Words on Sex and Cancer from Dr. Paul

Today, we take an excerpt on Sex and Cancer from Paul Joannides' Guide To Getting It On.

From a Young Couple We recently received an email from a young woman whose boyfriend has brain cancer. He’s 20, and she’s not yet. He’s had multiple brain surgeries, radiation, and now chemo. Because of his nausea and problems with stamina, she’s on top during intercourse more than before. And some of the things he used to love her to do before his cancer can make him feel nauseated now. But she says as long as they give each other lots of feedback, they still enjoy sex, which shows that you can cut into a person’s brain, nuke it and poison it—it won’t necessarily stop them from wanting sex. In this case, his orgasms help him to feel better after chemo, assuming he’s able. She says, “Sometimes we have sex just to feel closer in a hard time like after we heard he was going to need a second surgery. It’s comforting to be that close to the person you love and know that nothing is going to happen to them right then, even if outside of those moments you are living in constant fear. Sex has shifted to being almost totally focused on what feels best for him and I wouldn’t have it any other way.” She didn’t mention anything about her own emotional journey, but it’s worth noting that modern medicine is, by necessity, so focused on the person with the cancer that we sometimes forget that his or her lover can be suffer- ing just as much. The lover may feel way too guilty to even allow themselves to be conscious of how much emotional pain they are in. (This is a reminder to healthcare professionals, who are sometimes pretty overwhelmed themselves.) As for the details of how this couple approach sex and cancer, here it is in her own words: “We ended up trying me on top more because he didn’t have to move as much and it can be less physically trying for him. He has less stamina so it’s nice for him to be able to have sex without ending up completely exhausted. I was tentatively afraid that I would cripple him if I were on top, but it turned out to be a very successful position. He actually likes it best out of all the positions we’ve tried. “Communication has turned out to be key because he has sudden nausea or pain sometimes, but if sex is done correctly (with proper communication and being cautious not to overdo it) it can actually make him feel better. Sometimes we start but he needs to rest and then we keep going in a few minutes. He lets me know if something I’m doing is good or if it’s making him feel worse because some of the things we did before aren’t good anymore (for instance I used to kiss him on the stomach and back and he used to love it but now it can make him nauseated.) Sometimes things like that feel good and sometimes they don’t. “He has good days where he we can try different positions and places and bad days where we stick to me on top and we have intercourse in kind of a soft, relaxed setting. We discuss what he would like to do that day before we even start any foreplay and then he tells me if he’s changed his mind anytime after that based on how he’s feeling. That way we almost always avoid nausea, and intercourse can be great even with restrictions. “During his chemotherapy, sometimes he has close to no sex drive and then we don’t do much at all sexually, but he’ll still do things like finger me just pretty much to be nice, since he’s not so much up to anything sexual. “I’d say if anything has increased it would be the number of blowjobs I give him because that’s another thing that gives him pleasure but lets him remain pretty much still and comfortable. We don’t have as much intercourse because he’s just not up to it all the time.”

About the Author Dr. Paul Joannides is a training & supervising psychoanalyst and author of the Guide To Getting It On. He is on the editorial board of the Journal of Sexual Medicine and was formerly on the editorial board of the American Journal of Sexuality Education. He also writes the As You Like It blog for Psychology Today. Paul is a guest speaker on college campuses and he is an NCAA-approved speaker for college athletes on human sexuality.