Sexuality and Fertility After Cancer

Leslie R. Schover

Description

“Such a comprehensive resource for survivors has been long overdue.”
--Michelle Melin, M.P.P., Director of Patient Services Y-ME National Breast Cancer Organization

"An excellent, well-researched book that responds to the needs of survivors."
--Anna Meadows, M.D. Director, Division of Oncology and Children's Cancer Research Center, Children's Hospital of Philadelphia

Now as never before cancer survivors are discovering their potential for renewed sexuality, which many may never have thought possible. In this comprehensive new book, the leading authority in the field carefully and reassuringly explains your options and gives you the accurate, up-to-date information you need to take advantage of them. Now you can make the decisions that are best for you based on recent medical advances and the newest perspectives. This unique guide covers:
* The kinds of sexual problems both men and women are likely to face after treatment--and state-of-the-art solutions
* The most effective infertility treatments
* How to assess the risks of pregnancy
* The latest information on body image, low sex drive, performance anxieties, medications, sex aids, and reconstructive surgery
* Special topics such as sex after breast or prostate cancer, and the specific problems facing gays, singles, and survivors of childhood cancers

Sujets

• Santé et bien-être
• Santé du quotidien
• Santé au quotidien
• Santé au quotidien
• Fitness
• Health
• Sexuality
• American Cancer Society
• Cleveland Clinic

Informations

• Publié par: Turner Publishing Company
• Date de parution: 30 septembre 1997
• Nombre de lectures: 0
• EAN13: 9781620459126
• Langue: English

Extrait

Sexuality and Fertility after Cancer
Leslie R. Schover, Ph.D.

John Wiley Sons, Inc.
New York Chichester Weinheim Brisbane Singapore Toronto
To my friend and colleague, Dr. Wendy Schain, whose voice and example have guided me and helped so many women and men find joy in life after cancer.
This text is printed on acid-free paper.
Copyright 1997 by Leslie Schover
Illustrations 1997 by the Cleveland Clinic Foundation
Published by John Wiley Sons, Inc.
All rights reserved. Published simultaneously in Canada.
Reproduction or translation of any part of this work beyond that permitted by Section 107 or 108 of the 1976 United States Copyright Act without the permission of the copyright owner is unlawful. Requests for permission or further information should be addressed to the Permissions Department, John Wiley Sons, Inc.
The information contained in this book is not intended to serve as a replacement for professional medical advice. Any use of the information in this book is at the reader s discretion. The author and publisher specifically disclaim any and all liability arising directly or indirectly from the use or application of any information contained in this book. A health care professional should be consulted regarding your specific situation.
Library of Congress Cataloging-in-Publication Data
Schover, Leslie R.
Sexuality and fertility after cancer / Leslie Schover.
p. cm.
Includes bibliographical references and index.
ISBN 0-471-18194-3 (pbk. : alk. paper)
1. Cancer-Patients-Sexual behavior. 2. Fertility. 3. Cancer-Complications. 4. Sex (Psychology) 5. Cancer-Surgery-Complications. I. Title.
[DNLM: 1. Neoplasms-psychology-popular works. 2. Sex Behavior-psychology-popular works. 3. Sex Disorders-popular works.
4. Infertility-popular works. 5. Attitude to Health-popular works. QZ 201 S376a 1997]
RC262.S436 1997
616.99 4-dc21
10 9 8 7 6 5 4 3 2 1
Contents
Acknowledgments

Introduction
The Importance of Sexuality and Fertility
Sexual Activity and Health
Sexuality and the Stages of Your Life
Stages of Cancer Treatment and Your Sex Life

How to Use This Book
Sexual Beliefs and Values

PART I THERE IS SEX AFTER CANCER!
1 Sex, Cancer, and Your Emotions
Diagnosis: The Crisis of Survival
Getting through Cancer Treatment
When Treatment Is Over
Common Myths about Sex and Cancer
Cancer and Divorce
Cancer and Feeling Attractive
Depression and Your Sexual Feelings
In Sickness and in Health: Switching between Caretaker and Lover
Men, Women, and Cancer
Infertility after Cancer and Your Sexuality
2 Am I Normal? Men s Sexual Health
Sexual Desire: What Is This Thing Called Lust?
Sexual Arousal: The Excitement Mounts
The Male Orgasm: Not an Anticlimax
Resolution: Nature s Rest Period
Sex and Aging in Men: It s Not All Downhill
3 Greater Expectations: Women s Sexual Health
Women s Desire: Hormones and Fantasy
Female Excitement: A Hidden Flowering
The Female Orgasm
Resolution: Time for Afterplay
Menopause: What Is It?
Menopause and Sex
Menopause, Estrogen Replacement, and Women s Health
4 Getting the Words Out: Talking about Sex
Name, Rank, and Serial Number
Mount Vesuvius
The Average Guys
Sexual Athletes
Opening Up Communication about Sex
5 Going Back to Bed
Rethinking the Performance Model of Sex
Finding Time for Sex: The Minivacation
Rediscovering the Joys of Petting
Rub-a-Dub-Dub: Start Out in the Tub
Dancing the Fright Away
Flying Solo
Sensate Focus: A Framework for Exploring Sexual Touch
Coping with Physical Symptoms
6 Safer Sex after Cancer: Preventing Disease and Unwanted Pregnancy
Does Cancer Ever Make Sex Unsafe?
Times to Avoid Pregnancy
Cancer and Sexually Transmitted Diseases
How to Have Safer Sex

PART II IS THERE A PROBLEM? WHY IT HAPPENED AND HOW TO FIX IT
7 Getting the Help You Need for a Sexual Problem
Self-Help
Professional Help
8 Where Did My Libido Go?
Feeling Lousy
The Brain and Sexual Desire
Medications That Decrease Desire
Upsetting the Hormonal Balance in Men
Premature Menopause and Sexual Desire
9 Enhancing Sexual Desire after Cancer
Pills and Potions
Do You Need Extra Testosterone?
Promoting Desire in Your Daily Routine
Making Sex More Erotic
10 Causes of Erection Problems
Cancer Treatment and Performance Anxiety
Low Testosterone and Erection Problems
Medications That Interfere with Erections
Damage from Pelvic Cancer Surgery
Damage from Radiation Therapy in the Pelvic Area
Damage from Chemotherapy
11 How to Mend a Broken Part: Restoring Erections
Tests That Can Help You Choose the Right Treatment
Medical Treatments to Restore Erections
Sex Therapy for Erection Problems
Finding the Treatment That Works for You
12 The Bells Aren t Ringing: No Orgasms, Slow Orgasms, and Dry Orgasms
No Orgasms or Slow Orgasms
Medications That Interfere with Orgasm
Strategies for Reaching Orgasm More Easily
Premature Ejaculation after Cancer
Dry Orgasms: Where Is the Semen?
13 Causes of Painful Sex
Chronic Pain That Interferes with Sex
Pain in the Genital Area for Women
Genital Pain in Men
14 Overcoming Pain during Sex
Sex and Coping with Chronic Pain after Cancer
Coping with Genital Pain for Women
Vaginal Dilators: A Treatment for Several Seasons
Men Coping with Genital Pain

PART III FERTILITY AND PREGNANCY: WHEN CANCER ADDS INSULT TO INJURY
15 Empty Arms: The Pain of Infertility
Infertility May Come as a Surprise
Grieving over Lost Potential
Infertility as a Barrier in New Relationships
Infertility Brings Tough Choices
Choosing to Live without Children
Finding Emotional Support
16 Maybe a Baby? Researching Your Options
Finding the Right Infertility Specialist
Tests That Measure a Man s Fertility
Tests That Measure a Woman s Fertility
17 Sperm Manufacture: When Cancer Treatment Shuts Down the Line
Radiation Therapy and Sperm Cells
Chemotherapy and Sperm Cells
Can Sperm Cells Be Protected?
The Icemen Cometh: Sperm Banking before Cancer Treatment
18 Special Delivery: Getting the Sperm to the Egg
Dealing with Orgasm Problems
Making Every Sperm Count: Treatments That Bypass Low Sperm Counts or Low Motility
19 Women s Fertility: A Nonrenewable Resource
Women s Reproductive Systems: What You Forgot from Health Class
Cancer Treatments That Cause Infertility in Women
Preventing Infertility during Cancer Treatment
Embryo, Egg, and Ovary Banking
Treatments to Enhance Ovulation after Cancer
20 Pregnancy and Cancer: What Are the Risks?
Risks of Triggering a Return of Cancer
General Health Risks of Pregnancy after Cancer
When a Woman Is Already Pregnant at Cancer Diagnosis
21 Postcancer Kids: Are They Healthy?
Risk of Birth Defects in Children of Cancer Survivors
Cancer Risk in the Children of Cancer Survivors
Genetic Testing for Cancer Risk
22 Having Whose Baby? Third-Party Reproduction
Using Sperm from a Donor
Using Eggs from a Donor
Surrogate Mothers and Gestational Carriers
Dilemmas in Using Third-Party Reproduction
Adoption after Cancer

PART IV SPECIAL STROKES FOR SPECIAL FOLKS
23 Myths about Sex, Women s Health, and Breast Cancer
Myth 1: Mastectomy Destroys Women s Sex Lives
Myth 2: Women Who Have Lumpectomy or Breast Reconstruction Are Much Better Off than Women Who Have Mastectomy Alone
Myth 3: A Woman Has Not Adjusted Well to Breast Cancer Unless She Learns to Love Her Scars
Myth 4: Silicone Breast Implants Are Unsafe and Should Be Banned Forever
Myth 5: Prophylactic Mastectomy Ensures That a Woman Will Never Get Breast Cancer
Myth 6: Once You Are Through with Chemotherapy, It Has No Impact on Your Sex Life
Myth 7: Tamoxifen Causes Menopause and Other Sexual Problems
Myth 8: Women Should Never Take Estrogen after Breast Cancer
Myth 9: Women Should Never Risk a Pregnancy after Breast Cancer
Being an Informed Survivor
24 It s Not Prostrate Cancer
Choosing a Treatment for Localized Cancer: Weighing Survival and Sex
Sex and Hormone Therapy: Making the Best of It
The Trauma of Orchiectomy
25 Sex with a Part Missing
Radical Hysterectomy: Sex without the Uterus and Cervix
Radical Vulvectomy: Sex without a Vulva
Sex after Operations That Reconstruct the Vagina
Penectomy: Sex without a Penis
Urinary Ostomies: Sex without a Bladder
Sex with a Colostomy or Ileostomy
Laryngectomy: Sex without a Voice Box
26 Survivors of Childhood Cancer
Childhood Cancer and Long-Term Health
Second Generation: Children of Childhood Cancer Survivors
The Emotional Impact of Surviving Childhood Cancer
27 Gay and Lesbian Cancer Survivors
Sexual Orientation and Your Cancer Risk
Being Gay in the Health Care System
Gay Sexuality after Cancer
Standards of Beauty and Physical Changes from Cancer
Infertility Matters to Gay People, Too
28 Sex and the Single Survivor
Cancer and Your Social Network
Finding a Dating Partner
Don t Let Your Cancer Be the Skeleton in Your Closet!
Disclosing a Problem That Affects Your Sex Life
Making a Commitment despite Infertility
Dealing with Rejection

A Final Thought

Resources

Bibliography

Glossary

Index
Acknowledgments
This book is the culmination of the most important aspect of my career-my clinical work and research on sexual problems and infertility after cancer treatment. Because sexuality is such a private area, the vignettes you will read in this book are composites based on my years of experience, rather than on actual accounts of patients I have known. I want to take this opportunity, however, to thank all the men and women who trusted me over the years with their most intimate stories. I hope that by summarizing all that I have learned, I can give something back to the community of cancer survivors to equal the gift of knowledge and inspiration that I have received.
I also want to thank some very special colleagues. First and foremost are