into my heart. It
was not my lips you kissed, but my soul." Judy Garland

There are many obvious challenges resulting from a breast cancer
diagnosis. One of the most compelling surrounds intimacy and
sexuality. Because there are so many factors which impact
intimate and, more specifically, sexual satisfaction, we
encourage each patient to actively pursue intimacy in a manner
that feels appropriate to her at each stage of diagnosis and
treatment. The first step in this process is to identify how each
patient feels about herself, not only in her altered body image
but also how she thinks and feels about the integrity and meaning
of her journey with breast cancer, her self-esteem and sense of
self-worth. Intimacy requires self-disclosure – the experience of
being able to “stand naked” –physically, emotionally, mentally
and spiritually, first with self, and then with a partner.

Each patient must answer the question: “How has breast cancer
impacted on my sense of myself as a whole as well as my sense of
my sexuality?”

Each partner must ask: “How has the experience of loving my
wife/partner with breast cancer, altered me as a person and
challenged my ability to be intimate, not only sexually, but
emotionally, mentally and spiritually?”

The answers to these questions form the relationship foundation
for the ongoing “post-breast cancer” partner-to-partner dialogue
which is essential to reclaiming intimacy and which is the
prelude to sexual contact. Having identified the manner in which
the cancer diagnosis has impacted on her relationship to self,
each patient will then decide how and in what manner she
approaches her partner with her concerns and desires. Each
partner will also identify the changes in themself and their
partner and have the opportunity to choose how and when they
initiate dialogue around their concerns and desires. Because
intimacy is as unique as each person, there are an infinite
number of ways for patients and their partners to reclaim and
renew their intimacy after breast cancer.

Critical junctures and questions in the process of intimacy
renewal include:

The patient pre-diagnosis feelings about her body and sexual
satisfaction.

The patient’s post-diagnosis and treatment feelings about her
body and the impact on her ability to pursue the level of
intimate and sexual relationship that she desires;
The patient’s ability to communicate her thoughts, feelings and
needs, both generally and specifically as they impact sexual
functioning.

An honest and open identification and communication of fears
associated with sexual contact for both the patient and her
partner.

A plan of approach which may be mutual or individual, depending
on each patient and partner. For example, some patients prefer to
view and touch their altered body alone first, to have time to
explore and understand the way in which treatment has impacted on
them. Others prefer to have their partner join with them, to
touch or to see them first, and to engage in a mutual
exploration. Some treatments result in premature menopause which
may lead to hot flashes, diminished libido and decreased vaginal
lubrication. There are both medical and psychosexual
interventions which may help to alleviate some of this distress
and encourage the ongoing re-discovery. Your treatment team
should be concerned and available to assist in resolving your
specific concerns related to this process. This is a time and
opportunity for partners to approach each other – without
expectation and with a renewed sense of exploration and
creativity.


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Having Better Marriages & Relationships

Women's Issues & Women's Health

Better Sex & Sexuality Issues

Our Health and Wellness Center