In the work I do I feel I have discussed so many subjects related to cancer, but after a conversation with Sam I realised I hadn’t really talked too much about our physical relationships. Many might say, that is the least thing to worry about, but for a lot of us they are so important. Of course cancer doesn’t only affect us but our partners too, and things can change dramatically after treatment. What is also crucial here is that cancer affects all ages, and there are so many young people dealing with these issues as I write. I can’t begin to imagine starting my time of ‘sexual exploration’ having had serious treatment and trying to deal with the physical and emotional issues of that. On reflection in all my 8 years of treatment, the impact on my physical relationship has never been discussed. As things are moving dramatically these days, there are many new ways of working and I am finding it increasingly important to innovate, but if I am honest there seems to be a resistance to change from service providers. Below Sam shares her own views and experiences.
“As a sexual health and wellbeing writer and a former nurse I’m on a mission to get healthcare professionals (HCPs) talking about sex with their patients. Having a nursing background you’d think it would be easier to get people to take notice but it’s not! I have had so many negative responses and conversations with HCPs that I shouldn’t be surprised anymore. My passion for writing about practical ways in which people can overcome sex health issues arose from the numerous conversations I have had with customers about their sexual problems and the lack of advice given by their doctor and other HCPs. Initially I thought it was because we have many older customers, but I soon came to realise that HCPs don’t talk about sex.
Many healthcare professionals will tell you that they find it hard to talk about sex with their patients yet it’s often even harder for their patients to raise their problems with their doctor for fear of being dismissed or told they’ll just have to put up with it. Sex is so often medicalised by HCPs as they can’t think beyond their medical training. Those who do discuss sexual problems with their patients rarely offer practical solutions other than sex therapy, for which there is often a long wait, or prescribing medication or some medical device that is ineffective and patients won’t use.
Through exploring different pathways to sexual pleasure and intimacy there are so many ways in which people can enjoy sex, yet many HCPs fail to offer this advice and won’t recommend support groups and websites like Jo Divine. We have been told so many times by HCPs that, “ We love what you’re doing but can’t recommend you!” Yet they are not offering any advice to their patients, therefore failing to give the best care they can when they know this advice is available for free at the click of a button. HCPs are not guardians of the internet. Patients can find so much more information online but it would be good if the information they read is well written and offers correct advice and practical tips.
At the request of Consultant Urogynaecologist, Dr Alex Slack and women’s health physiotherapist, Pip Salmon, at Tunbridge Wells Hospital, we created a health brochure containing sex toys, lubricants and pelvic floor exercisers that can help with a whole range of gynaecological problems such as vaginal tightness, vaginal dryness, postoperative scarring, decreased sexual sensations and symptoms of the menopause. Both recognise the benefits of sex toys and Dr Alex Slack says he treats women so they can enjoy sex again which is such a refreshing attitude but there are very few consultants with this view.There are 14 gynaecologists at the hospital where he works, yet the health brochure is being given out by just 2 of them and Pip Salmon!
When I was invited to speak at the Survivorship Conference for gynaecology/oncology nurses, it amazed me just how many people avoided my table, which had a few slim vibrators nestled amongst the brochures. These nurses look at vaginas for a living yet are embarrassed by a bit of buzzing silicone! Some wouldn’t even buy a raffle ticket to win a sex toy. One comment was what would I do if I won and it fell out of my bag at the station! HCPs, especially doctors, always ask for the research about our products, yet very little has been done, we just have anecdotal evidence from people who have used our products and have found that they help their sexual problems, in addition to making sex better again. The impact of undergoing surgery for prostate cancer or gynaecological cancer can affect the sex lives of both partners, yet many couples do not have counselling prior to surgery or treatment.
Both partners need to be included in the discussion right from the start so that they fully understand the implications that cancer and its treatment can have upon their sexual relationship. Being made aware that there are ways in which you overcome some of these problems, if or when they arise, helps couples to deal with any problems, as well as involving them in the treatment process. It also speeds up the rate of recovery, allowing a couple to return to enjoying sexual pleasure and intimacy, in whatever way they can or want to. So HCPs, if you can’t get over your embarrassment about sex, don’t let your patients down, you have the choice of offering better advice to your patients by recommending support groups and websites, like Jo Divine, that fill in the gaps in your knowledge and save your blushes!”
Do you feel that we don’t discuss the physical side of our relationships after cancer enough? Did you feel you had adequate support around these issues? Please feel free to share your views and experiences below.