Life during and after breast cancer treatment.

The shock is subsiding. You may even surprise yourself one day soon and find you're thinking less about your diagnosis and more about living with breast cancer.

You'd be right: Your focus now should be on maintaining as normal a life as possible during and after your treatment. One area you may be grappling with is sexual intimacy. Between the sexual connotations associated with a woman's breasts, side effects of treatment, plus the emotional distress of having cancer, it's no surprise that research finds that about half of all women who have had breast cancer experience long-term sexual problems. (25)

One study of 558 women in the year after their breast cancer treatment found about one-fourth simply weren't interested in sex, particularly if they'd had chemotherapy. (26) Other reasons for a lack of sexual interest include menopausal symptoms like vaginal dryness and hot flashes that can result from cancer therapies.

And yet, now perhaps more than any other time in your life is when you need to be close with someone, both physically and emotionally.

So here's what I suggest: Forget about sex for the moment. Instead, focus on intimacy. Massage one another, hold hands, go on spontaneous dates. Find ways to bring sensuality into your life--beautiful negligees (several companies make lingerie for women who have had a mastectomy), romantic music, low lights. Spend one evening slowly touching each other. Ask your partner to gently touch your scar.

And if your desire for intimacy is affected by negative feelings about your body, try turning out all the lights before you start.

Communication is essential during this time. Talk about why you may not feel desire right now. Get your partner to talk about how your diagnosis and treatment has affected him or her. If you feel too uncomfortable talking, try writing letters in which you tell each other how you feel.

And share your concerns with your health care team who may be able to recommend strategies to help you regain the intimacy you've lost.

Other Lifestyle Issues

Fatigue is also a major problem, particularly if you're undergoing chemotherapy. Many women also complain about "chemo brain," in which they feel like they can't remember anything.

That's why you must take care of yourself first. That means napping instead of volunteering; working a shorter schedule during and after treatment; hiring out certain chores, if you can afford it; and even asking the student down the street to do your grocery shopping.

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It's also a time when I urge you to call upon the people in your life who love you. Most people want to help--they just don't know what to do. So tell them.

Ask a close friend to organize a dinner brigade, assigning neighborhood families a night to bring your family dinner. Call on a friend to drive if you feel too tired to drive yourself. I know one woman whose greatest feat was getting the laundry done for her large family--a friend came to her house and made sure it was done and put away every week.

And seek out other women with breast cancer, either in a formal or informal support group, in person or online. Numerous studies find such support can improve your overall quality of life. (27)

Finally, make time for some form of exercise every day to help you regain energy as well as confidence in yourself. It may even help your long-term survival. One study of 3,000 women with breast cancer found those who got a few hours of exercise a week were less likely to die of their cancer than women who got less than an hour a week. (28)

To learn more about breast cancer, visit www.healthywomen.org. See Take 10 for Breast Cancer Awareness.

References

(25) Ganz PA, Rowland JH, Desmond K, et al.: Life after breast cancer: understanding women's health-related quality of life and sexual functioning. J Clin Oncol. 16 (2): 501-14, 1998.

(26) Ganz PA, Kwan L, Stanton AL, et al. Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. J Natl Cancer Inst. 2004;96(5):376-87.

(27) Till JE, Evaluation of support groups for women with breast cancer: importance of the navigator role. Heaith Qual Life Outcomes. 2003;1(1):16.

(28) Holmes MD, Chen WY, Feskanich D, Physical activity and survival after breast cancer diagnosis, JAMA. 2005;293(20):2479-86.

By Pamela Peeke, MD, MPH

NWHRC Medical Advisor

Dr. Peeke is a Pew Foundation Scholar in Nutrition and Metabolism, and Assistant Clinical Professor of Medicine at the University of Maryland in Baltimore. She writes about health and lifestyle issues important to all women.