Cancer patients and survivors can have trouble with intimacy


People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.

People who survive cancer treatment — a growing group now topping 5 million — often have trouble with intimacy afterward, both from the actual treatment and physical recovery and from the psychological damage of feeling so vulnerable.(Photo: Getty Images/Comstock Images)

In the mirror, Kelly Shanahan looks normal, even to herself.


Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health.

But she does not feel like herself.

The breasts she had reconstructed eight years ago look real, the nipples convincing. But her breasts have no sensation. The only time she feels them at all is during the frigid winters of her South Lake Tahoe, Calif., home, when they get so cold, she has to put on an extra layer of clothing.

“For a lot of women, breast sensation is a huge part of sexual pleasure and foreplay. That is totally gone,” says Shanahan, 55, who has lived with advanced breast cancer for three years. “It can be a big blow to self-image, even though you may look normal.”
Kelly Shanahan of South Lake Tahoe, Calif., has been battling breast cancer for eight years. She’s a big believer in doctors and their patients discussing sexual health. (Photo: Kelly Shanahan)

Shanahan is part of a growing group of patients, advocates and doctors raising concerns about sexual health during and after cancer treatment.

“None of us would be here if it weren’t for sex. I don’t understand why we have such a difficult time talking about it,” she says.

Though virtually all cancer diagnoses and treatments affect how patients feel and what they think about their bodies, sex remains an uncomfortable medical topic.

Shanahan, an obstetrician herself, says that until her current doctor, none of the specialists who treated her cancer discussed her sex life.

“My former oncologist would rather fall through the floor than talk about sex,” she says.

Major cancer centers now include centers addressing sexuality, but most community hospitals still do not. The topic rarely is discussed unless the patient is particularly bold or the doctor has made a special commitment.

There’s no question that cancer can dampen people’s sex lives.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Weight gain or loss can affect how sexy people feel. Fatigue is unending during treatment. Body image can be transformed by surgeries and the idea that your own cells are trying to kill you. The constant specter of death is a sexual downer, as are the decidedly unsexy aspects of cancer care, like carrying around a colostomy bag. Then, there are the healthy partners, feeling guilty and terrified of causing pain.

And once people start to associate sex with pain, that can add apprehension and muscle tightness, which makes intercourse harder to achieve, says Andrea Milbourne, a gynecologist at the University of Texas MD Anderson Cancer Center in Houston.

There’s almost never a medical reason cancer patients or survivors shouldn’t be having sex, says Karen Syrjala, a clinical psychologist and co-director of the survivorship program at the Fred Hutchinson Cancer Research Center in Seattle. Even if there is reason to avoid intercourse, physical closeness and intimacy are possible, she says, noting that the sooner people address sexual issues the less serious those issues will be.

“Bodies need to be used and touched,” she says said. “Tissues need to be kept active.” Syrjala recommends hugging, romantic dinners, simple touching, “maybe just holding each other naked at night.”

There are ways to improve sexual problems, starting with doctors talking to their patients about sex. Milbourne and others say it’s their responsibility, not the patients’, to bring up the topic.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Hormone deprivation, a common therapy for breast and prostate cancer, can destroy libido, interfere with erections, and make sex extremely painful. Lubricants can help smooth the way.

Communication between partners also is essential. “A lot of times, it’s unclear, at least in the mind of the other partner who doesn’t have a cancer, what has happened. ‘Why does this hurt? Why don’t you want to do anything?’ ” Milbourne says.

For women who have pain during sex, Milbourne says one study found benefit to using lidocaine gel to numb vaginal tissue.

Jeanne Carter, head of the female sexual medicine and women’s health program at Memorial Sloan Kettering Cancer Center in New York City, recommends women do three minutes of Kegel exercises daily to strengthen their pelvic floor muscles and improve vaginal tone, and to help reconnect to their bodies.

For women sent abruptly into menopause, moisturizing creams can help soften tissue that has become brittle and taut. Carter says she’s conducted research showing that women with breast or endometrial cancers who use moisturizers three to five times a week in the vagina and on the vulva have fewer symptoms and less pain than those who don’t. Lubricants can help smooth the way, too.

“We’ve got to make sure we get the tissue quality and pain under control or that will just undermine the whole process,” Carter says.

Sex toys also take on a different meaning after cancer treatment. Specialized stores often can offer useful advice and the ability to examine a product before buying. Rings and other equipment, in addition to medications such as Viagra, can help men regain erections.

Doctors and well-meaning friends also need to stop telling cancer patients that they should simply be glad to be alive, Shanahan says. Of course she is, but eight years after her initial diagnosis and three years after her disease advanced, Shanahan wants to make good use of the time she has left.

And that, she says, includes having a warm, intimate relationship with her husband of 21 years.

Complete Article HERE!

These 3 Sex Ed Videos Aim To Take The Awkward Out Of Sex Education




Few moments in life are weirder than when an adult finally decides it’s time to impart the birds-and-bees speech. Or less pointless it seems.

Plenty of research has found that kids rarely get the answers to important questions they have about sex and puberty. And the sex ed they do get from their schools is oftentimes outdated, patronizing, and ignorant of modern-day realities like sexting and same-sex relationships. A new YouTube series called AMAZE is hoping to change that.

Created via a collaboration by the educational organizations Advocates for Youth, Answer, and Youth Tech Health, the series has already debuted a series of videos aimed at the 10 to 14 crowd throughout September, with plenty more scheduled for the future.

“It’s perfectly normal for young people to have questions about sex and growing up, and the internet is a natural place for curious minds,” said Debra Hauser, President of Advocates for Youth, in a statement announcing AMAZE’s debut. “But with so much information at their fingertips, what they discover online may not be the most factual or age-appropriate. The AMAZE videos address a range of critical topics about puberty and relationships in a way that — to young people’s relief — is less awkward, less weird and can help start important conversations with their parents and teachers, helping young people form healthy attitudes about sex and relationships during this critical time in their lives.”

With its blend of animation, stop-motion, and even the occasional crass word, the AMAZE series certainly seems to be approaching sex-ed in a different way.

Take for instance, one of its segments on male puberty, “How The Boner Grows.” With a song that’s far catchier than it ought to be, the short 2 minute video features clever sight gags and puns alongside a breezy explanation of just why the penis seemingly has a mind of its own during puberty.

There’s also the honest, “Talking Sexual Orientation with Jane,” which runs down and explains the wide spectrum of sexuality without any judgement. It even reassures kids that there’s no perfect timetable to figuring out who or what you like, so long as it works for you.

Then there’s “Boobs and More,” which illustrates the changes that come with female puberty while taking an aside to remind viewers that girls do indeed fart.

For those of us with children or little brothers and sisters curious about their maturing bodies, it might be worth it to send them a link to these videos.

Complete Article HERE!

Meet The Photographer Using Rope Bondage To Create Incredible Art


Art has a long history of drawing inspiration from the otherwise underground world of BDSM. The custom goes as far back as 1928, when the surrealist artist Man Ray captured an image of a woman sensually reclining while bound in ropes and a harness.

Robert Mapplethorpe famously stunned the ’70s art establishment with his documentation of the S&M play flourishing in certain corners of the gay community. Acclaimed Japanese artist Nobuyoshi Araki made his name with graphic, intensely sexual, and often controversial images of Kinbaku-bi, the ancient Japanese art of “tight binding” or rope play. The list goes on and on…

Contemporary photographer Garth Knight both aligns with and breaks from this complicated tradition. A former engineering student, Knight pursues his lingering interest in forces and mechanisms by creating intricate sculptural rope forms in which human models hang.


While Knight also draws from the kinbaku tradition, his photographs are less corporal and titillating than Araki’s work or your typical bondage art. The focus of Knight’s stunning and meticulous rope suspensions is more on transcendence than the human form.

Konbini spoke with Knight about his vivid rope worlds, his process, and whether he considers his work erotic. Read the full interview below!

Konbini: When did you begin drawing from bondage and shibari in your work? What attracted you to those worlds/forms?

Garth Knight: I have always had a strong affinity with line and had enjoyed playing with rope for practical purposes. In 1999, when I first saw a person being beautifully bound, it was like a revelation.

At that stage I wasn’t particularly interested in or even really aware of erotic bondage, but just seeing the rope and the body combined aesthetically spoke very deeply to me and I knew I had to do it myself.

The mechanics of tying came quite naturally and very easily to me, but the emotional and psychological aspects of rope bondage took a long time to develop. I still feel like there are whole worlds to discover and cultivate in this respect.

There was no internet back then and Japanese rope art (shibari, or kinbaku) was also completely unknown to me. I just started playing around and for many years I was just teaching myself, developing my own style and stumbling around in the dark. When I became aware of kinbaku I was very attracted to it and started incorporating elements of it into my style, though I have always been very careful to make this symbiosis influential rather than a replication.

Garth Knight

How has rope bondage influenced your art?

The more I’ve used rope and tying, the more I’ve learned that my own place in this world is tenuous and unreal and a construct of my mind. This world is connection overlayed with connection which we try and make sense of by building patterns.

When you work with rope, you lay rope onto rope and connection onto connection making an extended and cumulative embrace, forming a vibrating web of touch on the body and in the surrounding space, the connectivity and flow of energy pulsing through the space and the body and our psyches.

It’s a very powerful and sometimes transcendent place to be. It’s compelling and overwhelming and sensual and hypnotic. To release yourself to these emotions, to be able to submit to this, is all facilitated by the constraint of the rope.

Garth Knight

What does your process look like when you are making something like your Blood Consciousness or Vortex series? Who are your models? How long does it take you to finish one of your rope sculptures?

Ideas come mostly in daydreaming states, or while drawing, sketching. The end result is usually very process-driven: I make a start and the work develops organically. Working with the model is usually a very experimental process, working together to find their “place” in the work.

The rope used to tie someone takes up their energy, their sweat and skin and touch and experience. The models are a mixture of my friends and associates, as well as people contacting me who are interested in being part of this process. I choose people who intuitively feel right for that particular image, sometimes this just comes down to serendipity.

Each shoot takes place over several hours. The entire series takes many days to produce, normally stretched out over weeks or months.


Where do you draw or find inspiration? What other artists influence you? What do you draw specifically from the BDSM or bondage world?

The natural world with its constant infinite dance of order and chaos is always my greatest inspiration and ongoing fascination. I am attracted to bonsai and the constraint of form combined with simultaneously attempting to see and bring out the individual plants “true” being.

Surrealist artists like Dali and Man Ray set me on my path early. Escher, Odd Nerdrum, Andy Goldsworthy and Da Vinci are the kind of artists that also rate highly. From the kinbaku world, Kinoko and Kanna are two artists I really admire.

From BDSM specifically, I draw an interest in transcending the body and mind through the use of extreme sensation, and the use of physicality and eroticism as a pathway to awe.



Do you regard your work as erotic or sensual? What do you hope your work conveys about the human body, submission, and constraint?

I’ve brought up a couple of times the erotic and sensual aspects, both in the process and final images, and I definitely find both of these things to be essential elements and integral parts of my work.

In the past, I have avoided talking too much about this aspect, partly because it’s definitely not the only thing the work is about and since it is such a powerful element in people’s perception it can cloud the other aspects. Mostly though I’ve come to realize it’s because I find it very confusing and difficult to extricate some meaningful description of that part of the work using words.



Hopefully, ultimately, I would like to convey that the human body is just a construct for the perception and interaction of the flow of energy which we call consciousness, which moves from the infinite collective unconscious through our momentary singular consciousness to learn and grow and then onto its ultimate dispersal into the collective super-consciousness.

This flow adds to some spiritual momentum which, once it reaches some critical level, will lead to the complete enlightenment of the One which contains us all.

My mind tells me that this thought is ridiculous and just does not add up with what it sees and the physical reality that it has built and fastidiously maintains, and which we are so constrained by and invested in. And yet, when I submit myself entirely to the experience of the creation of art, I do believe this thought to be so.

More of Garth Knight’s work can be found on his website. The “Blood Consciousness” and “Vortex” series are also available in full in Knight’s new book

Complete Article HERE!

Expert Shares Tips for Talking Sexual Health With Cancer Survivors



Sexual health can be an uncomfortable or embarrassing topic to discuss for many people, and for patients with cancer and survivors it can feel even more awkward. Nevertheless, sex ranks among the top 5 unmet needs of survivors, and the good news is, proactive oncology practitioners can help fill that 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% get professional help, according to Leslie R. Schover, PhD, founder of the digital health startup, Will2Love. Among the barriers she cited 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 about these issues.

And, oncologists and oncology nurses are well-positioned to open up that line of communication.

“At least take one sentence to bring up the topic of sexuality with a new patient to find out if it is a concern for that person,” Schover explained in a recent interview with Oncology Nursing News. “Then have someone ready to do the follow-up that is needed,” and have other patient resources, such as handouts and useful websites, on hand.

Sexual issues can affect every stage of the cancer journey. Schover, who hosted a recent webinar for 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 for healthcare professionals.

“Sex remains a low priority, with very little time devoted to managing sexual problems even in specialty residencies,” said Schover. “I submitted a grant four times before I retired, to provide an online interprofessional training program to encourage oncology teams to do a far better job of assessing and managing sexual problems. I could not get it funded.”

In her webinar, she offered tips for healthcare practitioners who want to learn more about how to address sexual health concerns with their patients, like using simple words that patients will understand and asking open-ended questions in order to engage patients and give them room to expand on their sex life.

Schover suggests posing a question such as: “This treatment will affect your sex life. Tell me a little about your sex life now.”

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 both patients and their partners.

According to Schover, oncologists and oncology nurses should provide realistic expectations to patients when they are in the treatment decision-making process.

“Men with prostate cancer are told they are likely to have an 80% chance of having erections good enough for sex after cancer treatment,” Schover says. “But the truth is it’s more like 20 to 25% of men who will have erections like they had at baseline.”

To get more comfortable talking about sex with patients, Schover advises role-playing exercises with colleagues, friends, and family—acting as the healthcare professional and then the patient. When the process is finished, ask for feedback.

Brochures, books, websites and handouts are also good to have on hand for immediate guidance when patient questions do arise. But Schover is hoping for a bigger change rooted in multidisciplinary care and better patient–provider communication to find personalized treatments tailored to each individual’s concerns and needs.

Cancer treatment can impact hormonal cycles, nerves directing blood flow to the genitals, and the pelvic circulatory system itself, she explained. 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 stressed. “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 wants to make sure that those resources are easily accessible to patients and survivors. Thus, she has created the startup, Will2Love, which offers information on the latest research and treatment, hosts webinars, and provides access to personalized services.

“Sexual health is a right,” concluded Schover, and both oncology professionals and patients need to be assertive in getting the conversation started.

Complete Article HERE!

How to successfully navigate friends with benefits



The idea of having a friends with benefits relationship—two friends who have sex without a romantic relationship or commitment—can be very temping and convenient while in college. Due to the fact that students live away from their parents and in close proximity to many other people their age, friends with benefits relationships tend to be popular.

In theory, a limited relationship involves having sex with one person while also staying single and having the freedom to have sex with other people at the same time. Friends with benefits are more reliable than a hookup, but less reliable than a significant other. While this may sound like a good idea, these friendships oftentimes do not work.

Having friends with benefits comes with one small detail that everyone tends to forget about when first jumping into one of these relationships—you spend a chunk of time with someone that you find physically attractive. This aspect heightens the probability of developing feelings for this person.

While feelings are not always necessarily a bad thing, friendships involving sex can get messy if the other person does not reciprocate those feelings. Sex does not by any means always have to be serious; people generally use it to connect and as a result display feelings of love. Two people need to take this into consideration when deciding to become friends with benefits.

Just like any other relationship—whether romantic or platonic—communication is key for people participating in friends with benefits relationships. In order for these relationships to work, both parties must openly discuss their expectations for the relationship and set concrete ground rules before a bad situation occurs and feelings get hurt.

Some important things to discuss in a friends with benefits relationship include whether or not both parties will engage in sex with other people or just each other, whether they have any interest in hanging out in addition to having sex and whether they have feelings for one another at the moment.

By ensuring that each party understands the other’s desires and expectations, both people are completely aware of what they sign up for when it comes to their friends with benefits relationship. In addition, setting some ground rules helps make for a successful friends with benefits relationship.

Lastly, it is important to practice safe sex in any relationship, whether it be a one-night stand, a romantic relationship or a friend with benefits. Many times, a friends with benefits relationship is non-exclusive. Having sex with more than one person increases the likelihood of spreading sexually transmitted diseases, which makes protection and communication integral to maintaining your own personal health.

Though friends with benefits can come with many risks, STDs and unplanned pregnancies aren’t the type of risks you should take. Many friends with benefits relationships do not end well, so remaining cautious is how you can protect yourself.

It’s encouraged to ask what your partner expects out of the friends with benefits relationship. But, most importantly, don’t be afraid to tell them what you expect as well.

Complete Article HERE!