Sexual Healing : Cancer took the romance out of the Reinces’ lives. But with some help from a psychosocial oncologist, it’s Valentine’s Day again for the Huntington Beach couple.
Valentine’s Day, 1990, wasn’t exactly the most romantic holiday Chuck and Sue Reince of Huntington Beach ever celebrated together.
A week earlier, Sue--eight months’ pregnant--had noticed something that wasn’t a part of the normal changes her body was going through: a lump in her breast.
After a biopsy determined that the lump was cancerous, labor was induced and her son Gregory was born. That was Feb. 8. Two days later, the lump was removed, and on Feb. 13 Sue had her first chemotherapy session.
“She and the baby came home from the hospital on Valentine’s Day,” Chuck recalls. By then, the couple had pretty much forgotten about their traditional celebration for the day. “We always take turns being in charge for Valentine’s Day,” Chuck says.
Instead of gazing longingly into each other’s eyes, the Reinces “just felt numb,” Sue remembers.
The last thing they worried about at the time was their lost romantic evening. “Just the idea of anything sexual was tough for either one of us,” Chuck says. “I didn’t want to hurt her.”
Meanwhile, Sue “felt like my body had betrayed me. Here I was supposed to be experiencing the joy of motherhood, and instead I was dealing with cancer.”
After the lumpectomy was followed by a mastectomy, and the chemotherapy threw her 34-year-old body into early menopause, Sue felt so disfigured and self-conscious that she was even more uncomfortable with her body.
In one sense, dealing with cancer brought the Reinces closer together than ever in their 10-year marriage. But for nearly two years, it took away much of the intimacy that helped them keep that bond strong.
“There were a lot of ‘Not tonight, dears,’ ” Sue says.
“I didn’t want to make her feel like she should do anything if she didn’t feel like it,” Chuck says. “I wanted to cocoon and protect Sue, even from me.”
Sexual problems are perhaps the most ignored side effect of cancer, says psychosocial oncologist Wendy S. Schain. But the first and most important step in resolving those problems is recognizing that they exist.
Schain, psychosocial director in adult oncology at the Memorial Cancer Institute at Long Beach Memorial Medical Center, spoke Saturday at a workshop on sexual dysfunction in cancer patients at the Wellness Community/Orange County in Santa Ana.
“The majority of surgeons and oncologists do not address sexual issues specifically,” Schain says. “It’s just not their area of focus or concern.”
Even with sex organ-related cancers, she says, the sexual ramifications are usually ignored, leaving patients with problems in “a number of areas from emotional to concrete physiological changes that aren’t dealt with up front.”
And by dealing with the problem, Schain doesn’t mean just talking about it, although that is the beginning. “We really have now in our repertoire specific sexual therapies, not just talking, but prescriptions, reading, ways to deal with chemotherapy side effects. And that should be included as part of routine care.”
The problem, of course, affects not only cancer patients but their partners as well.
“There’s tremendous variability and individuality in people’s responses,” Schain says. “The sequence of denial, rage, acceptance and bargaining is true for some people, but not everyone.
“For some, there’s an an increase in sexual feelings, a need to be close. But they may not be used to asking for closeness, so they don’t know how to ask for it openly, and they end up expecting their partner to do a lot of mind-reading.”
Other patients become withdrawn. “When the patient or partner retreats, the significant other can be seen as solicitous and intrusive.”
Adding to the problem, she says, is “the myth that causes us to desexualize old or sick people. But we need to acknowledge the importance that it plays in people’s quality of life.
“We don’t just use sex to communicate love,” she says. “It’s an antidepressant, it’s for procreation, recreation, tension reduction. We need to stop ignoring it.”
Sexual problems affect patients with all types of cancer, Schain says. “It’s pretty blatant when you talk about a breast or a penis or a prostate gland. But with head and neck cancers, people may not be able to kiss, they may have gaping stomas in their faces. It’s a nightmare.
“Even (with) the hematologic cancers such as leukemia or Hodgkin’s, the treatments themselves are debilitating and can cause changes. Or if you have someone who’s had a sarcoma in the leg and an above-the-knee amputation, you can lose a lot of spontaneity.”
With Schain’s help, the Reinces were able to deal with the sexual changes that cancer brought. “We’re just starting to get back to normal,” Chuck says.
“I’m almost afraid to think that,” Sue says. “I’m afraid something else might go wrong.”
“In a sense, it was like starting over,” Chuck says. “We had to learn what was comfortable as far as touching and holding. Now we’re at the point where we can tease around.”
“Chuck was very understanding,” Sue says. “We did a lot of cuddling and caressing. Intercourse isn’t the only thing in a close, loving relationship.”
Sue has since undergone breast reconstruction, with a procedure that does not involve the silicone implants recently banned by the U.S. Food and Drug Administration.
After she recovered from that procedure, Chuck recalls, “she put on a swimsuit, stood there with her hands on her hips and said, ‘What do you think?’ ”
He didn’t hesitate to tell her his reaction. “She’s more beautiful now than ever,” he says.
A few days ago, the Reinces celebrated their--knock wood--return to normalcy with a romantic evening in honor of Sue’s 36th birthday.
“We always felt that we were like hand in glove,” Chuck says.
“But we have an even closer, better relationship now,” Sue says. “The little fights or arguments we once thought were so important have become nothing.”
