We investigated women affected by breast cancer and men by prostate cancer. The women with breast cancer often felt that the surgical ablation and the resulting wound were an insult to their femininity, no matter how small the cut and how inconspicuous the scar that resulted from it. Many women found it extremely difficult to get completely naked during lovemaking, and very few of them allowed their partners to touch their scar, saying it felt funny and uncomfortable.
Men affected by prostate cancer also have a disturbed body image after treatment, but that has a different and even more painful origin. In fact, radical prostatectomy does not result in disfiguring scars: it affects potency and the awareness of the problem is most disturbing. The erectile difficulty and the uncertainty of “masculinity without potency” are sources of a distress that plays its role in addition to the emotional reaction to a traumatic diagnosis.
Men and women need help to cope with their health problems and both need to receive the most effective support by their spouse. It seems clear from the many people interviewed, that each patient felt a great need to share his/her fears and emotional burden with the partner. When that was possible, it made a great difference in the ability to bear the treatment and react to its side effects in a more positive mood. Unfortunately, many relationships were just not intimate enough to make that happen,. Furthermore, many partners became highly distressed themselves and could not be of much help. In those cases, friends and family members became the providers of affection and support. Women were luckier than men in this regard, maybe because they are generally more accustomed than men to keep ongoing friendships; anyway it seemed easier for them to open up and be comforted.
Often the detachment and physical limitations affect sexuality. As a consequence intimacy, of which couples are in dire need, becomes even more difficult to attain.
When possible, sexual gratification is a relief and a source of powerful emotional bonds. That is why we believe that providing early counseling on psychosexual attitudes and physical functions will be of great help for cancer patients and their spouses.