Sex after cancer

It's a heavy letter today. I hope people who have been through this will chime in.

Also, chat at 1.

I have been a long time reader. Really enjoy everyone's input. Since October is Breast Cancer Awareness Month, I thought my issue may be timely.

I've been married for almost 10 years. Right after we were married, I was diagnosed with breast cancer. I was in my 30s and was devastated. After multiple surgeries (including a mastectomy), chemo, and radiation, we started to build our married life. We were blessed to have two beautiful children. After my second child, my remaining breast started showing "signs" of potential breast cancer. Over the next year, I had two biopsies and multiple mammograms. Emotionally this tipped me over the edge and I had the remaining breast removed.

My issue? Since my last surgery three years ago, my husband refuses to have "marital" relations with me. No grill cheese sandwiches. No touching. No nothing. I mean NOTHING!!!! A peck in the morning to say good-bye and a peck in the evening to say good night. A few "I love you"s throughout the day. I understand for men breasts are very important. I miss them also. I've tried to approach the topic and his response is "we need to schedule a time." Well, with two children, it's difficult to schedule a time. Counseling? He owns his own business and works seven days a week. He feels he doesn't have time to go. And no, he isn't cheating on me.

I love my husband but I can't remain in a non-physical marriage. It's lonely. He knows I'm not happy but he feels that the marriage is OK. Well, its not. I hate ultimatums but I don't know what else do to.
Meredith ... Readers ... Help!

– Breastless in Massachusetts

This isn't about his busy schedule, BIM. And it's not about your breasts. It's about the whole ordeal.
When someone gets cancer, their family and friends become a full-time support group. And when it's over -- if things work out for the best and life is preserved -- there's this massive sigh of relief and everyone tries to go back to their normal lives as best they can.

That's fine, except for the fact that the main caregivers are still emotionally exhausted. They've used up all of their energy to help their loved ones (and themselves) get through the experience. Sometimes they're not just tired, they're angry. Irrational or not, sometimes they're furious with their formerly sick loved one for unintentionally putting them through so much. And no matter what, they're panicked that the illness will return.

There's a lot of literature out there about sex after cancer -- that caregiver spouses are afraid of accidentally hurting their partner physically by taking part in sexual activity, or worse, hurting their partner's feelings if they have a negative reaction to their new body. That could be a part of his problem. Fear.

There's less literature out there that adequately describes the emotional crash that happens after years of compartmentalizing a very scary thing. Having cancer is lonely and scary and weird. So is helping someone with cancer. You've asked him for support for years and now you're asking for something else. He's having trouble understanding that this request is supposed to be a fun one. I think he's still shell-shocked.

I'd start slow -- with cuddling. Sit close to him in front of the television or offer up a back rub. See if you can move it along from there over time.

No matter how he responds to PG touching, he has to make time for therapy -- probably without you. You can tell him that a lack of interest in sex after cancer is very normal -- and fixable. He'll probably be relieved to hear that he's not a horrible jerk for wanting to avoid it all after all that you've been through.

Assure him that you'll watch the kids while he takes an hour to talk to a professional or, better yet, a cancer support group (of which there are many). Do this with a loving smile on your face. Remind him that your marriage is "OK" only if you both think it is.

And maybe plan a vacation. Get some of those supportive friends to watch the kids. The more new memories you make that don't involve waiting for the results of a PET scan, the better it will be for both of you.

Readers? Anyone been through this after an illness? Is this really about her breasts? What can she do without giving him an ultimatum? Talk.

– Meredith