Category Archives: Cancer

How a Cervical Cancer Scare Made Me Take My Sexual Health More Seriously Than Ever

My doctor’s advice on how to not get HPV again threw me for a loop.

By Rachel Bowyer

Before I had an abnormal Pap smear five years ago, I didn’t even really know what that meant. I’d been going to the gyno since I was a teenager, but I never once really thought about what a Pap smear was actually testing for. I just knew I’d have a “twinge” of discomfort, as my doc always says, and then it would be over. But when my doctor called me to tell me I needed to come back in for more testing, I was pretty concerned. (Here, find more on how to decipher your abnormal Pap smear results.)

She assured me that abnormal Paps are actually quite normal, especially for women in their 20s. Why? Well, the more sexual partners you have, the more likely you are to get human papillomavirus (HPV), which is what generally causes the abnormal results. I quickly found out that it was the cause of mine, too. Most of the time, HPV resolves on its own, but in some cases, it can escalate into cervical cancer. What I didn’t know at the time is that there are several steps between testing positive for HPV and actually having cervical cancer. After having a couple of colposcopies, procedures where a tiny bit of tissue is removed from your cervix for closer examination (yes, it’s as uncomfortable as it sounds), we discovered that I had what’s known as high-grade squamous intraepithelial lesions. That’s just a technical way of saying that the HPV I had was more advanced and more likely to turn into cancer than other kinds. I was scared, and I got even more scared when I found out I had to have a procedure to remove the tissue on my cervix that was affected, and that it needed to be done ASAP—before it got worse. (According to new research, cervical cancer is deadlier than previously thought.)

Within two weeks of finding out about my abnormal Pap, I had something called a loop extrosurgical excision procedure, or LEEP for short. It involves using a very thin wire with an electrical current to cut away precancerous tissue from the cervix. Normally, this can be done with local anesthesia, but after an attempt that went awry (apparently, local anesthetic isn’t as effective for everyone as it’s supposed to be, and I found that out the hard way…), I had to make a second trip to the hospital to have it done. This time, I was sedated. After six weeks, I was declared healthy and ready to go, and told I needed to have a Pap smear every three months for the next year. Then, I’d go back to having them once yearly. Let’s just say I’m not a great patient, so after all was said and done I knew I never wanted to have to go through this process again. Since there are over 100 strains of HPV, I knew it was a real possibility that I could contract it again. Only a small number of the strains cause cancer, but at that point, I really didn’t want to take any chances.

When I asked my doctor how to prevent this situation from happening again, her advice really surprised me. “Become monogamous,” she said. “That’s my only option?” I thought. I was dealing with the perils of the New York City dating scene at the time, and at that point couldn’t even imagine meeting someone I’d want to go on more than five dates with, let alone finding my mate for life. I had always been under the impression that as long as I was *safe* about sex, opting not to settle down wouldn’t be detrimental to my health. I almost always used condoms and got tested for STIs regularly.

Turns out, even if you use a condom every single time you have sex, you can still get HPV because condoms don’t offer complete protection against it. Even when used correctly, you can still have skin-to-skin contact when using a condom, which is how HPV is passed from one person to another. Pretty crazy, right? I didn’t think there was anything wrong with not wanting to be monogamous (and still don’t), so it was hard to grasp the fact that my ideological stance on sex was directly opposed to what was best for my sexual health. Was my only option truly to settle down at 23 and decide to only have sex with one person for the rest of my life? I wasn’t ready for that.

But according to my doctor, the answer was essentially, yes. To me, this seemed extreme. She repeated to me that the fewer partners you have, the lower your risk of contracting HPV. Of course, she was right. Though you can still get HPV from a long-term partner that could take years to show up, once your body clears whatever strains they have, you won’t be able to get it from them again. As long as you and your partner are only having sex with each other, you’re good to go in terms of re-infection. At the time, I was pretty taken aback by the fact that the best thing I could do to protect my sexual health was basically to not have sex until I found “the one.” What if I never found that person? Should I just be celibate forever!? For the next couple of years every time I even thought about having sex with someone, I had to ask myself, “Is this really worth it?” Talk about a mood killer. (FYI, these STIs are much harder to get rid of than they used to be.)

Truthfully, it didn’t turn out to be such a bad thing. Whenever I decided to have sex with someone in the years after that, not only did I follow safe-sex practices to the letter, but I also knew that I had strong enough feelings about the other person for it to be worth the risk I was facing. Basically, that meant I was genuinely emotionally invested in every person I slept with. While some would say that’s how it should be all the time, I don’t really subscribe to that school of thought—in principle. In practice, however, I did save myself a ton of heartache. Since I had fewer partners who I got to know better, I dealt with less post-sex ghosting. Some people might not mind that, but even when I wasn’t super-invested in someone, the ghosting part almost always sucked.

Now, five years later, I happen to be in a long-term monogamous relationship. While I can’t say that it happened directly because of my experience or my doctor’s advice, it’s certainly a relief when what your heart wants and what’s best for your health happen to match up. And not having to constantly worry about HPV the way I once did? Love.

Complete Article HERE!

Childhood cancer treatment may hinder later-life sexual relationships

 

Neurotoxic treatment for cancer during childhood may influence sexual activity and relationships in adulthood, according to new research.

Study co-author Vicky Lehmann, Ph.D., of Nationwide Children’s Hospital and Ohio State University – both in Columbus, OH – and colleagues found that adults who received high-intensity neurotoxic treatment for cancer as a child were less likely to meet certain sexual and romantic milestones.

However, the team found that childhood cancer treatment did not affect overall satisfaction for sexual and romantic relationships in adulthood.

Lehmann and team recently reported their findings in the journal Cancer.

According to the American Cancer Society, it is estimated that around 10,380 children aged 15 and under were diagnosed with cancer in the United States last year.

Leukemia is the most common form of childhood cancer, accounting for around 30 percent of all cases, followed by brain and spinal cord tumors, which make up around 26 percent of all childhood cancer cases.

Childhood cancer treatment and psychosexual development

While cancer was responsible for more than 1,200 childhood deaths last year, over 80 percent of children diagnosed with the disease will survive for at least 5 years. This is due to significant advances in cancer treatment, which include surgery, chemotherapy, and radiation therapy.

However, such treatment is certainly not without risk. For example, studies have shown that cranial radiation – often used to treat brain tumors – may cause harm to the developing brain, leading to long-term neurocognitive impairment.

Previous research has shown that neurocognitive impairment as a result of childhood cancer treatment may impact social interaction in adulthood, but studies investigating the effects of such treatment on psychosexual development are few and far between.

“Psychosexual development entails reaching certain milestones, such as sexual debut, entering committed relationships, or having children.

It is a normative part of becoming an adolescent or young adult, but only comparing such milestones without taking satisfaction into account falls short. These issues are understudied among survivors of childhood cancer.”

Vicky Lehmann, Ph.D.

To address this gap in research, the team enrolled 144 survivors of childhood cancer aged between 20 and 40. A further 144 participants who were not treated for childhood cancer (the controls) were matched by age and sex.

All participants completed questionnaires on psychosexual development, sexual satisfaction, and relationship satisfaction.

To determine the brain toxicity of cancer treatments in childhood, the researchers used data from the participants’ medical charts.

Neurotoxic cancer treatment might predict later-life psychosexual issues

Overall, the team found that adults who were treated for cancer in childhood did not differ significantly from the controls in terms of psychosexual development, sexual satisfaction, and relationship satisfaction.

However, on analyzing subgroups of childhood cancer survivors, the researchers found that those who previously received treatments high in neurotoxicity were less likely to have had sexual intercourse, be in a relationship, or have had children, compared with controls.

The type of cancer treatment in childhood did not appear to affect sexual satisfaction, the team reports. “This highlights the subjective nature of psychosexual issues, and the importance of addressing any concerns in survivorship care,” notes Lehmann.

The researchers say that their findings indicate that the neurotoxicity of cancer treatment in childhood may predict the likelihood of psychosexual problems in adulthood. They add:

“Additional research is needed to delineate how neurocognitive impairment undermines social outcomes for survivors, as well as other related factors.

Given the findings of the current study, healthcare providers should assess romantic/sexual problems among survivors, especially those who received high-dose neurotoxic treatments. Referrals to psychosocial care could prevent or reduce potential difficulties.”

 
Complete Article HERE!

Sexual Healing for Cancer Survivors

By KATIE KOSKO

sexual-healing

Sexual health can be an uncomfortable or embarrassing topic to discuss for many people, and for patients with cancer, survivors and their partners, it can feel even more awkward. In fact, sex ranks among the top five unmet needs of survivors, and a new digital health startup, Will2Love, has been launched to help fill this void.

Sixty percent of cancer survivors — 9.3 million individuals in the United States alone — end up with long-term sexual problems, but fewer than 20 percent get professional help, according to Leslie R. Schover, PhD, Will2Love’s founder. Among the barriers she cites are overburdened oncology clinics, poor insurance coverage for services related to sexual health and an overall lack of expertise on the part of providers, many of whom don’t know how to talk to patients and survivors about these issues.

Sexual issues can affect every stage of the cancer journey. Schover, who hosted a recent webinar for health care practitioners on the topic, has been a pioneer in developing treatment for cancer-related problems with sexuality or fertility. After decades of research and clinical practice, she has witnessed firsthand how little training is available in the area of sexual health.

“Sex remains a low priority, with very little time devoted to managing sexual problems even in specialty residencies,” she adds.

The problem is twofold: how to encourage oncology teams to do a better job of assessing and managing sexual problems and how to help those impacted by cancer to discuss their sexual concerns.

Schover says that simple, open-ended questions such as: “This treatment will affect your sex life. Tell me a little about your sex life now,” can help to get the conversation started.

Sexual side effects after cancer treatment vary from person to person, and also from treatment to treatment. Common side effects for men and women include difficulty reaching climax, pain during sexual intercourse, lower sexual desire and feelings of being less attractive. Men specifically can experience erectile dysfunction and dry orgasm, while women may have vaginal dryness and/or tightness, as well as loss of erotic sensation such as on their breasts following breast cancer treatment.

Sexual dysfunction after cancer can often lead to depression and poor quality of life for survivors and their partners.

Cancer treatment can impact hormonal cycles, nerves directing blood flow to the genitals, and the pelvic circulatory system itself, explains Schover. In addition, side effects like prolonged nausea, fatigue, and chronic pain also can disrupt a patient’s sex life.

“Simply to give medical solutions rarely resolves the problems because a person or couple needs to make changes in the sexual relationship to accommodate changes in physical function,” Schover stresses. “That kind of treatment is usually best coming from a trained mental health professional, especially if the couple has issues with communication or conflict.”

Schover hopes that Will2Love will bring much-needed attention to the topic by providing easily accessible resources for patients, survivors, their partners and health care providers. (Box)

Currently visitors to the website can subscribe to its e-newsletter and receive a free introductory five-part email course covering topics related to what your doctor may not be telling you about sex, fertility and cancer. After the fifth lesson, users will receive a link to the Will2Love “Sex and the Survivor” video series. “Sexual health is a right,” Schover stresses, and oncology professionals, patients and survivors need to be assertive to get the conversation started.

Complete Article HERE!

Sexual pain after cancer treatment an unspoken affliction for many women, UC Davis oncologist says

Sexual pain is a common, but unspoken, aftermath of women’s cancer treatment. Doctors can be reluctant and patients too embarrassed to discuss it.

But it’s an all-too-real aspect of cancer treatment for women, according to Dr. Vanessa Kennedy, a gynecological oncologist for the UC Davis Health System.

Dr. Vanessa Kennedy, assistant professor in gynecological oncology, UC Davis Health System, Sacramento.

Dr. Vanessa Kennedy, assistant professor in gynecological oncology, UC Davis Health System, Sacramento.

“Some patients are two to three years out of treatment and they’re dealing with sexual pain and no one’s talked about it. Patients hesitate to bring it up because it’s a sensitive issue,” said Kennedy, who recently discussed the problem in the journal Obstetrics & Gynecology. Her co-author, Dr. Deborah Coady of New York University Langone Medical Center in New York, is author of the book, “Healing Painful Sex: A Woman’s Guide to Confronting, Diagnosing and Treating Sexual Pain.”

Kennedy estimates that about 50 percent of female patients with cancer – of any type – experience some form of sexual pain, due to physical changes caused by surgery, chemotherapy and radiation. It can range from vaginal dryness caused by early menopause to anatomical changes that can make sex uncomfortable.

Some women feel guilty they’re even concerned about their sex lives, given what they’ve been through battling cancer. “There’s some guilt that they should just feel lucky to be alive and shouldn’t ask about these other things,” she said. But when sexual health is addressed, “They’re actually relieved to know they’re not alone.”

Twice a month on Fridays, Kennedy holds a regular clinic, seeing UC Davis patients who’ve been referred for post-cancer problems with sex. She works with patients on a number of interventions, including physical therapy, lubricants (even coconut or olive oil), vaginal dilators and couples counseling to re-establish intimacy.

Kennedy said doctors and medical students need to learn to be comfortable broaching the topic. “A lot of students and providers are still a little bit nervous asking about sex,” she said. “How do you get comfortable talking about these things? You just do it. It’s just like asking a patient about changes in appetite or changes in sleep. Sex is another thing (on the list). Get over it and ask about it.”

There’s a difference in how men and women cancer patients deal with sexual health, Kennedy contends. For men who’ve undergone prostate cancer treatment, there’s an emphasis on restoring their sexual function. For women, there’s often physical pain and a loss of intimacy, along with the added fear by some that their partners view them as less desirable. In some cases, where sex has become nonexistent, patients confide that their partners have threatened to leave or cheat on them.

Kennedy, who did fellowship training at the University of Chicago, which has a sexual health program for women cancer patients, says research on women’s sexual health issues is lagging, compared with that for men with prostate cancer. Next April, she’s hosting a national gathering of the Scientific Network on Female Sexual Health and Cancer, which promotes research and information for women patients and their providers.

“Sex is a quality-of-life issue and a core of our well-being,” Kennedy concludes. “We have to bring back the intimacy and make this a part of the body that’s associated with pleasure, rather than an uncomfortable, negative place.”

Complete Article HERE!

Does Anal Sex Lead To Anal Cancer?

3 Facts And Myths For Sexual Partners

 

Anal sex is no longer quite the salacious taboo it once was.

Not only has society steadily become more accepting of sexual relationships between men, but more heterosexual people are trying it and trying it more often than ever before. Recent surveys  estimate that 40 percent of women between the ages of 20 to 24 have tried anal sex, and 20 percent of all women have tried it in the last year.

Our greater societal acceptance aside, you may have heard that anal sex can have some dangerous effects on our health, particularly as a leading cause of anal cancer. So let’s take a brief look at some basic facts and myths about anal sex and its connection to cancer.

The myths and facts behind the connection between anal sex and anal cancer.

The myths and facts behind the connection between anal sex and anal cancer.

1. It Can Cause Anal Cancer

The long and short of it is that yes, anal sex is a risk factor for anal cancer.

Anal sex can transmit the human papillomavirus (HPV), and HPV in turn leaves the cells around our rectum more vulnerable to mutating and becoming cancerous. A similar risk exists wherever HPV rears its ugly microscopic head, including the mouth, throat, and cervix. And because anal sex is generally more damaging to the inner lining of the rectrum than the stereotypical notion of heterosexual sex is to the vagina, HPV and other sexually transmitted infections are more easily spread between people who engage in anal sex. Similarly, the greater number of sexual partners, the greater the risk of cancer.

2. But It’s Rare

Close to 90 percent of anal cancer cases can be traced back to HPV. But the cancer itself is relatively rare.

According to The American Society of Colon and Rectal Surgeons, only 8,000 people will be newly diagnosed with anal cancer this year. And though cases have been slowly increasing in recent decades, only one of every 500 people will develop anal cancer in their lifetime, generally between the ages of 55 to 64 — a stark contrast to the one in every 22 people who will develop colorectal cancer.

3. And Preventable

Like other forms of cancer fueled by HPV, the available HPV vaccine can likely cut down the risk of developing anal cancer in both men and women.

While HPV vaccination rates still aren’t anywhere near as high as we’d like them to be, there is already evidence that the vaccine has lowered the risk of later cervical cancer in teen girls. And though we don’t have any concrete evidence that the same decline has occurred for anal cancer just yet, there is some showing the vaccine reduced the risk of cells in the anus becoming precancerous in young men who have sex with men.

Both teen boys and girls are now regularly encouraged to get the HPV vaccine, but when it comes to anal cancer, it may benefit women more — two-thirds of new cases are diagnosed in women.

Complete Article HERE!