Sexuality during and after treatment of breast cancer: an important issue… M. Van de Wiele seksuologe

1.Introduction Some stories…

2.Sexuality, sensuality, sensoriality Talking about sexuality is not easy for most of the people, especially not for the seriously ill. Language seems to fail or to lack here. Only humour seems for many of us to be appropriate to express some of this enhanced sensorial perception, that is present in sexuality.

3. A triple taboo Breast cancer problems can’t nearly be discussed by all persons involved, due to the fact that the problems are linked to breasts, life-threatening diseases and sexuality. Patients, partners and relief workers get all faced with their own perceptions of life, suffering, love and sensuality and sexuality when they have to deal with breast cancer.

3.1 Talking about breasts. 3.2 Talking about life-threatening diseases. 3.3 Talking about sexuality.

4.The effect of disease on sexuality 4.1 Determinant factors for the effect of disease on sexual functioning (JPC MOORS) 4.2 The influence of somatic factors

4.3 The influence of psychological factors * A changed impaired body image thwarting life * Reactions by others: - the daily environment - the social context

5. Advantages and disadvantages confused This requires relief workers who - dare to bring up sexuality - are able to consider patients’ and their environment’s feelings and reaction patterns as normal… - are able to assess the effects of the operation and the disease… - pay attention to relation and interaction patterns…

6.Sex and mutilating operations 6.1 Sex is related to action 3.2 Sex is related to feeling and experience 3.3 Sex is related to thinking

7. The question isn’t any longer if, but how we can discuss sexuality within breast cancer treatment.

7.1 observational function 7.2 diagnostic function 7.3 supporting function 7.4 caring function