Man! It’s hard to feel sexy when you have cancer.

Picture the scene: Your partner gives you the let’s get frisky look. They start petting you in the way you are normally into. The sexy dance has started. The lights are dimmed aaaaaaand……nothing. You are laying there all bald and post chemo( well it has been a few days but you get the idea), fresh off your latest chemo hot flash, tired, bloated and not the least bit sexy….in your mind. You just aren’t up for it. It’s not you. It definitely isn’t your partner. It’s the freakin absence of sexiness that sometimes comes with cancer and chemo. I tell ya, the changes in appearance alone are a real confidence killer at times. My husband is the most amazing partner and best friend on the planet and regular me can’t get enough of him. But, cancer me is another story.

Cancer and cancer treatment can have a very significant impact on a woman’s sexuality in many ways. Disfiguring surgery may be required that can significantly affect your self esteem and confidence. Treatments can sometimes put you into premature menopause with hot flashes, vaginal dryness, pain with intercourse and decreased libido. Certain pelvic cancers require such extensive surgery, radiation, etc that a woman is left without proper function of her sexual organs permanently.

I get it, this sounds all doom and gloomy. The good news is that not all women are left with permanent sexual dysfunction after cancer. Sometimes the effects are temporary and things go back to normal when treatment is over. I am seriously hoping that I fall into this category.

Fortunately the data shows that if a woman was able to have satisfactory sexual experiences before cancer, she will be able to again. The American Cancer Society has a whole section of helpful tips and information for women who are having sexual issues resulting from cancer treatment. Some of these are in fact very helpful. The bottom line of all of them is that sometimes you have to get creative and you have to reinvest in your own self-love and confidence. Sometimes the same techniques for sexual satisfaction that you used before will not be successful anymore. You might not even have the same parts anymore. You may have to use more lubricant when you didn’t have to before. You may have to explore different things that excite you. You may require a vibrator for extra stimulation. You may need to try different positions. You may need to employ more fantasies into your sexual relationships. You may need dilator therapy to re-stretch the vaginal canal. These are just a couple of examples.

There is an interesting set of exercises recommended by the American Cancer Society for patients feeling anxious about sex and the way that their appearance has changed and adjusting to those changes. They suggest looking in the mirror, dressed at first, and noting the changes in your appearance: your surgical scars, ostomies, missing parts, etc. Then notice what you try to avoid looking at. Then while dressed, try to find three things that you like about your appearance. Once you are comfortable looking at yourself as a stranger might see you, then change the exercise and repeat it with you being dressed “sexy” for your partner. Finally, repeat the exercise nude with the same steps until you are able to look at yourself and adjust to the changes and feel comfortable. Don’t stop until you can give yourself 3 compliments like you did in phase one of the exercises.

The last thing to address regarding the impact of cancer on sexuality is the anxiety that goes along with it. It takes time to realize even when treatment is over that you are actually better and that life can go on, including sex. Clear communication is the absolutely paramount here. Talk openly with your partner about your fears and issues. Don’t leave them in the dark and just reject them. They can’t possibly understand what is going on in your head unless you tell them. Get therapy if you need to. Talk openly with your doctors. You be the one to bring it up. I can tell you right now that most physicians are not comfortable enough to make sure to address sexual issues at any time, much less with their cancer patients. This will be something that you really need to take charge of and advocate for if you want things to change and improve. As much as we try to deny it at time, our sexuality and sexual health are key components to our relationships and overall health. Sex is just as important for cancer patients as it is for every day folks. So, do what you can to preserve it. It’s for your health!

Dr. Katz

Listen to the WHO

Hey everybody! Show of hands…who is stressed out right now?…..Ok yes. I see all of your hands….and that is perfectly NORMAL right now. We just don’t want to convert that stress into panic and do something stupid. So, let’s look at some advice on how to not let that happen. The WHO(World Health Organization) Director-General Tedros Adhanom Ghebreyesus said it best during a daily press briefing on COVID-19 at the WHO headquarters in Geneva on March 11th. He was giving out tips on how to stay physically and mentally healthy while living under quarantine. His advice was simple and did not involve any rocket science….Don’t smoke, limit alcohol, exercise and try not to watch too much news!

Actually, he broke it down even further. Let’s go over it. Remember this is right from the WHO so I feel like we can trust it. I will add some of my personal touches as well.

Eat healthy to boost your immune system. Now is not the time to max out on junk food in a nervous binge. I have been fighting this myself. I have also turned to my favorite Amazing Grass Immunity Blend for a little extra immune support.

Limit alcohol and sugary drinks. Particularly avoid sugar alcohols like maltitol. Your body cannot really digest most of them. With regard to alcohol, you have to remember that your body reacts to it essentially as a toxin and devotes all it’s energy into getting rid of it. You just don’t need the extra stress on your body right now. Ok. I get it. Drinking some alcohol may be part of your stress reduction plan right now, but I would advise you to at least keep it in moderation ( A drink or two at most). The term sugary drinks refers to any beverage with added sugar or other sweetener like high fructose corn syrup, sucrose, etc. This includes soda, pop, cola, fruit punch, lemonade, powdered drinks and sports drinks. According to the T Chan School of Public Health at Harvard University, these add calories only and increase your risk of type 2 diabetes, heart disease and other chronic disease. Really, your body does not need the extra stress right now. Save money! Drink water!

Don’t smoke. It can make COVID symptoms worse and increase your chances of getting really sick. I get it. The number of nicotine addicts in the world has not suddenly decreased and this may not be realistic for everybody, but try your best. This includes vaping and Juuling btw.

Exercise at least 30 minutes a day for adults and an hour a day for kids. Make sure it gets your heart rate up and your blood pumping. Physical activity can hep flush bacteria and viruses out of the lungs more quickly. Exercise causes changes in white blood cells and antibodies. These are key elements in fighting infection. The brief rise in body temperature during and right after exercise may help fight bacteria. This is similar to what happens when you have a fever. Also, exercise slows the release of stress hormones.

If you are allowed outside, go for a walk, go for a run or go for a bike ride…remember to keep a safe distance from others ( 6 feet is the magic number for now). Social distancing is very important right now. The concept of social distancing is deliberately increasing the physical space between people to avoid spreading illness. Staying at least six feet away from other people decreases your chances of catching COVID. Remember that the biggest reason for trying to practice preventative measures now is to decrease the spread of the virus and hopefully not overwhelm the healthcare system to the point that we have to turn away people for treatment like other countries have had to do.

If you are not allowed outside, run the stairs, dance, do some yoga. I am going to add pull out an ancient exercise dvd or the Wii and get playing! There are a startling amount of free exercise and dance classes on the internet right now. Take advantage of it! They won’t be free forever.

Attention to everybody working from home! Don’t sit too long in one position. Get up every 30 minutes or so and stretch and change position to keep your circulation moving.

Take a 3 minute break every 30 minutes…and I don’t mean a 30 minute break to watch the news!

Get your mind off of all this crisis. Find your spot of zen. Listen to music. Read a book. Play a game. Light a candle. Meditate. You are probably saying right now meditate? I don’t know how to meditate! Let me let you in on a little secret. There is no right or wrong way to meditate. The definition of meditation is to think deeply or focus one’s mind for a period of time, in silence or with the aid of chanting, for religious or spiritual purposes or as a method of relaxation. If you are finding yourself too much a newbie to get started, may I suggest the apps Calm or Headspace. They are pretty amazing.

Be aware of what is going on in the world, enough to know what restrictions etc are necessary, but don’t watch the news incessantly enough to freak yourself out. If you do tune it for an update, tune in to a reliable source like the WHO or the CDC, not your neighbor or the latest Facebook messenger forward that you cannot verify. I have gotten countless forwards from unverifiable sources. These are all from well-meaning people just passing it on, but really all they are doing are making me more anxious. Tedros suggests that you check in maybe once or twice a day, again, only to reliable sources.

I just wanted to put together some ideas and include the reasoning behind them. I think that too often lately we are just barking out instructions and people are either listening to them or balking at them, but not really understanding the “whys.” Hopefully, this will help. I often find that it is easier to follow through with something if you understand why you are doing it.

Dr. Katz