Cancer Survivor: Can I Have an Intimate Relationship Again?


A reader wrote:

 I am 62, single, and once was a very sexually active woman. I’ve undergone treatment for breast cancer twice. My recovery required my full attention for years, but now I feel ready for new adventures — hopefully including sex. After rounds of chemotherapy, surgeries, radiation, and continued estrogen blocking medications, sex with another became a thing of the past. 

Currently, sexual intercourse may no longer be possible for me — but I still enjoy having orgasms and I desire the wonder of touch.
However, I am so concerned about my limitations as a sexual partner that I am afraid to attempt to date again. 

I have no idea what men in my age group expect or desire in terms of performance from their partners. What are woman experiencing in the 60-year-old dating world in terms of performance expectations? Would my current physical circumstance deter most men from being interested in exploring an intimate relationship with me?

I am grateful for this message and all it conveys about hope and healing and moving forward. I understand why you’re apprehensive. I would encourage you to get out there and go after what you want.

I know that many single men in our age group also fear “performance expectations”  when erections are no longer possible or predictable. There are many who would welcome a sexual partner who did not expect intercourse, who would be happy exchanging touch, oral and manual stimulation, and fabulous orgasms — without intercourse.

These men may be cancer survivors themselves, wanting to return fully to life, including sex and intimacy, but they don’t know how to navigate the dating world either — when to divulge the cancer, when to divulge the sexual issues.

You might find out if there’s a local cancer survivors’ singles group. Or try online dating: I did a search on “cancer survivors singles” and came up with several sites that promote themselves as dating sites for cancer survivors.

There’s even one — “2date4love” —  that “enables people who cannot engage in sexual intercourse to meet and experience love, companionship and intimacy.” I haven’t vetted any of these sites — if any of you have tried them, I hope you’ll share your experiences.

You don’t need to limit yourself to dating companions who share a similar medical history, though. Just be up front about your cancer on a first date if it looks like there’s potential for a second date. (If not, you don’t need to mention it.)

Then if you progress to a few dates and there’s chemistry, it’s important to explain that yes, you are interested in sex, but no, this might not include intercourse. Be prepared: Men who desire intercourse may want to discontinue getting to know you, and that’s okay.

When all the cards are on the table, if the relationship progresses, you have the delightful journey of exploring all the ways you can be sexual without intercourse!

Even when a date doesn’t progress to more, it’s still worth getting to know new people, “practicing” dating, trying out how to tell a potential partner about your needs, desires, and challenges.

If you take it all as part of the brave new world of dating experience, you don’t need to feel regretful or shamed when a new relationship (or potential relationship) doesn’t work out. Most of them will not work out — that’s the nature of the game.

Everything I’ve said so far presumed that you’re right that intercourse will not be possible for you. But please explore whether there are ways that you can heal yourself vaginally, if this is something you want to pursue. An excellent resource is “Vaginal Recuperation after Cancer or Surgery” from A Woman’s Touch, one of my favorite sexuality resource centers.

I hope you’ll check in again and share what you tried, how it worked for you, what you learned and gained.

I hope that you’ll share your thoughts, too, readers.

Adult Sex Ed Month: HuffingtonPostLive, AASECT conference, and a new senior sex book


 http://agoodwomansdirtymind.com/wp-content/uploads/2013/06/adultsexedmonth-e1369184560239.jpgJune has been declared Adult Sex Ed Month (#AdultSexEdMonth) by Ms. Quote
(@GoodDirtyWoman on Twitter) who blogs at A Good Woman’s Dirty Mind. This idea caught on, and this month, hundreds of posts designated #AdultSexEdMonth from sex educators and bloggers appeared all over the Internet. View the list with links here.

In my world — advocating for senior sex and educating about older-age sexuality — every month is Adult Sex Ed Month. This month has been particularly fruitful.

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This month, I participated in a Huffington Post Live event titled “How Old Is Too Old To Have Sex?” with fellow panelists Ashton ApplewhiteWalker Thornton, Sidney Schwab, and Ken Solin, hosted by Abby Huntsman. Of course the answer to the question in the title is obvious to us (though not obvious to Abby, until we raised her consciousness), but you’ll find the discussion interesting even though you know the answer! Watch it here:


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The annual conference of the American Association of Sexuality Educators, Counselors
and Therapists
conference always makes my brain swell with new information and ideas from sex educators who are trailblazers in the field. Counselors, therapists, sex educators in community or medical settings, and other people who care about your sexual knowledge and enrichment gather to learn from the leaders. Then people like me come home and spread it around – to people like you.

As always, it was impossible to attend all the sessions of interest, and there’s no way I can share all of the 25 pages of single-spaced notes that I took on my laptop, no matter how many blog posts I write. But here are some highlights and tips that are especially relevant to our age group:

  • Some sexual issues are psychological; some are medical or physiological. But even when it’s a medical issue, a sex therapist can be important to help you work with whatever is going on. Medical sexual issues affect your sense of self and your relationship. “Any pharmacotherapy for sexual dysfunction should occur within the context of sex and relationship therapy.” (Ricky Siegel)
  • One more good reason to quit smoking: Nicotine has been shown to decrease blood flow to the penis and increase venous outflow from the penis — in other words, less ability to get and maintain an erection. (Ricky and Larry Siegel)
  • Women with vulvar or vaginal pain have a difficult time getting the pain diagnosed and treated effectively. Possible causes of pelvic pain are varied, and with the wrong diagnosis (or no diagnosis!), the wrong treatment follows. Look for a three-pronged approach: a sexual medicine physician, a pelvic floor physical therapist, and a certified sex therapist, such as used by the Summa Center for Sexual Health in Akron, Ohio. (Kimberly Resnick Anderson)
  • Pelvic floor physical therapists are trained to do internal evaluation of the pelvic floor muscles — evaluating muscle function, strength, tone, and any points of tenderness. Regular physical therapists are not trained to do this. (Amy Senn)
  • Men with low libido: Anxiety, mood, relationship, and religious factors affects libido. “First know what’s going on in the relationship before throwing medication at it.” (Larry Siegel)
  • “Nerve sparing” prostate surgery is “a bit of a misnomer.” Erectile nerves on the outside of the prostate are very difficult to see and avoid during surgery. “The prostate is deep in the pelvis, and they go pushing around with stainless steel instruments. If cauterizing instruments are anywhere near nerves, it damages them for life. Nerves recover from the pushing and pulling – it takes a long, long time. Nerves go into shock and stop sending message to blood vessels to relax and let blood in.” (Anne Katz)
  • “Sexual arousal requires healthy blood flow for everything else to work. Otherwise, nothing happens. Take a 15 minute walk with your partner before sex. It will prime the pump.” (Ellen Barnard)
  • After treatment for female genital cancer, using a vibrating wand internally will reduce scar tissue. “Vibration directly to the scar tissue starts breaking up that scar tissue, allowing it to expand, become more comfortable, and allow penetrative sex if we want it.” (Ellen Barnard)
  • After cancer treatment, start getting to know “what is”: “What feels good? What doesn’t feel good? What’s numb? What’s painful? How does arousal happen? What does it take? How does orgasm happen and feel? When during the day do I have energy?” (Ellen Barnard) You need to learn this for yourself before you can teach your partner.  (JP: This applies to aging in general, also.) A Woman’s Touch has excellent educational brochures for both men and women online at no cost, for example, Healthy Sexuality After Cancer. Visit  www.sexualityresources.com, see the Educational Brochures link in the upper left hand corner of the menu bar for a complete selection.

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The huge news this month for me as a senior sex educator was an invitation from Cleis Press to write a book for them: The Ultimate Guide to Sex after Fifty! I’m thrilled to have a new book to write on my favorite topic, and I’m proud to be part of the fabulous Ultimate Guide collection of sexuality guidebooks. You can be sure you’ll hear more about my new endeavor as it unfolds.

Meanwhile, if there’s a topic you want to be sure that I cover in this new book, please either post it as a comment here or email me. I love to hear from you. I’m too busy to promise to answer all your questions in detail, but I try to acknowledge your email and point you in the right direction. I admit sheepishly that I have about 400 unanswered emails waiting. If one of these is yours, I thank you for your patience!  (I do give private, educational consultations answering your questions by phone or Skype for a modest fee — email me for more info about this.)

“Promise me you’ll keep doing your work…”

 “Promise me you’ll keep doing your work,” Robert said, taking both my hands in his and pressing them to his heart, looking deeply into my eyes.

It was three years ago — end of March 2008 — and we had learned that his body was succumbing to multiple myeloma. There were treatments we could and would try, but this conversation marked the countdown to the end, as I think back on it.

He would have one more month of health — fatigued, but able to live the way he loved — going to his art studio to paint, dancing joyfully, and loving me as if his life depended on it (and maybe it did). Then, as treatments failed, his back fractured in multiple places. The extreme pain led him into another world — a world where love was not enough to heal or even ease the physical, emotional, and spiritual pain. 

A world of preparing to die.

 “Promise me you’ll keep doing your work…”

Our profound sexual connection had powered our relationship for our seven, soul-soaring years together. Neither of us had ever had a relationship as sexually exuberant or as emotionally satisfying! Professionally, our spicy hot afternoon delights propelled me to switch writing topics from health and fitness to senior sex. Better Than I Ever Expected: Straight Talk about Sex After Sixty celebrated our love affair. We married in 2006, the year the book came out.

We already knew that our love wasn’t “forever” the way young people think of it. Besides being seniors, we had the challenge of Robert’s diagnosis — at that point — of leukemia and lymphoma. Our wedding celebrated not only our love, but that six months of chemotherapy had sent Robert’s cancer into remission. We were told we might have ten or more good years of health, a magical gift.

But we didn’t have ten years — we had two.

 “Promise me you’ll keep doing your work…”

March 2011: Two countdowns shift in my mind. In August, I’ll face the 3-year anniversary of Robert’s death. (When does it get easier?) But before that, in June, I’ll welcome a new book into the world — Naked at Our Age: Talking Out Loud about Senior Sex — the book I started working on with Robert. In fact, you’ll see that he wrote part of the chapter, “Unlearning Our Upbringing: Men’s Stories.”

I think at our age, those of us who dare to live and love fully have this balancing act between the sweet surprises and rewards of living our dreams out loud and the inevitable losses. Robert gave me the right advice: “Promise me you’ll keep doing your work.” It sustains me and brings me great joy — as does sharing it with you!

Viagra “not a sack of cement installer”

I’m writing the chapter about cancer and sexuality for my new book, Naked at Our Age: Talking Out Loud about Senior Sex. The stories people sent me about reclaiming their sexuality after cancer treatment fill me with admiration. I looked back at some older posts on this blog that deal with sex & cancer, and decided to bring back this one from 2006. With the prevalence of Viagra use, I think BillyBob’s experience and his thoughts about it are important. – Joan

BillyBob, age 62, has told some of his story previously as a comment here. He recently sent me an email detailing an experience that he wants to share — and he makes an important point:

I started dating a lady I have known for a year, mostly through phone conversations. I knew that she likes sex. Last weekend we went for dinner. After dinner she wanted to go back to my place for a while.

Well, as it turned out, it was the most embarrassing time I have ever had, all because of a misconception some woman have about impotency.

I took a Viagra after we got back to the motel hoping it worked fast! It did its normal thing and got me sexually aroused but not 100%. She knew I had to take it because of the prostate cancer killing my prostate.

Here is where the misconception comes in. It seems that women who do not know about Viagra seem to think if you take it you just get ramrodding hard, and they do not need to do any stimulation. Well that’s just plain wrong. Men still need stimulation along with the Viagra. The drug is not a sack of cement installer.

And I was not about to masturbate myself in order to get it hard. Not in the presence of a woman.

So as it turned out she turned me off instead of on. What a bummer. It was so disappointing. I had looked forward to our meeting for some time. And the possibility of finally enjoying good sex with some one that likes sex.

All a woman needs to know about the drug is that you do things as normally, using stimulation together. So please tell your readers what my experience was.

BillyBob, thank you for sharing this experience. Viagra helps when there’s a physical cause for lack of erection, as you know, but it doesn’t increase libido, or substitute for all those other crucial components of good sex that you (and I, and probably everyone reading this) crave — touching, kissing, bonding, stimulating each other physically and emotionally, enjoying each other’s pleasure as well as our own.

It sounds like most of this experience was missing for you. What a bummer, I agree. I’m sorry you didn’t feel you could communicate your needs and desires to your partner — I don’t know, maybe she would have been happy to help you get aroused if she had understood. It’s hard to understand why she didn’t seem interested in stimulating you just as part of the sex play (with or without Viagra), since that’s a good part of the fun of sex.

I know you were too embarrassed to masturbate in front of her when she didn’t help arouse you, but as a woman, I find it very pleasurable and exciting to watch a man stimulate himself. I don’t know if your partner would have reacted this way, but I’ll bet she would have.

If you see a future or at least a repeat date with this woman, I hope you’ll communicate candidly with her before you get to “the act.” And please continue to write.

Thank you again, BillyBob.

— Joan