•  Breast Cancer Center •  Doctors You'll Need for Breast Cancer Care •  First Person: Did I Create This Cancer? •  What Do I Do Now?

Because women themselves consider their breasts to be a central part of their sexuality, as well as because of the frequent emphasis on the breast in the media and in art, many of them fear that breast cancer means an end to their sexuality -- that they will no longer be attractive, or ever again enjoy sexual experience.

Let's begin with what I think is the common happy ending to this part of the story: there is no doubt that women and their sex partners may have complex issues to work out after breast cancer treatment. But from what I have seen in my practice, breast cancer seldom has long-term or disastrous consequences on the personal lives of my patients. There is a period of adjustment, but it's my impression that it isn't very long and that most couples put their fears behind them and reestablish satisfying and loving relationships.

Many single women who are not in a relationship at the time of their illness have great fear -- even a sad certainty -- that a "new" person will not want to take on as awkward a situation as this. They may worry that they won't be attractive to someone who has not lived through this experience with them. Again, though this evidence can't be statistical, I hear wonderful stories of strong and happy relationships built after breast cancer.

In fact, though it may be hard for you to imagine now, women often find that this experience takes its place in their history just as other difficult life experiences do. They surely would not have chosen it, but having had breast cancer has by no means ruined their lives.

Here's what one woman, now in her late forties, had to say at her five-year checkup:

"I had a mastectomy and at first I was in pretty bad emotional condition. Reconstruction wasn't advised at the time and I'm not sure I would have wanted to go through more surgery anyhow. I didn't have a man in my life at the time and I thought to myself, okay kid, you better fill up your life with other things because romance is out from now on. Well, then I met Michael and I have to tell you I was shaking like a leaf the first time he even stood close to me because I was afraid he'd feel how my breast was gone and be really repelled. But that's not the way it turned out at all. In fact, when I told him, I think it opened up to a lot of tenderness that was good for both of us and that's stayed on in our relationship."

Another woman, trying to decide with her husband and her doctor what course of treatment was best for her, heard her husband ask incredulously, "What makes you think the only place you're sexy is in your right breast?"

A third patient who was treated with only the removal of the cancerous lump and radiation now says that aside from a thin scar, her appearance has hardly changed.

Indeed, there are so many happy endings after breast reconstruction that it's hard to select among them.

The sum of these experiences? The majority of women who survive breast cancer make a good adjustment to any changes in their bodies that result from the illness or its treatment.

I had a patient in the office recently to whom I had to explain that the small lump on her breast was indeed cancer. For the rest of the visit she shut out all the reassurances I could truthfully give her, as well as all the conversation we needed to have about treatment. "Am I going to die?" she kept asking. "Promise me that I'm not going to die."

No one can do that, as much as I wished I could.

Yet this woman's fear is perfectly understandable. It is perfectly natural. It's a fear that everyone in these circumstances experiences. But to get the best treatment possible, to put together the best team of doctors, services, and loving support, you can't panic and let your fright overwhelm you.

"Easy for you to say" may be your reaction to that statement. But, in reality, most women find that after the first shock of the threat of breast cancer, their own desire to survive soon pushes to the forefront. It overcomes any initial paralysis they may experience. They go ahead with what needs to be done to find expert help and to otherwise take care of themselves. (That patient I was describing came back a few days later, having absorbed the shock and far more ready to deal with her problem.)

Use whatever resources you can muster to support yourself emotionally. Talk to your husband or partner, to trusted family members, or to friends. Think about earlier challenges in your life and how you overcame them. Deep breathing exercises, meditation, and physical activity can be useful for some people during these first worrisome and uncertain days. That is especially true if you normally use such techniques for relaxation.

But, whether or not you do these things, it seems to me that you'll get the most comfort and confidence when you begin to understand that though you are confronting a new and frightening adversary:

•You are not alone.

•There are competent and experienced specialists who can help you.

•Other people are beating this enemy every day.

There's more to take comfort from in what we've learned thus far:

•You are almost certainly not facing immediate death.

•You will almost certainly not be disfigured.

•You are almost certainly not going to be shut off from the physical side of your life.

Put out of your mind any idea that you should "keep a stiff upper lip" or suppress your anxiety. Don't do that. Talk as much as you need to, to whoever will be the most helpful. That may or may not be your husband or partner. If the person who is closest to you is likely to panic at the thought that you have breast cancer, or has a completely different approach to illness than you do, turn to a friend or a close relative to act as your sounding board. Or take into your confidence another woman who has had breast cancer in recent years. Don't use these people instead of a doctor: use them as companions on this journey you're setting out on.

Ask one of the people you most trust to act as your personal advocate in the period ahead. See if that friend, or relative, or husband or partner can accompany you to your medical appointments when you feel you need support or when you will be making treatment decisions. You may not want this personal ombudsman to take over for you, but it will be helpful if he or she keeps up with your case, knows your physicians, and understands you as a person. The emotional concerns we've been discussing are shared by most women who face the prospect of breast cancer. The first practical problem they encounter is finding a doctor. That is the task we'll consider next.

-- Adapted from Breast Cancer: The Complete Guide by Yashar Hirshaut, MD, FACP; and Peter I. Pressman, MD, FACS; © 1992 by Yashir Hirshaut. Used by permission of Bantam Books, a division of Random House, Inc. For online information about other Random House, Inc. books and authors, see the Internet Web Site at http://www.randomhouse.com.

First published May 17, 2001
Last updated March 12, 2008
Copyright © 2001 Consumer Health Interactive

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