Changes in Your Sex Life of breast protection on cancer

The most uncomfortable stuff to talk about is probably your sex life and the changes that have taken place with your illness. You may not know what needs fixing or how to fix it, but you know things are different.
Many women report having less sex than before their illness, for several reasons:

• The breast cancer experience slows down your body. It takes longer to do lots of things, including getting interested in and starting and finishing sexual intercourse.
• Sex may be uncomfortable or even painful if you've been thrown into sudden-onset menopause. No surprise that you tend to have less sex, for now. Many women may have had little or no sex from the time of diagnosis through treatment.

Most people have wild ideas about what goes on in other people's bedrooms. Give yourself a break: The carefully researched book Sex in America (by Michael, Gagnon, Laumann, and Kolata) tells us that Americans have a lot less sex than the movies, television, and the guys in the locker room would have you believe. The averages reported in that book are:

• seven times a month between ages 30 and 40
• six times a month between ages 40 and 50
• five times a month between ages 50 and 60

For people over 60, the numbers continue to decline. But although you may assume that no one in their 70s and 80s has a sex life, that's just not so.
Molly, 78, described her sex life after breast cancer treatment: "I stopped the action for a while, and then we went back at my request. He was waiting for me to give him the go-ahead." Hilda, an 82-year-old breast cancer survivor, explained that she didn't have a lover "at the moment." Sex goes on even into the 90s for some. And now with Viagra, who knows what new limits will be set?
Don't let the myths about other people's sex lives get in the way of what's happening in yours. And remember that there are exceptions to every pattern.
If your sex life is not working the way you want it to, your doctor or nurse may be able to referee these issues with your partner and you. You can cue your doctor in advance, since he or she has most likely already touched on delicate issues with you. Maybe he or she can be the tour guide for the two of you. If your partner is there when you talk with the doctor who's managing your care, you and your partner both get a chance to air and dispel fears, and replace myths and false information with facts.

Expert Quote

One of my patients had told me that her breasts had been a crucial part of her sexual life before the discovery of her disease. She had breast cancer in both breasts, treated with l lumpectomy and radiation. Her breasts looked great—but her husband was ignoring them completely. I scheduled an appointment that included her husband and was able to reassure him that her breasts would not be harmed by fondling, kissing, or whatever; that he could not catch cancer; and that she was not radioactive. They quickly resumed their former lovemaking habits.

Robin M. Ciocca, D.O.

You and Your Partner about sex and breast cancer protection

What do partners of breast cancer patients care most about? In spite of what you may imagine or fear, studies show that the answer is simply this: Their loved one is alive and feeling well. The loss or alteration of a breast is almost meaningless in contrast. "I don't care what they take from you as long as I can see your face" is a common sentiment. Most caring partners (both men and women) see their lovers as having many parts to love, and as being more than the sum of those parts.
Nobody is promising there won't be ups and downs. While you're worrying about feeling less attractive, your partner is also dealing with worry, anxiety, and maybe even guilt, wondering: "Could I have been responsible? Could I in some way have contributed to the cancer? Will I become radioactive if I touch her, if I touch her breast? Is her cancer contagious?" And (perhaps feeling guilty), "When will I be able to worry about myself for a change?"
It may be hard for you figure out your needs and concerns, let alone tell them to your partner. You don't want to make light of what your partner has already done for you, so phrase your requests as carefully and positively as possible: "You've been working so hard, doing so much—and it's made a huge difference. But what I really need right now is to be close to you and tell you what's making me nervous and anxious. I need you to listen, and maybe just hold me."

Communication's the key

Communication—talking to each other, listening to each other—is the basis of any intimate relationship. But most people haven't a clue about how to talk about something as big as cancer. So here are some tips to get you started:

• Find some time. Most couples have limited time together anyway. A breast cancer diagnosis just adds more distractions. Even when you do get to talk, there are so many interruptions the conversation may go nowhere. Schedule some time in a quiet place where you know you won't be interrupted.
• Start somewhere. Begin by talking about something comfortable and manageable—your vacation plans, even the weather. Once you're talking, then you can work the conversation around to your fears, concerns, how the illness has changed you, and the importance of your relationship.
• Talk, talk, talk. Even if your partner isn't a good talker, that doesn't mean he or she isn't listening. You may need to do most of the talking yourself but, believe it or not, what you're saying WILL be heard and it WILL sink in. Stop along the way to get feedback. Eye contact and touch can give your words greater meaning and emphasis.
• Reassure your partner. Your partner may feel that you've got enough to deal with without listening to someone else's fears and concerns. Make it clear that you WANT to hear how he or she is feeling, that you're both in this together.
• Bring in a third party. If you're both having trouble communicating, a visit with a therapist can get the ball rolling.
• Write it down. Sometimes it's much easier to write how you're feeling in the form of a letter or even a journal entry than to say it face to face.

Breast cancer is not good for relationships, but good relationships can be made stronger by sharing hardship. Your partner may have doubts, and miss and mourn the "old" you, just as you may be doing. But that doesn't mean he or she is prepared to trade you in. "My husband stood by while I cried and screamed, and he hugged me when I let him get close enough," said Debra. "Our marriage is better now than it ever was before."

Should you be in this relationship?

If you see yourself as damaged goods, you probably assume your partner feels as you do. But that simply isn't a given.
One consequence of feeling less than lovable is fear of being abandoned. It's true that in some cases a man sees his partner's altered body as a personal reflection of his value—and just wants out. Other partners simply come apart under stress.
Overall, though, following a diagnosis of breast cancer, as many women leave their husbands as are left by husbands. They don't want to waste their time in an unfulfilling, unhappy marriage.

Sex and Intimacy on breast cancer protection

Many women find that breast cancer diagnosis and treatment seriously disrupt their sexual lives. First there are the most obvious issues—the physical changes, exhaustion, nausea and pain from treatment, self-image, empty energy reserves, and the emotional chaos from the diagnosis itself. But there are also many other issues that women and their partners may not even know they'll have to face.
Yet retaining intimacy in your relationship both during and after your breast cancer ordeal is critical to your overall recovery. And single women who want to become part of a relationship worry how breast cancer will affect their prospects, about how and when to tell those prospective lovers about their condition.

Personal Quote

Vicky Cosgrove was married nearly 20 years and had four children, ages 6 to 17, when she was diagnosed with breast cancer in February 2000. Yet after a year in which she had a bilateral mastectomy and reconstruction, chemotherapy and radiation, and began taking tamoxifen, she says her intimate life with her husband has never been better. "Maybe it has something to do with feeling that we shouldn't waste our time, maybe it's that I feel he's even more in tune with my needs," she says. "But he's just become a much more giving person."

Flawed marriages don't have to come apart, with or without breast cancer. Divorce rates are not higher among couples in which a woman has had breast cancer. Sometimes the shock of a cancer diagnosis pushes partners in a troubled relationship to consider the source of their problem and seek counseling.
Or YOU may be the one who responds unpredictably. One very independent woman became overwhelmed, uncertain, and very dependent when her breast cancer was diagnosed. This new "frailty" devastated her, and her marriage went through a rough spell till she finally returned to something of her old self.

Talking, telling, supporting each other

It would be nice to have a partner who understands and helps you feel better as you work to get back your old confidence, but that may just be unrealistic. He or she is probably suffering, too, and may be less able to express that suffering than you are. So each of you have all this emotion buried somewhere inside.
Ginny could not understand her husband's silence. "What's the matter with you? Why don't you talk to me about what's happening? I have CANCER! I could die! Say SOMETHING!" Ginny felt as though she was yelling at a stone wall.
Breast cancer has become so common that most men have someone close in their life who has suffered the disease. There's no way to predict how any man will respond, but there is no doubt that many men are supportive and prepared to continue the relationship.
Women may find it easier to talk to one another, and lesbian partners may be particularly sensitive and supportive. It is also true, however, that a woman may feel especially vulnerable and personally threatened if her partner has breast cancer, knowing this disease is one that can affect her as well.

Types of Exercise helps on breast cancer

There are three basic types of exercise:

• Aerobic Exercise: increases your heart rate, works your muscles, and makes you breathe faster and harder
• Flexibility Exercise: may include stretching, foam rolling, yoga, tai chi, and Pilates
• Strength/Resistance Exercise: may involve barbells and weight plates or dumbbells

Examples of each type of exercise are in this section, as well as the benefits it offers, the equipment you’ll probably need, and where you can do it. The ideal exercise program contains all three types, plus warm-up and cool-down sessions. That may sound like a lot, but after you have your doctor’s approval to start exercising, you can start slowly and gently and then gradually extend the time you work out.
According to an exercise survey Breast cancer did October through November 2011, quite a few of our visitors -- 82% of respondents -- walk  for exercise. Other top exercise choices were weight lifting (35%), cycling (29%), yoga (28%), and running (23%).
If you’re starting a new exercise program after breast cancer surgery, adding any additional aerobics to your routine can potentially overwork the arm on the surgery side. For example, if you start an exercise program designed specifically for breast cancer survivors, wait to use an elliptical machine, play tennis, do cross-country skiing, or anything else that works your arm until your arm is stronger. It may be too much right after surgery.

Finding an Exercise Trainer on protection of breast cancer.

If you’re planning to do strength training after breast cancer treatment, you may want to work out with a certified trainer (or physical therapist trained in lymphedema diagnosis and management) who has experience working with breast cancer survivors. A qualified trainer can help you start slowly, teach you precautions to take and push you enough but not too much.
Make sure your trainer is certified by a national trainer organization. The American College of Sports Medicine, the National Association of Sports Medicine, and the American Council on Exercise are three well-known, respected organizations, but there are others that are also good.
A trainer who has a cancer and exercise training certification from the American College of Sports Medicine has done additional training to work specifically with people who’ve been diagnosed with cancer. After completing the cancer and exercise training program, a trainer will “understand the potential impact of cancer therapy, especially surgery and chemotherapy, in putting cancer patients at increased risk of injury and other complications, such as lymphedema, from exercise.” You can search for a cancer and exercise-certified trainer on the American College of Sports Medicine website.
The PALS for Life training program teaches trainers to work specifically with breast cancer survivors. This program is based on the protocol used in the Physical Activity and Lymphedema trial. Visit the PALS for Life website to find a PALS for Life-qualified trainer.
While a college degree isn’t necessary to be a good trainer, a degree in a field related to exercise physiology means the person has that much more education.
Here are some questions to ask a potential trainer:

• Have you worked with breast cancer survivors before?
• Are you certified? If so, which organization is your certification from?
• Do you hold a cancer and exercise-training certification?
• May I have the names of three of your current client references?

Exercise on breast cancer protection.

Regular exercise is an important part of being as healthy as you can be. More and more research is showing that exercise can reduce the risk of breast cancer coming back (recurrence) if you've been diagnosed, as well as reducing the risk of developing breast cancer if you’ve never been diagnosed.
Breastcancer.org visitors know how important exercise is. According to a survey we did in October and November 2011, 70% of people who answered the survey exercised regularly and 23% exercised less often. But they were still exercising!
A roundtable convened by the American College of Sports Medicine in 2010 reviewed available research and concluded that exercise is safe during and after all breast cancer treatments (as long as you take any needed precautions and keep the intensity low) and improves physical functioning, quality of life, and cancer-related fatigue. There also is evidence that exercise can help breast cancer survivors live longer and lead a more active life.
In this section, you can read about the benefits of exercise for people diagnosed with breast cancer, types of exercise, and when you can exercise, both during and after treatment.

Why Exercise?

Exercise can lower your risk of breast cancer coming back, as well as help you maintain a healthy weight, ease treatment side effects, boost your energy, and more! Read about the many ways exercise is good for you.

Exercise Safely

Learn how to start exercising safely by following these nine steps.

Finding an Exercise Trainer

If you’re planning to do strength training, you may want to work out with a certified trainer or therapist who has experience working with breast cancer survivors. Learn how to find one in your area and the questions to ask before you sign a contract.

Types of Exercise

Read about the three types of exercise -- aerobic, strength/resistance, and flexibility -- and learn why you need to do each. There’s also information on intensity levels and how to measure how intense your exercise is.

Exercise During and After Treatment

Research shows that it’s safe to exercise during all types of breast cancer treatment, as long as you take certain precautions and keep the intensity low. Learn what you can do and when and how to stick to your exercise routine.

How to Stick to an Exercise Routine

After your initial enthusiasm wears off, use these tips recommended by other women and experts to stick to your routine.

Exercise Resource Guide 

Browse a list of links to websites offering information on exercise for breast cancer survivors, including warm-up and stretching exercises.

Exercise Testimonials

Read about what motivates other women diagnosed with breast cancer to stick to their exercise plans, tips they use to get moving even when they don’t want to, and the moves that keep them glowing and fit.

The experts for Exercise are:
Linda T. Miller, P.T., D.P.T., C.L.T., clinical director of the Breast Cancer Physical Therapy Center, LTD. Dr. Miller specializes in treating post-operative complications of breast cancer surgery, including lymphedema, and also heads Recovery In Motion, LTD, a network of facilities that use Miller’s Recovery In Motion education and treatment program for breast cancer rehabilitation. Linda teaches continuing education programs nationally and has published several articles on post-operative breast cancer rehabilitation and breast cancer-related lymphedema.
Nancy J. Roberge, P.T., D.P.T., M.Ed., Legislative Chair of the Oncology Section of the American Physical Therapy Association. Dr. Roberge is the director of Chestnut Hill Physical Therapy and focuses her work on helping women move through breast cancer diagnosis, recovery, and beyond, achieving the highest quality of life possible. She has developed a two-day comprehensive breast cancer rehabilitation course and teaches nationally and internationally.

What Happens to Food in Your Body on protection of breast cancer

Just thinking about eating causes your body to start secreting insulin, a hormone that helps keep blood sugar (glucose) under control. Insulin is made by the pancreas. As you eat, more insulin is released, in response to the carbohydrates in the meal. Insulin is released when you eat protein-rich foods, but at a slower rate. If your pancreas is functioning properly, the amount of carbohydrates in what you’re eating usually determines how much insulin is released.
As you digest carbohydrates, they go into the blood stream as glucose. To keep blood sugar levels under control, insulin signals the cells in your body to take in glucose from the blood stream. The cells use some of glucose for energy and store some for later use. The way glucose is stored depends on the type of cell doing the storing. Muscle cells store glucose as glycogen. Liver cells store some glucose as glycogen and convert some to fat. Fat cells store glucose as fat.

A special note about high-fructose corn syrup: High-fructose corn syrup was introduced in 1978 and replaced the sugar in most soft drinks by about 1985. Total yearly sugar consumption (which excludes artificial sweeteners) immediately increased from 120 pounds per person to 150 pounds per person. High-fructose corn syrup is 55% fructose, 42% glucose, and 3% other carbohydrates. One important fact about fructose: it’s the carbohydrate your body converts to fat most easily. When you digest high-fructose corn syrup, much of the glucose in it ends up in the blood stream, raising your blood sugar levels. But the fructose in high-fructose corn syrup is processed almost totally in the liver, which has the proper enzymes to do the job. So fructose has no immediate effect on blood sugar and insulin levels, but there are lots of long-term effects.
Your liver isn’t designed to process the amount of fructose most people eat today. Fruit has fairly small amounts of fructose – a cup of blueberries has about 30 calories of fructose in it. But soft drinks or juices sweetened with high fructose corn syrup have much higher amounts – 12 ounces of Pepsi or Coke has 80 calories of fructose; 12 ounces of apple juice has 85 calories of fructose.
Your liver’s answer to this flood of fructose is to turn most of it into fat and ship it to your fat tissue. At the same time, the glucose that comes with the fructose in high-fructose corn syrup raises your blood sugar levels and makes your body secrete insulin, which tells your fat cells to store whatever comes their way, including the fructose processed into fat coming from your liver.
The more high-fructose corn syrup you eat and the more years you spend eating it, the more your body adapts by converting high-fructose corn syrup to fat. Over time, you accumulate fat in your liver (a condition called “fatty liver disease”). So while fructose has no immediate effect on your blood sugar and insulin, after a few years it will likely cause you to store calories as fat.

As glucose is removed from the blood stream, insulin levels go down and your cells start using fat for fuel instead of glucose. This is why you can go for long stretches – overnight, for example, when you’re sleeping, without eating. Your cells rely on fat for fuel.
There are two types of body fat: fatty acids and triglycerides. Fatty acids are small enough to move in and out of cells and be used as fuel for cells. Fat is stored inside fat cells as triglycerides, three fatty acids bound together. Triglycerides are too big to flow through cell membranes and so are stored for future use.
Insulin also plays a major role in telling your body when to store and use fat and protein. It does this by affecting the actions of two enzymes, lipoprotein lipase (LPL) and hormone-sensitive lipase (HSL).
LPL sits on the surface of cells and pulls fat out of the bloodstream and into the cell. If LPL is on a muscle cell, it pulls fat into the cell where it’s used for fuel. If LPL is on a fat cell, it pulls fat into the cell and makes it fatter.
It’s important to know that the hormone estrogen suppresses LPL activity on fat cells. This could be one reason why some women gain weight after menopause or after breast cancer treatment that dramatically decreases estrogen levels. With less estrogen in the body, LPL can pull more fat into fat cells and store it there.
The HSL enzyme works to make fat cells leaner by breaking down triglycerides into fatty acids that then can leave the fat cell and be used as fuel by other cells. So the higher HSL levels, the more fat we break down and burn.
Insulin reduces HSL enzyme levels, which stops triglycerides from being broken down and means more fat is stored in fat cells. When insulin levels are up even a little bit, fat accumulates in fat cells.