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Mastectomy presents intimacy challenges – and opportunities

Q. I’m in my early sixties and I’ve been a widow for almost 10 years. Four years ago, I had a mastectomy and reconstructive surgery. My dilemma is this: I’ve recently met a man who I’ve become very fond of and our relationship is about to go to the next level. By that I mean physical. It’s been a long time since I’ve been sexually active and I’ve never been naked in front of anyone (except medical people) since the surgery. I’m terrified and feeling very self-conscious but I don’t want to run for the hills. Help!

Jeanie, Edmonton


A. Your feelings are completely understandable. Even women who’ve been with the same partner for 30 or 40 years and have gone through what you have can fear being intimate again. On the other hand, some women are quite at ease with their changed physicality after cancer and are ready for anything. Anne Katz has seen both ends of the spectrum and everything in between. She’s a Winnipeg-based certified sexuality counsellor who specializes in the connection between cancer and sexuality issues, and she’s written quite a few books on the subject.

You don’t mention whether you’ve actually told this man about your cancer and the reconstructive surgery. If you haven’t, Dr. Katz recommends starting there. Open up and be honest – about the cancer, the surgeries, your fear – all of it. “Communication underpins everything,” she says. “It’s natural to feel scared of exposing yourself, to be vulnerable, but you need to lay it all out on the table and say something like, ‘It’s been a long time. I’m really scared and I’m not confident in who I am’.”

After that, you do whatever makes you feel comfortable. If you don’t want to wear lingerie, for example, she suggests wearing a man’s oversized cotton shirt, which is very sexy and really comfy. “Cover up what you need to cover up and don’t feel guilty about it,” advises Dr. Katz, emphasizing that “he’s probably really scared as well, plus he’s not perfect and 22 either. It can be nerve-wracking for him too. There’s that pressure to perform.” It could be that having a frank discussion will bring both of you a tremendous sense of relief.

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