ARI SHAPIRO, HOST:
Cancer survival has made giant leaps in recent years, but after treatment, patients' lives can be fundamentally reshaped. One common struggle - dating and intimacy. We want to warn you that this story discusses sex and sexual health. Here's NPR's Yuki Noguchi on the latest in her series Life After Diagnosis.
YUKI NOGUCHI, BYLINE: Just five years ago, Deltra James led a very different life. She was 33, married and happily homeschooling her five daughters in Waterbury, Connecticut. Within a year, James was diagnosed with stage 4 breast cancer. Then came divorce, going back to work and cramming into the spare room of her mother's house with all her kids. There was much to grieve.
DELTRA JAMES: And I was really angry that I had to start over, especially at a time where I got a diagnosis. It felt like starting over at the end, you know?
NOGUCHI: Newly single and still young, James craved escape, pleasure and connection through dating.
JAMES: Going through my divorce, going through cancer - all these different things that kind of made me feel, like, empowered, if nothing else. And I think that's sexy. So I felt like, oh, for the first time in a lot of years, I kind of know who I am and what I deserve.
NOGUCHI: But James worried, as many cancer patients do, whether sex after surgery and chemotherapy might hurt. James' oncologist, however, dodged her questions uncomfortably.
JAMES: When would be a good time to talk about certain things? Because I don't want to just be existing.
NOGUCHI: As cancer survivorship grows, so do the number of people living with sexual side effects. Yet doctors often don't help patients find solutions like counseling, vaginal moisturizers or therapeutic devices that might help. Janeane Anderson is a researcher and professor at the University of Tennessee.
JANEANE ANDERSON: Sexual health is one of the greatest unmet needs among survivors. Dating and relationships and sex and sexuality have been ignored.
NOGUCHI: She estimates about 80% of patients struggle with sex after treatment. Many also crave advice about related matters, like...
JAMES: When do I disclose I'm a cancer survivor? When do I share my body? When do I share my scars?
NOGUCHI: Deltra James did not always share her diagnosis with partners.
JAMES: So I had to learn how to do things just to look healthy-presenting, just to not look like I didn't have eyebrows or eyelashes. And I'd try and do things like use all of the wig glue that I could, kind of thinking about your positioning. Like you being on top is less likely for your hair to come off.
NOGUCHI: Treatments didn't affect her libido, but it made her joints hurt. And eventually, a lumpectomy left a C-shaped scar on her left breast.
JAMES: That's very, very noticeable changes. They couldn't be ignored. And so that's when dating got a little scary.
NOGUCHI: James was especially nervous about telling a man named Mike Carbone (ph).
JAMES: When I told him about my diagnosis after knowing him for, like, seven months, he actually felt kind of relieved because I had canceled dates enough that he questioned how much I was, like, into him. But the real reason was, like, I had just had chemo and was feeling like garbage.
NOGUCHI: The disclosure brought them closer. His compassion, she says, became its own turn-on. They're still together three years later. But some things are still delicate, like when Carbone dreams about a future together.
JAMES: Like, to check in and make sure that he understood what I'm dealing with and, like, the realistic odds of a future. And that was an important conversation to have because he was like, I maybe shouldn't have said that. And I was like, well, I don't want you to, like, talk in a way that totally writes me off.
NOGUCHI: Even with its challenges, James says, dating after cancer has given her the gift of a fuller life.
Yuki Noguchi, NPR News.
(SOUNDBITE OF TIWA SAVAGE SONG, "LOST TIME") Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
