Dating, relationships, intimacy and sexuality...

LAUREN: Dating is a real concern for me. I can't have children because of my cancer. When do I break the news to a date, especially if I really like a guy? I haven't met anyone, but I think that when I do date, not being able to have children is going to be an issue.

TANYA: I wouldn't want to talk about my cancer experience on a first date. I'd rather get to know the other person better before I open up to such a vulnerable part of my life. Being single, I can tell you that cancer is a good relationship barometer. It helps week out some of the guys you don't want to be involved with.

LAUREN: I think cancer has weeded out my whole age group!

DANI GRADY (cancer activist, survivor): I usually waited several months before telling a man. But I told the man that I'm married to the first night I met him. I told him and showed him. It really depends on the person and how comfortable you feel with him.

TANYA: Ultimately, it's a matter of trust. However early or late it is in a relationship, that sense of trust is imperative.

DANI GRADY (cancer activist, survivor): It truly is a sense of trust. Once you've gone through a serious illness, you don't waste your time. I would not have ever given that gift of sharing this most intimate part of myself to someone I didn't trust or feel deserved it.

NATALIE: I'm twenty-seven years old and I finished my treatment for breast cancer about two months ago. I had a lumpectomy and a lot of radiation. Ever since treatment finished, I have wanted to be with my boyfriend all the time. I want to have sex all the time, I can't keep my hands off him. I've never felt quite like this before. He's not happy about it. He wonders what it's all about. I guess I do, too. I think my boyfriend is feeling a little confused, maybe even used. He doesn't think that my newfound interest in sex has much to do with him.

HALINA (therapist): You say your boyfriend is taken aback, which is a perfectly normal reaction. When we change in any way, positively or negatively, the people who are used to us being a certain way are usually taken aback. As for your reaction, this diagnosis of cancer, especially at such a young age, produces a very strong sense that your life is being threatened. And feelings-especially passion and lust-are affirmations of life. What you're describing is a renewed sense of lust for life; you're rejoicing at being alive and feeling sexual again, after having been under the shadow of death for a while. Maybe you could explain to your boyfriend this way: "I am so happy to be alive that all of my feelings are intensified-all of my joy, all of my sexuality, all of my love. You are the one I love, so I will be loving you even more."

LISA: I'm thirty years old. I had breast cancer, a mastectomy, and chemo. I've had no sex drive since the chemo, there's been no intimacy between myself and my husband. I'm concerned that he's going to leave me or have an affair, since I'm not able to have that intimacy with him. I'm just not feeling like I want to be touched at all.

HALINA (therapist): Howe long ago did you finish the chemo?

LISA: Just a few months ago.

HALINA (therapist): Sometimes there is a chemical reason for changes in sexual desires; chemo tends to change your hormonal levels.

DR. MICHAEL (medical oncologist): Chemotherapy can have that kind of effect. It's usually temporary, but the loss of estrogen and ovarian function can be associated with less libido. You're thirty, so my best guess is that your libido will come back. But it could take four months, six months, even a year.

HALINA (therapist): Besides the chemical aspect of your treatment, there's a psychological component. When you go through surgery and chemotherapy, your whole sense of your attractiveness, your femininity, changes. Your feelings about your body image change. It's sometimes very hard to feel sexual, to feel interested, if you don't think of yourself as still being attractive. Do you think that might be happening to you?

LISA: Yes, I do believe that's happening. And we're having a communication breakdown. My husband is getting very angry with me; we're not talking, and it's turning into a much larger issue. I just don't know how to talk to him.

HALINA (therapist): Does he tell you that he still finds you attractive, and wants you, and does not understand why you're pushing him away?

LISA: Sometimes. We used to be just so happy together, and make love often.

HALINA (therapist): It sounds as if the problem is not that he finds you unattractive, but that you find yourself unattractive.

LISA: Yes, that has something to do with it.

HALINA (therapist): Identifying that as the issue, and recognizing that in his eyes you are still sexual and desirable, and that he loves you, can be helpful. Maybe you could use some of the love he is trying to give you to integrate this different sense of yourself, to realize that even though your body may have changed and you have been through a lot, you still are attractive. It would also help to get some support. Perhaps you should get couples' counseling, even if only for a few sessions, because it sounds as if you could benefit from learning how to speak and listen to each other.

DR. MICHAEL (medical oncologist): Speaking not as a physician but as a man, I think it might be helpful to reassure your husband how much you care about him. Let him know that it's something you're going through; it's not him. Tell him that if he gives you time, the problem will resolve.

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