Sexuality and Fertility after Cancer

by Schover, Leslie R.

• ISBN13: 9780471181941
• ISBN10: 0471181943
• Edition: 1st
• Format: Paperback
• Copyright: 1997-09-30
• Publisher: Wiley

Summary

"Finally! 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 Phildadelphia. 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.

Author Biography

LESLIE R. SCHOVER, Ph.D., is a clinical psychologist and sex therapist at the prestigious Cleveland Clinic Foundation. Widely recognized as the leading authority on cancer and sexuality, Dr. Schover is in great demand as a lecturer and consultant. Her writings and interviews appear frequently in a variety of print and broadcast media.

Table of Contents

Acknowledgments	ix	(2)
Introduction	xi	(4)
The Importance of Sexuality and Fertility	xii	(1)
Sexual Activity and Health	xii	(1)
Sexuality and the Stages of Your Life	xiii	(1)
Stages of Cancer Treatment and Your Sex Life	xiii	(2)
How to Use This Book	xv
Sexual Beliefs and Values	xv
PART I THERE IS SEX AFTER CANCER!	3	(58)
1 Sex, Cancer, and Your Emotions	3	(11)
Diagnosis: The Crisis of Survival	3	(2)
Getting through Cancer Treatment	5	(1)
When Treatment Is Over	5	(2)
Common Myths about Sex and Cancer	7	(1)
Cancer and Divorce	8	(1)
Cancer and Feeling Attractive	9	(1)
Depression and Your Sexual Feelings	10	(1)
In Sickness and in Health: Switching between Caretaker and Lover	11	(1)
Men, Women, and Cancer	12	(1)
Infertility after Cancer and Your Sexuality	12	(2)
2 Am I Normal? Men's Sexual Health	14	(7)
Sexual Desire: What Is This Thing Called Lust?	15	(1)
Sexual Arousal: The Excitement Mounts	16	(2)
The Male Orgasm: Not an Anticlimax	18	(1)
Resolution: Nature's Rest Period	18	(1)
Sex and Aging in Men: It's Not All Downhill	19	(2)
3 Greater Expectations: Women's Sexual Health	21	(9)
Women's Desire: Hormones and Fantasy	22	(1)
Female Excitement: A Hidden Flowering	22	(2)
The Female Orgasm	24	(1)
Resolution: Time for Afterplay	25	(1)
Menopause: What Is It?	25	(1)
Menopause and Sex	26	(1)
Menopause, Estrogen Replacement, and Women's Health	27	(3)
4 Getting the Words Out: Talking about Sex	30	(12)
Name, Rank, and Serial Number	31	(1)
Mount Vesuvius	32	(1)
The Average Guys	33	(1)
Sexual Athletes	34	(1)
Opening Up Communication about Sex	35	(7)
5 Going Back to Bed	42	(10)
Rethinking the Performance Model of Sex	42	(1)
Finding Time for Sex: The Minivacation	43	(1)
Rediscovering the Joys of "Petting"	44	(1)
Rub-a-Dub-Dub: Start Out in the Tub	45	(1)
Dancing the Fright Away	45	(1)
Flying Solo	46	(1)
Sensate Focus: A Framework for Exploring Sexual Touch	47	(4)
Coping with Physical Symptoms	51	(1)
6 Safer Sex after Cancer: Preventing Disease and Unwanted Pregnancy	52	(9)
Does Cancer Ever Make Sex Unsafe?	52	(1)
Times to Avoid Pregnancy	53	(2)
Cancer and Sexually Transmitted Diseases	55	(1)
How to Have Safer Sex	56	(5)
PART II IS THERE A PROBLEM? WHY IT HAPPENED AND HOW TO FIX IT	61	(74)
7 Getting the Help You Need for a Sexual Problem	61	(3)
Self-Help	61	(1)
Professional Help	62	(2)
8 Where Did My Libido Go?	64	(7)
Feeling Lousy	64	(1)
The Brain and Sexual Desire	64	(1)
Medications That Decrease Desire	65	(2)
Upsetting the Hormonal Balance in Men	67	(2)
Premature Menopause and Sexual Desire	69	(3)
9 Enhancing Sexual Desire after Cancer	71	(8)
Pills and Potions	71	(1)
Do You Need Extra Testosterone?	72	(2)
Promoting Desire in Your Daily Routine	74	(4)
Making Sex More Erotic	78	(1)
10 Causes of Erection Problems	79	(7)
Cancer Treatment and Performance Anxiety	79	(1)
Low Testosterone and Erection Problems	80	(1)
Medications That Interfere with Erections	80	(2)
Damage from Pelvic Cancer Surgery	82	(2)
Damage from Radiation Therapy in the Pelvic Area	84	(1)
Damage from Chemotherapy	85	(1)
11 How to Mend a Broken Part: Restoring Erections	86	(20)
Tests That Can Help You Choose the Right Treatment	86	(3)
Medical Treatments to Restore Erections	89	(13)
Sex Therapy for Erection Problems	102	(2)
Finding the Treatment That Works for You	104	(2)
12 The Bells Aren't Ringing: No Orgasms, Slow Orgasms, and Dry Orgasms	106	(6)
No Orgasms or Slow Orgasms	106	(1)
Medications That Interfere with Orgasm	107	(1)
Strategies for Reaching Orgasm More Easily	107	(2)
Premature Ejaculation after Cancer	109	(1)
Dry Orgasms: Where Is the Semen?	109	(3)
13 Causes of Painful Sex	112	(4)
Chronic Pain That Interferes with Sex	112	(1)
Pain in the Genital Area for Women	112	(3)
Genital Pain in Men	115	(1)
14 Overcoming Pain during Sex	116	(19)
Sex and Coping with Chronic Pain after Cancer	116	(1)
Coping with Genital Pain for Women	117	(5)
Vaginal Dilators: A Treatment for Several Seasons	122	(8)
Men Coping with Genital Pain	130	(5)
PART III FERTILITY AND PREGNANCY: WHEN CANCER ADDS INSULT TO INJURY	135	(52)
15 Empty Arms: The Pain of Infertility	135	(4)
Infertility May Come as a Surprise	135	(1)
Grieving over Lost Potential	136	(1)
Infertility as a Barrier in New Relationships	136	(1)
Infertility Brings Tough Choices	136	(2)
Choosing to Live without Children	138	(1)
Finding Emotional Support	138	(1)
16 Maybe a Baby? Researching Your Options	139	(6)
Finding the Right Infertility Specialist	139	(1)
Tests That Measure a Man's Fertility	140	(2)
Tests That Measure a Woman's Fertility	142	(3)
17 Sperm Manufacture: When Cancer Treatment Shuts Down the Line	145	(6)
Radiation Therapy and Sperm Cells	145	(1)
Chemotherapy and Sperm Cells	146	(1)
Can Sperm Cells Be Protected?	147	(1)
The Icemen Cometh: Sperm Banking before Cancer Treatment	147	(4)
18 Special Delivery: Getting the Sperm to the Egg	151	(6)
Dealing with Orgasm Problems	151	(3)
Making Every Sperm Count: Treatments That Bypass Low Sperm Counts or Low Motility	154	(3)
19 Women's Fertility: A Nonrenewable Resource	157	(8)
Women's Reproductive Systems: What You Forgot from Health Class	157	(2)
Cancer Treatments That Cause Infertility in Women	159	(2)
Preventing Infertility during Cancer Treatment	161	(1)
Embryo, Egg, and Ovary Banking	162	(1)
Treatments to Enhance Ovulation after Cancer	163	(2)
20 Pregnancy and Cancer: What Are the Risks?	165	(3)
Risks of Triggering a Return of Cancer	165	(1)
General Health Risks of Pregnancy after Cancer	165	(1)
When a Woman Is Already Pregnant at Cancer Diagnosis	166	(2)
21 Postcancer Kids: Are They Healthy?	168	(8)
Risk of Birth Defects in Children of Cancer Survivors	168	(1)
Cancer Risk in the Children of Cancer Survivors	169	(3)
Genetic Testing for Cancer Risk	172	(4)
22 Having Whose Baby? Third-Party Reproduction	176	(11)
Using Sperm from a Donor	176	(2)
Using Eggs from a Donor	178	(2)
Surrogate Mothers and Gestational Carriers	180	(1)
Dilemmas in Using Third-Party Reproduction	180	(2)
Adoption after Cancer	182	(5)
PART IV SPECIAL STROKES FOR SPECIAL FOLKS	187	(57)
23 Myths about Sex, Women's Health, and Breast Cancer	187	(12)
Myth #1: Mastectomy Destroys Women's Sex Lives	187	(1)
Myth #2: Women Who Have Lumpectomy or Breast Reconstruction Are Much Better Off than Women Who Have Mastectomy Alone	188	(2)
Myth #3: A Woman Has Not Adjusted Well to Breast Cancer Unless She Learns to Love Her Scars	190	(1)
Myth #4: Silicone Breast Implants Are Unsafe and Should Be Banned Forever	191	(2)
Myth #5: Prophylactic Mastectomy Ensures That a Woman Will Never Get Breast Cancer	193	(1)
Myth #6: Once You Are Through with Chemotherapy, It Has No Impact on Your Sex Life	194	(1)
Myth #7: Tamoxifen Causes Menopause and Other Sexual Problems	195	(1)
Myth #8: Women Should Never Take Estrogen after Breast Cancer	196	(1)
Myth #9: Women Should Never Risk a Pregnancy after Breast Cancer	196	(2)
Being an Informed Survivor	198	(1)
24 It's Not Prostrate Cancer	199	(8)
Choosing a Treatment for Localized Cancer: Weighing Survival and Sex	199	(4)
Sex and Hormone Therapy: Making the Best of It	203	(1)
The Trauma of Orchiectomy	204	(3)
25 Sex with a Part Missing	207	(13)
Radical Hysterectomy: Sex without the Uterus and Cervix	207	(2)
Radical Vulvectomy: Sex without a Vulva	209	(2)
Sex after Operations That Reconstruct the Vagina	211	(2)
Penectomy: Sex without a Penis	213	(1)
Urinary Ostomies: Sex without a Bladder	214	(2)
Sex with a Colostomy or Ileostomy	216	(2)
Laryngectomy: Sex without a Voice Box	218	(2)
26 Survivors of Childhood Cancer	220	(6)
Childhood Cancer and Long-Term Health	220	(1)
Second Generation: Children of Childhood Cancer Survivors	221	(1)
The Emotional Impact of Surviving Childhood Cancer	222	(4)
27 Gay and Lesbian Cancer Survivors	226	(8)
Sexual Orientation and Your Cancer Risk	226	(1)
Being Gay in the Health Care System	227	(2)
Gay Sexuality after Cancer	229	(2)
Standards of Beauty and Physical Changes from Cancer	231	(1)
Infertility Matters to Gay People, Too	231	(3)
28 Sex and the Single Survivor	234	(10)
Cancer and Your Social Network	234	(1)
Finding a Dating Partner	235	(2)
Don't Let Your Cancer Be the Skeleton in Your Closet!	237	(1)
Disclosing a Problem That Affects Your Sex Life	238	(2)
Making a Commitment despite Infertility	240	(1)
Dealing with Rejection	241	(3)
A Final Thought	244	(1)
Resources	245	(6)
Bibliography	251	(22)
Glossary	273	(8)
Index	281