The Lovin' Ain't Over for Women with Cancer

By Ralph Alterowitz, Barbara Alterowitz and Joycelyn Elders M.D.

The Lovin' Ain't Over for Women with Cancer takes a frank and open approach to discussing the issues with sexuality and intimacy that many women experience after undergoing cancer treatment. It guides women and their partners with facts, knowledge and techniques that have worked for other women, and strategies recommended by top health professionals.

The book takes a holistic view of creating a good sex life after female cancer treatment. It recognizes that a strong sense of self, and good communication between the partners, are essential to a happy and satisfying sexual experience, and gives pointers and examples to help on that path. It provides facts about women's bodies and sexual function, and the effects of cancer therapies. It covers information about aids and medications in understandable language. It contains many practical suggestions and examples from women who have gone through the experience of breast and gynecological cancers, and strategies recommended by top sexual health professionals.

• Language: English
• Publisher: eBookIt.com
• Release date: Apr 26, 2016
• ISBN: 9781456604134

Book preview

Advance Praise for The Lovin’ Ain’t Over for Women with Cancer

I am a prostate cancer survivor. Seven years ago I lost my wife of 47 years to breast cancer. I am no stranger to this disease and its consequences to all aspects of one's life.

This book treats matters that doctors, therapists, and friends rarely want to touch. It deals with preserving intimacy, and all the support that flows from a loving relationship, for women who are recovering from cancer therapy. The authors provide the knowledge and inspiration for patients and their significant others to defeat this disease by resuming a fulfilling life. Read it!

—Jess Rifkind

Los Angeles, CA

All the questions you are afraid to ask about your sex life after cancer are answered in The Lovin’ Ain’t Over for Women with Cancer. Praise to Ralph and Barbara for providing women, their partners, and the healing professionals who treat them with a complete guide to reclaiming, relearning, & rediscovering intimacy and sexuality after cancer. This book is a remarkable resource that contains the information you will need to take you from living on the edge after cancer to a new and exciting normal!

—Patti L. Renko, MSW, LCSW-C

Sex-cessful Relationships & Psychotherapy, LLC

Woman, sister, friend, survivor

Ellicott City, MD

Helping women cancer survivors find their ‘new normal’ in their intimate life has finally found a voice. Ralph and Barbara Alterowitz offer practical, down to earth information combined with caring and compassion. Because they survived the effects of cancer in their own sexual life as a couple, they understand the need for practical and meaningful information. Through this well-researched, sensitive and helpful book, they are helping so many survivors reclaim and revive their sexual selves.

—Paula Plona, ACSW, OSW-C

Oncology Social Worker, Payson Center for Cancer Care

Concord Hospital, Concord, NH

Intimate, imaginative, inspiring and informative! An engaging, empathic yet practical, hands-on guide to making love again after a woman gets cancer. How-to manuals don’t get better than this! It’s a must-read for women and men alike.

—Rabbi Ed Weinsberg, EdD, DD, author of Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life

Sarasota, FL

This is a very empowering book for women dealing with breast cancer and their partners. It provides a myriad of information and resources, but more importantly it encourages women and couples to value intimacy, touching, and sexuality during and after their cancer treatment. The authors discuss in detail psychological, biological, and relational factors which promote healthy sexuality after cancer, and they urge women to own their bodies, rather than their body and sexuality being controlled by the disease and treatment. The empowering message is you can live a quality, satisfying intimate and erotic life during and after cancer treatment. Strongly recommended.

—Barry McCarthy, Ph.D.

Washington Psychological Center, P.C.

Professor of Psychology, American University, Wasington, D.C.

Author of Rekindling Desire, Discovering Your Couple Sexual Style and other books on sexuality

The Lovin’ Ain’t Over for Women with Cancer is encouraging, comprehensive, holistic, and positive. It even made me feel less anxious about the possibility of me or my family getting it (g-d forbid). The book is exceptionally well organized. I love that it covers such a holistic approach. The newest Alterowitz book is a one-of-a-kind support for female cancer survivors. It is really inspiring.

—Mieke R. Sidorsky, LSW, Sex Therapist

Silver Spring, MD

Generally, sexual life is not evaluated in the medical setting. When there is a disease like cancer, the attention is focused on the physical aspects of the patients, and the evaluation and treatment of the disease.

Ralph and Barbara Alterowitz pay attention to the importance of self-esteem and of intimacy in a relationship. I recommend the reading of this book to any person who suffers from cancer and to their partner. This book is an essential reference for primary physicians, nurses and all people involved in the care of cancer patients.

—Isbelia Segnini MS C-AASECT

Clinic Psychologist - Sexologist - Marital Therapist

Policlínica Santiago de León

Caracas, Edo. Miranda, Venezuela

This book is an asset for the woman who is interested in regaining her sexuality and intimacy after cancer. It is a thoughtful resource guide. This book will help the lives of patients and their partners through awareness of the assessment and treatment process coupled with the knowledge of the physical, psychological, medical and surgical causes of sexual problems. This book is clear and meaningful, not only about living with cancer, but more importantly about reclaiming a loving sensual and intimate life!

—Michael Krychman MD

Executive Director

Southern California Center for Sexual Health and Survivorship Medicine, Newport Beach

AASECT Certified Sexual Counselor

Associate Clinical Attending USC, Los Angeles, CA

Associate Clinical Attending UCI, Irvine, CA

What a find! The Alterowitzes offer an easy to read, comprehensive and frank guide to the female cancer survivor and partner. As more and more medical advances and openness about cancer mean that there are more and more persons who survive and go on to lead productive lives, the need for this resource is wide spread. But the resource is also pertinent for anyone living with ongoing health concerns. I encourage any person in a helping profession—medical, pastoral, or counseling—to include this valuable resource in your library, and its information in your head.

—Youtha C. Hardman-Cromwell

Assistant Dean

Wesley Seminary at Mount Vernon Square

908 Massachusetts Avenue NW

Washington DC 20001

The Lovin’ Ain’t Over for Women with Cancer

Ralph and Barbara Alterowitz

The material provided in The Lovin’ Ain’t Over for Women with Cancer is for informational purposes only. The information contained in this book is not intended as a substitute for medical advice; it does not endorse any products. All matters pertaining to your mental and physical health should be supervised by a health care provider. The authors and publisher shall have neither liability nor responsibility to any person or entity with respect to any loss, damage, or injury caused, directly or indirectly, by the use of the information contained in this book.

Names of survivors and partners mentioned in this book have been changed to protect their confidentiality.

Every reasonable effort has been made to trace the sources of materials in this book, but in some instances this has proven impossible. The authors and publisher will be glad to receive information leading to more complete acknowledgements in subsequent printings of the book and in the meantime extend their apologies for any omissions.

Published by CIACT, Inc. Publishing.

This work is subject to copyright. All rights reserved. Except in a review or critical articles, the reproduction or utilization of this work in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including xerography, photocopying, and recording, and any information storage and retrieval system, is forbidden without permission of the publisher. For permission requests or further information, address CIACT, Inc. Publishing, P.O. Box 341388, Bethesda, MD 20827-1388.

Copyright 2011 Ralph and Barbara Alterowitz,

All rights reserved.

Published in eBook format by CIACT, Inc.

Converted by http://www.eBookIt.com

ISBN-13: 978-1-4566-0413-4

Foreword

It is an honor to contribute to this marvelous book. I write with the enthusiasm of a person who needs this book to refer to many friends and family who have received a diagnosis of cancer. Also, it is helpful to all of us as we age - including me! This book can help anyone to explore in depth the options available to satisfy sexual longings and enhance intimacy in a relationship.

Ralph and Barbara Alterowitz write with the ease and knowledge of those who have made the journey from cancer diagnosis to a positive change in their spousal relationship. The journey requires the kind of knowledge, understanding and caring that is obviously present in this much-needed book.

Each year, hundreds of thousands of women receive the shocking diagnosis of cancer. Just hearing it can burn in your ears until nothing else can be heard or felt. The dreaded C word brings with it another dreaded C word - change. Who can remain unchanged after receiving a diagnosis of cancer? However, most will find that their view of living can be adapted to suit the new normal Ralph and Barbara so vividly describe, which eventually comes after the diagnosis and treatment.

It is accurate to say that we are sexual beings from birth to death. As we move past inexhaustible adolescent sexuality, changes usually come slowly, until we realize one day that even when the spirit is willing the body may not be cooperating - whether from surgery, aging, medication or some other factor. While change is inevitable in ordinary living, cancer brings a special realization of imminent change that can be used by a couple to have a positive impact on their relationship.

When the immediate shock of the diagnosis subsides, questions emerge concerning mortality, image to others and self-image. You might ask, Will my partner still be attracted to me? Is this the end to sex? Since I’m not going to die right away, what will my life be like? To answer these questions and many more, invaluable information from people who have been where you are now is available in The Lovin’ Ain’t Over for Women with Cancer.

A cancer diagnosis may be received by a woman of any age, in or out of a relationship, and in any sort of relationship. Whoever you are and no matter what your situation may be, you will be able to find yourself in this book. The Lovin’ Ain’t Over for Women with Cancer can be viewed as a guide to better living through making informed choices regarding your relationships as well as by maneuvering some of the choices during treatment.

While loving sexual relationships are rife with ups and downs, scary emotions and angst, they are also a great source of security, bonding and fulfilling emotions. As the authors write, Good loving is the physical expression of emotional intimacy, and there are few humans who do not want or need emotional intimacy. How do you get there after cancer? The answer, Good humor and information help, is a tip from the authors.

How do you keep up relationships with friends, acquaintances and intimate partners during and after cancer treatments? The dreaded C words - cancer and change - can be dealt with via a good C word - communication. Communication that delivers confidence, closeness and understanding is a key to all good relationships.

While this book is intended to be mostly about relationships following a cancer diagnosis, Barbara and Ralph offer numerous tips throughout the book for anyone facing treatment for cancer.

Finally, this book is not only for the person who has received a diagnosis of cancer, it is also for your partner, because together you can strengthen your relationship while learning about how best to make this journey.

Ignorance is never bliss; knowledge is a light that obliterates ignorance and paves the way to better choices and a fulfilling life.

Joycelyn Elders, M.D.

Former Surgeon General of the United States

Preface

Cancer throws a woman off balance. Quite often, it also changes her relationship with her spouse or significant other, including their sex life. For single women, a change in sexual function after cancer treatment can potentially affect future relationships. But cancer does not have to mean the end of a healthy and happy love life. You can rebuild a strong and vibrant sexual relationship - and that is such an important part of our human experience and of a couple’s bond.

We have lived this experience of survivorship and rebuilding intimacy, albeit in our case, the cancer patient was Ralph. His treatment for prostate cancer caused sexual dysfunction and, at the same time, threw us into a world of survivors and support groups. Along the course of this journey, we discovered that the great undocumented - and misunderstood - topic for prostate cancer survivors was sex. We were not the only couple trying to figure out sex after cancer! Over the next few years, we researched, studied and became certified sexuality counselors. We brought the subject out into the open and wrote The Lovin’Ain’t Over: The Couple’s Guide to Better Sex After Prostate Disease, the pioneering guidebook for couples on renewing their intimate life after prostate cancer surgery. Many couples told us that the book helped them create a greater level of intimacy than they had expected, one possibly even more satisfying than what they had enjoyed before the partner’s cancer. Encouraged by this feedback, and by the success of the book, in 2004 Da Capo Press asked us to update it and published Intimacy with Impotence: The Couple’s Guide to Better Sex After Prostate Disease.

After many of our prostate cancer support group sessions, we had women participants come up to us to say that major female cancers can have just as profound an impact on women’s sexuality as prostate cancer can have on men. Many women whose male partners had survived prostate cancer had had their own bouts with breast or gynecological cancers, or had friends who went through this experience. They said it was just as necessary to provide women with information about sexuality after women’s cancers as it was for male cancers, and urged us to research and publish our findings. They also asked us to keep our focus on the whole person and whole couple - the physical mechanics of sex, the psychological aspects of intimacy, and the dynamics of both partner/partner and patient/practitioner discussions. We have done exactly that in this new book in the The Lovin’Ain’t Over series.

The Lovin’ Ain’t Over for Women with Cancer takes a holistic view of creating a good sex life after female cancer treatment. It recognizes that a strong sense of self, and good communication between the partners, are essential to a happy and satisfying sexual experience, and gives pointers and examples to help on that path. It provides facts about women’s bodies and sexual function, and the effects of cancer therapies. It covers information about aids and medications in understandable language. It contains many practical suggestions and examples from women who have gone through the experience of breast and gynecological cancers, and strategies recommended by top sexual health professionals. The goal is to help readers cope and take the necessary action to make their sex lives as vibrant, vital, and fulfilling as they would like.

Each chapter provides women and their partners with information and options. In plain, frank language, we offer a reader-friendly, proactive, practical, and optimistic guide for women and couples struggling with sexual difficulties after cancer.

Our aim is to help you understand the facts and be aware of your options regarding the renewal of intimacy after struggling with the physical, emotional, and psychological impact of diagnosis and treatment. With this information, a woman or couple will have tools at their disposal to overcome the challenges. You can use this content to create your personal path to reinvigorating your love life.

We wish we had such a guide to give us facts, ideas and approaches when we worked through the process of rebuilding our own sexual relationship. We went through much trial and error, and it took a while to regain our balance as a couple. We hope The Lovin’ Ain’t Over for Women with Cancer helps you get back on track faster. It will still take some time to figure out what works best for you - but you know it can be done! And there is nothing more wonderful than making love with gusto and feeling deeply connected to the person you love. It’s life affirming and love affirming.

If you would like more help, you may want to seek out a sex therapist or counselor. Our sexuality counseling services are available through our non-profit organization, The Center for Intimacy After Cancer Therapy Inc. (C-I-ACT), www.renewintimacy.org.

We hope you will find this book helpful and that you will tell others about it, as well as write a review on our and other websites. Your comments and questions are important to us, and are very welcome. Note that there is a feedback form on the website. Also, please consider a tax-deductible donation to C-I-ACT, Inc. (P.O. Box 34 1388, Bethesda, MD 20827-1388) so that we can continue developing materials and programs for patients and cancer couples.

Thank you, and best wishes for a happy and healthy life!

Ralph and Barbara Alterowitz

Potomac, Maryland

March 2011

Chapter 1

Cancer and The New Woman

My hair was my crowning glory. The first thing people often mentioned after they met me was that I had beautiful hair. So you can understand how freaked out I was when I saw a big clump in my hand while showering. This was the moment I had dreaded. I had gotten somewhat complacent because it had not happened after so much therapy. Other women in the support group kept saying it would happen.

But I was prepared. After the first clump came out, I bought two wigs. It didn’t make me feel better about losing my hair, but I was determined to look good, hair or no hair.

Feeling good about how I looked with my wig lasted for a few days. The wigs were uncomfortable and hot. I was suffering while trying to look cool, as the kids would say. Before the breast cancer, summer temperatures in Virginia had forced me to run for air conditioning whenever I could. Now with this rug on my head, and that’s what it felt like, I was perspiring all the time.

It suddenly hit me that I was doing this for others, not for myself. I felt good about me. That’s what mattered. I was respected in the work world, had a loving family, and so on. So, even though I had said that I would never let anyone see me bald, I tossed the wigs in the closet. I felt freer than ever in my life. With the wigs went a lot of fears. I saw the breast cancer as a sort of signal, the beginning of an open road. It was an opportunity to reshape my life. I began to think about things that I’d never done. It’s like opening a new life book. I’ve gotten the message to give myself the freedom to do new things even if there are some risks that they won’t work out. What a feeling!

Janice (the names of all women quoted about their personal experience as cancer survivors have been changed to protect privacy)

The New Normal. Some call it a mantra, but the phrase seems to aptly characterize many women’s post-cancer-therapy phase of life. Life will never be exactly as it was before, and many aspects of themselves and their lives now need to be redrawn, revised, or even created anew. While some of these women have not even completed their treatment - usually chemotherapy - their declaration of I am not the same as I was is a notice to the world to be prepared for dealing with a changed and often renewed person.

The New Normal can come at any time. Thoughts and feelings, and just things going on around her, can prompt a woman to notice that although many aspects of her life seem to be the same as before cancer, there are distinct differences. The Old Normal and the New Normal now need to be meshed to form a new and different whole.

The experience of cancer creates an opportunity for a woman to stop and think about her objectives and her needs, about what she expects her future quality of life to be. Cancer means change, and change can be both frightening and invigorating. As they go through the experience of cancer diagnosis and treatment, many women feel that they get to know themselves much better. They have a reason to step back and think about their lives and how they would like to reshape them.

Hundreds of thousands of women annually go through the shock of receiving a diagnosis of cancer. Suddenly, they must make decisions about therapy, and then fight to achieve a desired quality of life. Cancer therapy affects everything.

Where do intimacy and sexuality, key components of quality of life, fit in? Part of a woman’s cancer journey consists of rebuilding her love life. And energizing or reviving intimacy and sexuality in a relationship requires the partners to work together.

According to Barry McCarthy, Ph.D., Professor of Psychology at American University, when sexuality functions well, it is a positive and significant part of a relationship. Sexuality energizes, strengthens, and makes the marriage bond special. However, when sexuality is dysfunctional, it has a powerful negative effect, robbing the relationship of vitality, closeness, and intimacy. Intimacy is especially crucial for couples dealing with cancer, and merits special attention.

Both intimacy and sex involve people opening themselves to others, presenting themselves through their thoughts, ideas, and behaviors. The total person appears, which is the basis for intimacy. Intimacy may evolve into its sexual dimension to provide satisfaction and a sensation of physical and emotional connection. Sharing sexuality is the most intimate experience two people can have.

Sexuality reflects and is a part of a person’s total health and quality of life. Sex expresses both partners’ emotional states, the health of the partners, their physical environment, each partner’s view of her- or himself, the nature of their relationship, and the quality of the relationship. Cancer treatment changes sexuality in many ways. It can change mental orientation and the way the body functions as it concerns sex, and can create physical changes that may affect the way a woman makes love.

A good sex experience is complex. Even healthy couples that are madly in love can’t expect a great experience every time they make love. When cancer is added to the mix, in addition to the physical effects of therapy, the entire experience changes.

Relationships After Cancer

A loving environment all day long sets the stage for good sex, and the pleasure of sex is heightened by feelings of love and intimacy. Both partners should be in the mood, bring high emotional content into the physical interaction, have intensity, and be creative.

Sex is possible without these things. But good sex happens when all these factors come together. Making love is no different than playing a sport, singing, or performing on a musical instrument. If everything is just right, it can be great. When one partner is out of sorts, tired, or distracted by a crisis, sex can feel just so-so. It can prompt the question, Why did we bother? If this happens merely once in a while, it is not a problem. But if it happens most of the time or all the time, it is a serious issue.

A cancer diagnosis may alter a woman’s self-image and often changes the balance between partners. After working through the battery of cancer tests and determining her therapy, a woman may wonder if she will still be desirable. She might even wonder, Will I still be a woman?

The assault of cancer treatment often leaves a woman with physical changes, and almost surely leaves her psychologically affected. As a result, some women shy away from sexually connecting with their partner. On the other hand, some women, like Christie, believe their partner needs to be taken care of and put sex on their schedule regardless of their personal desire. Christie said that she thought she would address her own sexual needs after she completed her chemotherapy. But for her, making sure her husband’s needs were met was a priority even throughout her therapy. He showed his appreciation by being caring and considerate during loving - and in everyday life. This mutually supportive relationship enabled them to keep their sexual relationship alive even during treatment.

As they go through therapy, many women take steps to redefine their future. They shape their world by initiating changes in their relationships and in the face they present to the outside world. Throwing away their wigs, as Janice did, says This is me, and Here I am.

A diagnosis of cancer may reveal tensions that have existed in a relationship for a long time.