Licensed social worker Gail Hamm, who is certified in oncology social work, knows from talking with clients and physicians how cancer treatments and surgeries, particularly for gynecological, breast, bladder and prostate cancers, can affect sexual function and desire, body image, hormones, mood, energy and emotions.
“I've been wanting the agency to offer something on sexuality,” said Hamm, Cancer Services' clinical director. “The need is there. It's underground. People don't know how to talk about it. We call them our private parts, for crying out loud.” In general, people have difficulty talking about their bodies and sex in healthy, helpful ways. Cancer adds an additional layer of reluctance, secrecy and communication issues.
CANCER'S HEAVY TOLL
An estimated 1.7 million new U.S. cases of cancer will be diagnosed this year, including nearly 36,000 in Indiana, according to the American Cancer Society. The good news is 5-year cancer survival rates have risen nearly 40 percent in the past several decades, thanks to new drugs and therapies, surgical advances and earlier diagnoses. However, cancer and its treatment can have temporary and sometimes lifelong effects on the individual physically, emotionally and marriage-wise.
A study published in 2009 in the journal Cancer revealed the divorce rate for a woman diagnosed with a serious disease is nearly double that of women in the general population.
Treatment side effects such as dryness and scarring in the genital tract can make intercourse painful, said Dr. Frances Esguerra with Women's Health Advantage. Lubricant products and dilators can help. Devices are available to help women achieve orgasm and for men who can no longer get an erection on their own.
But treatment side effects are not just physical, Esguerra said, noting, “It can lead to mood disorders and depression.” Problem-solving requires communication between the patient and healthcare provider and between the individual and their spouse or partner. “Sexual health is important to overall health and wellbeing. The best thing is going to be education.”
Jen Fecher, who holds a teaching degree and has four children, teaches in and manages Boudoir Noir's School of Loving Arts (SOLA). SOLA already had in place most of what Cancer Services was seeking to offer. Men and women are sometimes referred by their healthcare providers to the store for products and devices which are less costly than if purchased from a pharmacy. Boudoir Noir staff also have ongoing training in explaining products in a relaxed, non-clinical setting, Fecher said, pointing out, “We are knowledgeable and professional, but we also want to make it fun.”
While fun is not associated with cancer, when energy begins to return and the cloud of cancer is not all-consuming, putting some fun back into life is the best prescription.
SEXUAL INTIMACY'S SPECTRUM
Though cancer surgery and treatments may change the way an individual can experience sexual intimacy, it is important people realize “There are so many different ways to be intimate. It starts with trust and communication.” Intercourse is not the only way.
Fear of embarrassment, personality, and home and religious upbringing impact a person's comfort level in seeking help for what is a God-given, natural part of life. Imagine the man, a prostate cancer survivor, who goes to his neighborhood pharmacy to fill a prescription for a penis pump. Though it was demonstrated in the doctor's office and he watched a video about how to use it, he isn't sure he remembers and is wondering if he can use it at home. When the pharmacy tech hands him the white, stapled-shut paper sack and asks, “Do you have any questions for the pharmacist?” he is highly unlikely to say yes, thinking to himself that he no longer feels like a normal man. Perhaps he'd like to talk to his wife of 52 years about his fears and concerns but doesn't know how to do so. He wonders about other options for sexual fulfillment for him and for his wife.
Boudoir Noir's partnership with Cancer Services to offer the free class is a continuation of support given to the nonprofit agency for several years, said owner, Tim Straley. The annual October Scare Away Breast Cancer and other in-store fundraisers have raised thousands of dollars for Cancer Services.
“We're a little different than most other stores like this. We focus on customer service,” Straley said, noting, “We've worked hard to overcome the image this is a seedy place to go. We offer a place for people to come and talk to our staff about products and ideas on what is available.”
The class goes to the heart of the mission of Cancer Services, which “seeks to address the whole person,” Hamm said. “If we leave out sexuality, then we are leaving out an important part of the whole person.”
Jennifer L. Boen is a freelance writer in Fort Wayne who writes frequently about health and medicine. This column is the personal opinion of the writer and does not necessarily reflect the views or opinion of The News-Sentinel.