Jay Lake (jaylake) wrote,
Jay Lake

[cancer] Sex on chemo

I've been holding on to a blog post concerning sex on chemo for quite some time. Not because I'm unwilling to discuss this, but because it's quite explicit. That's a bit outside the editorial bounds of this blog, not to mention which, I don't want to be blacklisted as an inappropriate site by the various net nanny type filtering mechanisms.

Finally I realized that I could make that blog post into a short essay on a Web page, block search engines from it, and link directly. So, with the warning of explicit, NSFW content, I have posted Sex on chemo: A user’s guide to cancer and your love life.

Basically the problem comes down to this: oncology professionals don't want to talk about sex. In some cases that may be individual squeamishness or boundary issues — though I personally think any doctor with those kind of boundary issues might want to rethink their chosen profession — but it's more often a liability issue. As I say in the essay, oncologists are deeply paranoid about the possibility of chemo pregnancy. (Think Thalidomide.) As a result, they generally counsel absolute abstemption from sex, without acknowledging outercourse or any other aspects of nonprocreative sex such as older age, infertility or nonheteronormative lifestyles. For liability purposes, any endorsement of sexual behavior of any kind opens the door to a pregnancy-related lawsuit against the doctor and their institution.

Basically, once you are a cancer patient, your sexuality is assumed to be in remission. Other cancer patients have reported to me experiencing resistance or even revulsion from oncology professionals about the subject of sexuality. Which is a crying shame, and deeply inappropriate.

One of the key problems is that oncology professionals can't tell you about the breakdown curves and toxicity risks of the chemo drugs and their byproducts, especially with respect to transmission through saliva or ejaculate. That's not a subject that gets studied for obvious liability reasons. And on chemo, any bodily emissions are considered cytotoxic, systemically toxic, and possibly caustic, due to both the primary pharmaceutical load and the drug breakdown by-products. In other words, 100% risk, 100% of the time. Sex = bad. No cookie for you, chemo lad!

Which is obviously ridiculous. But in absence of clinical guidance, neither I nor any other responsible chemotherapy patient is going to risk their partner's health. And there simply is no clinical guidance.

This abrogation of patient sexuality is a major failing of oncology as a specialty. The sometimes shaming of patients seeking counsel on the subject is a major failing of oncology professionals as compassionate, understanding human beings. The reality is we are all sexual beings, however we choose to express ourselves. Evolution put us on this earth to do two things: fuck off, and die. We fuck off to make more of ourselves, and we die to get out of their way.

A chemo patient generally has a pretty good handle on the dying part. Denying the rest of the process is unfair and dehumanizing. My little essay is a small brick being thrown at that wall of denial.

Tags: cancer, health, personal, sex

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