Metastatic breast cancer, we can (and must) also talk about sexuality
If talking about sexuality after cancer is still difficult, imagine how difficult it can be when the cancer is metastatic. But it is an unmet need that can no longer be ignored. The women themselves are asking for it. And there are over 50 thousand those with advanced breast cancer in our country, mostly with a type of hormone-sensitive tumor treated with therapies that knock out estrogen. With all that this entails for the urogenital system and the intimate sphere. To break the taboo, the campaign “The voice of intimacy – Sexuality and metastatic breast cancer: we can talk about it“, promoted by Pfizer and created in collaboration with the associations Europa Donna Italia and Komen Italia, which has the objective of increasing awareness and information on the topic of sexuality in those affected by breast cancer, especially stage IV . The heart of the initiative is a video in which the actress Claudia Gerinitestimonial and guide, interviews two women: Paolawho has been living with metastatic breast cancer for about 8 years – and among the bloggers of Fighting, Living, Smiling de the Republic – And Silvia, with early-stage cancer he had in 2022, at just 30 years old. Together with them there are also specialists: the psychologist and psychotherapist Gabriella De Benedetta and the oncologist Michelino De Laurentiisboth from the National Cancer Institute Pascale Napoli Foundation, and the gynecologist Fedro Alessandro Peccatori of the Fertility and Procreation Unit of the IEO in Milan.
Video
The set is that of a beauty salon: an intimate place of “cuddles” and confidences that are difficult to do in front of a camera. We talk about femininity and how the disease has changed the relationship with one’s body and with the intimate life of a couple. “Women must be prepared for the difficulty – underlines Silvia – I was very far from menopause, so I didn’t have any peers or friends who could talk to me about it. I wasn’t ready: I didn’t know what the implications were.” This is why it is important to talk about it: because – as Paola recalls – “she makes you understand that your problem is not just yours and makes you feel less alone”. Two very different women, with different stories and different ages, comments Claudia Gerini: “But the feeling of sisterhood, mutual listening and understanding was evident. They were in the mirror, facing each other. They understood each other and are given courage. It was exciting and I am happy to be able to contribute to giving visibility to this initiative.”
Psychologist and sexologist in multidisciplinary teams
The video campaign, spread on social networks, was followed by two closed-door events, one in Milan and one in Rome (25 and 31 October), again in collaboration with the associations, in which groups of patients met multidisciplinary teams with the presence of two sexologists. A site with specific educational and information content for those with metastatic breast cancer will also be available online to patients, caregivers and doctors. “I believe that a lot of suffering would have been avoided if there had been a psycho-oncologist in the medical team,” comments De Benedetta. Not only for patients, but also for partners. It is not surprising, in fact, that as many as a quarter of couples split after a cancer diagnosis.
“Sexuality is still considered an irrelevant topic by the oncologist. But there cannot be an excellent quality of life without sexuality – adds De Laurentiis – In addition to the psycho-oncologist, there should also be a sexologist in the multidisciplinary team. Where this is not possible, the oncologist has the task of at least directing the patient to those who can take care of these aspects”. “We must not forget – Peccatori finally underlines – that sexuality is not just penetrative intercourse, there is much more than it can be done alone or with your partner. However, you need to find space and time to explore a different sexuality than before the diagnosis, especially in such a complex area.”
