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Female (Gynecologic) Cancer

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Facing a cancer diagnosis is never easy, even when the prognosis for recovery is good. Women dealing with cancers that affect their sexual organs, whether directly or indirectly, face a particular set of challenges.

This group of cancers is comprised of breast, bladder, and gynecologic cancers, including cervical, endometrial, uterine sarcoma, Fallopian tube, ovarian, vaginal, vulvar, and Gestational Trophoblastic Disease (GTD). For the sake of clarity, we will collectively refer to them as “female cancers.”

Being diagnosed with a female cancer forces a woman to confront not only the illness itself, but also the question of who she is now as a woman. Even in cases of early detection and successful treatment, women will often find themselves feeling that their identities have been compromised, as they struggle to adjust to their post-cancer bodies and spirits.

The urgent medical process that follows, including additional tests, surgery, administration of various medications, etc., often causes a feeling of being trapped in a roller coaster without any control of its speed and direction.

How a woman’s sexual health will be impacted by cancer and/or cancer treatment will be determined by a range of factors, including what type of cancer she has and how advanced it is; her family history and genetics; her general state of physical and emotional health pre-diagnosis; her lifestyle habits; and what kind of support system she has in place. Some cancers will target the reproductive system/genitals directly, while others will exert indirect effects. Either way, we advocate for an approach that takes into account the patient as a whole, not merely her specific body parts.

With medical urgency as their ultimate priority, it is rare that health-care providers address their patients’ emotional needs at the time of diagnosis, leaving them unprepared for the challenges ahead. Our clinical experience with cancer patients has shown us time and time again that it is not enough merely to address a woman’s physical needs, but her psychological needs as well.

Emotional devastation is inevitable: anger, sadness, and the feeling of victimization – why me? Worries about the future – will the cancer recur? Self-doubt about choices and options – did I make the right decision? And, have I been receiving the best care possible?  Additional issues and concerns may include

  • Treatment side effects
  • Thoughts about mortality, or death and dying
  • Navigating the hospital and medical system
  • Intimacy and dating during and after a cancer diagnosis
  • Sexuality: changes in sexual desire, intimacy
  • Induced menopause (vaginal dryness, pain during intercourse, etc.)
  • Work related issues: sharing your diagnosis in the workplace, applying for disability, returning to work during and after treatment
  • Financial stressors, such as medical co-pays and drug costs
  • How to talk to loved ones, including children, about cancer
  • Getting back to “normal” after treatment
  • Choosing complementary or alternative treatment options

Pelvic radiation, and especially internal vaginal radiation, tends to affect all the surrounding tissues, including the bladder, the urethra (urine tube from the bladder outwardly), the vagina, the vulva (the lips, etc.), the rectum, and the skin surrounding it.  Ideally, the radiation team will be attuned to the needs of the woman who is undergoing the treatment by providing guidance, sufficient explanations and reassurance, and even contact with other women who went through the process and who can assist with encouragement and a positive attitude.

Watch Ovarian Cancer and Sex
VIDEO: Ovarian cancer and sex. How to return to life and living (a radio interview recorded 5/18/2015)

Of utmost necessity is the need for perineal care instructions before, during, and after the treatment, especially because of a commonly overlooked fact: most women are not familiar with proper genital care in general, and do not know how to manage the breakdown associated with radiation in particular.  Additional attention should be given to maintaining vaginal elasticity for sexual and pelvic exam penetrations using vaginal dilators.

Pelvic and/or vaginal radiation provoke additional stressors present: Will it hurt? Will it burn? How much will it burn me on the inside? What side effects will I suffer? Will I have a normal vagina again, ever? How do I use the dilators they handed me? Who can help me with the dilators because I will not do it to myself? Will I be able to enjoy a normal sexual life once the radiation is over? Will I bleed with intercourse? Will the penis damage my broken vagina? And the ultimate question, will the cancer return anyway?

Our intervention will attend to your physical, emotional, and sexual concerns, including restoring vaginal penetrations, always aiming at ensuring genital health and positive emotional outcome before, during, and posttreatment.

Contact us for further information, and to schedule an appointment.