Many women find that breast cancer diagnosis and treatment seriously disrupts their sexual lives. First, there are the most obvious issues — the physical changes, exhaustion, nausea and pain from treatment, self-image, empty energy reserves, and the emotional chaos from the diagnosis itself.
Cancer treatment can dampen your libido, make sex painful (or impossible), change your ability to orgasm and even render your private parts less sensitive.
Chemotherapy and radiation can damage the mucous membranes in your mouth, nose, eyes, ears, and yes, vagina, penis and anus. Radiation can also burn your skin, and turn soft, sensitive tissue thick and tough. Anti-hormone treatments, put a brake on intimacy— even cuddling is out when hot flashes make people uncomfortable. Blood flow keeps our private areas plump and moist (what makes sex great!); and both [chemo/radiation] reduce blood flow, causing these tissues to thin and tear.
Patients often try to get things rolling after recovery but can have difficulty — lost erection, vaginal pain — and they won’t know how to talk about it. After multiple attempts, sex can become awkward, and they give up.
At this point, neither partner wants to bring up this topic.
Partners often act as caregivers and, once treatment is over, have trouble leaving that role.
This happens with couples in their 30s and couples in their 70s, with mixed-gender couples and with same-gender couples. It effects couples of all kinds equally.
Perhaps the most frustrating change in your sexual life is the loss of libido, of “those urges.” You’ve lost your hair, your breast is altered or gone, you’ve put on weight, you have no energy, you’re tired, you’re nauseated, and you hurt in new places. Not ‘sexy.’
Keeping intimacy in your relationship both during and after your breast cancer ordeal is critical to your overall recovery. And single women who want to become part of a relationship worry how breast cancer will affect their prospects, about how and when to tell those prospective lovers about their condition.
I tell my patients that their breasts may be crucial part of her sexual life before the discovery of her disease. After treatment, the breasts look great—but may have decreased sensitivity. The discussion is always had especially prior to nipple sparing mastectomies.
How to Rediscover Intimacy
- Talk with your care team
- Explore products that can alleviate dryness
- Focus on other kinds of intimacy
- Don’t let self-care lapse
- Take your time
Advice from your doctors, or from friends who’ve been down the same road, may help, but some impairment of sexual function is generally unavoidable. Over time, however, things do get better, so keep a positive mindset and look to the future.
Authored by: Dr. Anjeanette Brown, MD
Breastfeeding is one of the best ways a mother and her newborn can strengthen their emotional connection, while also providing her infant with essential nutrients for development. While not all mothers chose to breastfeed, the process of nursing is a topic that brings on a lot of questions to new mothers, especially those who are breast cancer survivors. The ability to breastfeed depends on a number of factors, including milk production, the milk ducts, and the nipple/areola.
Chemotherapy and other Long-term Medications
Patients diagnosed with breast cancer may undergo several different treatments depending on the best option for their specific cancer diagnosis. Breastfeeding after cancer treatment may be possible, but there are some complications to be aware of. Patients who are currently going through chemotherapy should not breastfeed their baby. Those who completed their chemotherapy can typically breastfeed, but be sure to talk to your doctor to ensure breastfeeding is safe for you and your baby after a certain amount of time has passed. Some women may take long-term medications for their cancer treatment (such as tamoxifen, aromatase inhibitors, or trastuzumab) and should not breastfeed while taking these medications. If you are currently taking one of these medications or any other medication for cancer treatment, talk to your doctor about when to stop taking the medications, how long to wait until you breastfeed, and when to resume the medications. 2
Mastectomy, Lumpectomy, and/or Biopsy
Another possible treatment for breast cancer is surgery. A mastectomy is the process of removing the entire breast (or breasts). It may be possible to use the remaining tissue to produce milk and breastfeed your baby. However, if you received a double mastectomy (meaning both breasts are entirely removed), you will not be able to produce milk for your baby. 2
Another surgical option is a lumpectomy or partial mastectomy. During a lumpectomy, the diseased breast tissue and some of the surrounding healthy tissue is removed. Many patients are still able to breastfeed following a breast biopsy or lumpectomy. Depending on the amount of breast tissue that is removed, there may be a greater risk of damage occurring to the glandular tissue which may affect milk supply in the future.
Radiation Therapy
Radiation is another possible treatment for breast cancer. Although it can be a very effective cancer treatment for many, radiation therapy may permanently damage your ability to produce breast milk. It may also alter the texture and appearance of your breast milk, causing many women to decide to not feed their baby that milk. However, there is no evidence supporting that this milk is dangerous for your newborn to consume. It is also possible to nurse your baby using the breast that was uninfected and exposed to minimal radiation.3 Certain surgeries may alter the structure of your breast, which could cause severe pain or discomfort while nursing. This may also make it difficult for your baby to latch on to your breast 1.
Overall, many women are fit to breastfeed their infant even after battling breast cancer. In many cases, it poses no risk to you or your baby’s health to breastfeed after receiving cancer treatment. Of course, there are certain instances where your treatment may prevent you from breastfeeding. Regardless, many cancer survivors are still able to feed their baby their breast milk; it is even encouraged if you are able to do so. If you are a cancer survivor looking to breastfeed, or currently undergoing cancer treatment and curious how this may impact your future ability to breastfeed, talk to your breast surgeon!
Sources
- Pregnancy and Breastfeeding After Breast Cancer. American Cancer Society. (2019, October 3). https://www.cancer.org/cancer/breast-cancer/living-as-a-breast-cancer-survivor/pregnancy-after-breast-cancer.html.
- Siegrist, P., Comber, E., & Evilsizor, E. (2016, October 19). Breastfeeding After Treatment for Early-Stage Breast Cancer. Living Beyond Breast Cancer. https://www.lbbc.org/young-woman/your-medical-needs/breastfeeding-after-treatment-early-stage-breast-cancer#:~:text=removes%20the%20entire%20breast%2C%20so,because%20both%20breasts%20are%20removed.
- West, D. (2018, December 17). Cancer and Breastfeeding. La Leche League International. https://www.llli.org/cancer-and-breastfeeding/.