2 Hours of Erection Post PCa Treatment; Couples Survive Cancers Tied to Sexuality

Couples can survive cancers tied to sexuality

Both genders will face formidable challenges

By Gail Rosenblum
MCT NEWS SERVICE

December 19, 2006

MINNEAPOLIS - Minnie Wharry had one thing on her mind when her
husband was diagnosed with prostate cancer at age 55: survival. Her
husband had his mind on something else: Could he still have sex?

"The doctor told me the removal of my prostate could lead to erectile
dysfunction," said Donald Wharry of Edina., Minn. "But he said he
was trained in keeping nerves intact, with an 80% success rate. I said,
'That's pretty good.' "

It might seem frivolous to focus on sex in a story about cancer. But
those facing the disease, particularly types tied to sexuality -
breast, ovarian or prostate, for example - say that sex, or the
simple joy of intimate touch, aids enormously in healing. Without it,
many patients plummet into self-doubt or desperation.

But discussions of cancer rarely include sexuality. Doctors often don't
want to bring it up. Books on cancer typically devote only a few pages
to it. Sexuality, writes Dr. Susan Love in the updated version of her
"Dr. Susan Love's Breast Book," is "one of the least discussed
subjects about life after breast cancer. Your surgeon won't bring it up
if you don't; in fact, most surgeons will assume that if you're not
complaining, everything must be fine."

Often, though, it's not.

Dr. Barbara Bowers, an oncologist and the medical director of the
Breast Center at Fairview Southdale Hospital in Minneapolis, is one of
the few who make a habit of asking every patient if she has sexual
concerns. "The vast majority say they just have a great sex life.
Then I read their chart and it says, 'I'd do anything to get my libido
back.' "

The challenges are formidable. For women with breast cancer,
chemotherapy and cancer-fighting drugs such as Tamoxifen can cause
vaginal dryness. Drugs also push many women into early menopause, so if
exhaustion, painful intercourse and hair loss aren't enough, they're
having hot flashes, too. Removal of the ovaries due to ovarian cancer
can also lead to loss of sexual desire; half of a woman's testosterone,
an ingredient in healthy libido, is produced in the ovaries.

Prostate cancer poses its own challenges. Wharry, whose father died of
prostate cancer, wore a post-surgery catheter on his leg. Sex, his
doctors told him, was out of the question for six to nine months.

Emotional scars are equally hard to bear. Women struggling with whether
to undergo reconstruction (a choice for about 20% of women 65 and older
and for about 70% of younger women) are sometimes surprised by the
depth of their sadness at the loss of a breast.

While most partners are loving and supportive through the early stages
of treatment, they do become understandably impatient about their own
unmet needs. Anger and stress can build to the breaking point.

Kerry Ciardelli-Olson, 48, of Minneapolis, was four years into a
serious relationship when she was diagnosed with breast cancer. Her
boyfriend, with whom she had "a great sex life," went with her to
every appointment and stayed through her double-mastectomy. Then
everything changed.

"I was so vulnerable," Ciardelli-Olson said. "I lost my hair, my
breasts."

They broke up before her radiation treatments began, she said, leaving
her to go through reconstruction alone.

For others, cancer brings unexpected goodness. Nancy Mack, a
44-year-old software project manager who is single, was diagnosed with
breast cancer a year ago. She decided to have both breasts removed.
Boyfriend Colin Carruth, 35, moved into her Plymouth, Minn., home
immediately to care for her.

"I wanted to be able to enjoy the time I had with her," Carruth
said. "I had fear that I'd lose her."

He was constantly by her side with a kind word and a gentle touch, when
she felt good enough to be touched, just "to hold her, let her know I
was there."

Mack said Carruth has contributed greatly to her recovery.

"Having another person touch you, his arms around you as you fall
asleep, is so healing," she said.

Carrie Rogers Sartin, 37, would agree. She had been separated for nine
months and was nearing divorce, with two young children, when diagnosed
with breast cancer in 2004. Her soon-to-be ex-husband moved back home
to care for her and help with finances.

"We told the kids up front: 'Daddy is just helping mom when she's
sick.' " He has since moved out, but Rogers Sartin says, "He was
definitely the one I was with after becoming bald."

Ciardelli-Olson still stings from the "betrayal" of first her body,
then her relationship. But today, looking stunning and healthy, she is
dating again. "I'm finding more caring men, with integrity and
understanding." When she tells them about her reconstructed breasts,
"it isn't even an issue for them. I'm liked for who I am."

Wharry feels lucky, too. He smiles and confesses that he started
functioning well again months earlier than expected (with a little help
from Viagra). In fact, he remembers the actual day with the clarity
usually reserved for wedding anniversaries. Today Wharry, 64, a retired
school principal and board member of the American Cancer Society,
encourages other African-American men to take action.

"A lot of guys who find out they have prostate cancer won't come back
(to the doctor)," he said, frustrated. "I ask them, 'Would you
rather die?' Real men get checked."

Most couples do return to sexual intimacy eventually, although it might
look a little different. Touch and talk become more important. So does
taking it slow, which isn't necessarily a bad thing.

Keith Laken, 61, of Winona, Minn., is a prostate-cancer survivor who
travels the country with his wife, Virginia, talking to people about
post-cancer sexuality.

"When I tell men that I now make love more like a woman, in that it's
more pleasure-based than performance-based, they choke," Laken says
with a laugh. "But when I remind them that they may have two hours of
erection (with the help of drugs or shots), their eyes light up."

Dr. Bowers has been heartened by how some couples grow closer through
the cancer experience.

"All of a sudden the husband realizes that he could lose this person
forever. They had both been very busy, lost contact. (Now) they make
commitments to do special things, such as a surprise vacation,"
Bowers said. "They're just so much happier."