Friday, April 11, 2014


Dear Patrick: I am a straight man whose steady girlfriend was diagnosed with breast cancer a year and a half ago. She has gone through surgery, radiation, and chemotherapy. It looks like the cancer is in remission. This has been pretty tough for her, so I feel guilty for having any issues with the relationship.

            We had not been dating for very long when she got the bad results from her mammogram. Of course I didn’t want to abandon somebody who was in crisis. But I feel like I got sucked under water by a shipwreck and then spit out with all my bones broken. It has been so scary. I understand that some of her reactions would be extreme. But now I don’t know who I am with. Am I with a healthy woman? Do I have a right to expect some normal peace and quiet? Or is she always going to be a person who has cancer?

            All of our friends assume that we are a committed couple. Other men have asked me how I got through this ordeal and told me they admire me. But I don’t know if I was brave or kind, or if I was just afraid to look like a jerk. There are days when I think I am with the best woman I ever met. All I can see is the good in her. Then there are days when I tell myself I have to run away right now, before I get stuck again. This impulse has gotten so strong that I find myself throwing clothes into a suitcase when I should be getting ready for work.

            This question affects me sexually. I tried not to ask a lot from her while she was getting treatments that made her feel like hell. She had to get a double mastectomy. Her doctor did a good job of reconstruction. But her body looks very different. When I touch her breasts, she can’t feel a thing. It is so awkward. Do I touch her because it is expected, or to let her know I find her attractive? Do I avoid her breasts so I don’t remind her of unpleasant experiences? Or what? I am afraid I will hurt her or break her, and I can’t get excited with all this uncertainty and restrictions.

            She has been hinting that she would appreciate a more passionate bedroom style, and I am not sure I can deliver. How do I begin to make sense out of this mess?



It sounds to me like the two of you are the victims of some really bad luck. You have proved that you are a decent guy by sticking with somebody who was in crisis. But you have also been holding a lot back from the relationship. You felt morally pressured to stay with this woman, so you have never had a chance to allow the intimacy between you to deepen—or fizzle.

            I’ve never had someone write to me who deserves a counselor more than you. Having a partner who is suffering from a life-threatening illness is traumatic and depressing. If that was the only thing you had been through, you would have needed support. But this situation put a lot more stress on you. At the same time, you felt that you could not admit that you were suffering. With a witness who is not invested in the outcome, you may be able to unravel how you feel about this woman. Since she is doing better, pay attention to the dynamic you have as a couple. Is this what you want? Is your life better with her in it? I can understand that she had some mood swings when she was going through the treatment. Only time will tell if she is more stable now. But she needs to understand that her behavior has consequences. Even if she could not help it, you were affected by what happened. If you are angry with her for anything she did or said, that has to be expressed, or you will continue to be distant and full of mistrust.

            If you can’t figure this out by talking about it, you may need to take a few steps back. Get your own place. Take some time to be alone. See if you miss her. There is no guarantee she will wait for you, but if she is still available, maybe the two of you can start over again. I wonder if she, too, is concerned that a cancer diagnosis pushed the two of you together prematurely. It is quite a taboo topic, and if the two of you can’t make headway trying to figure this out on your own, get someone objective who can help the two of you communicate better. I think that might be the best context for asking whether she sees herself as a healthy person, or if she still feels on some level that she has cancer. The ideal is to be a brave “cancer survivor,” but I don’t know how many people achieve that state of denial. This is a disease that can return. How do you enjoy decent quality of life if that fear is hanging over you? It can be done, but not by keeping silent and ignoring the topic.

I have seen other couples facing serious health problems who simply shut down, shut up, and backed away from each other. When you care about somebody, the thought of losing them is terribly painful. The more you love them, the more terror their absence invokes. Sometimes people reject each other rather than enjoy every possible moment they do have together. This is a premature death, in a way, but it can restore a false sense of being in control.

            Men often withdraw sexually from female partners who have had a mastectomy. Breasts are so strongly associated with female sexuality in our culture that some men behave as if their wife or girlfriend has had her libido or her genitals excised. But our primary sex organ is our skin, and it covers our whole bodies. Touching each other all over is a way to start getting more comfortable with a big change in a partner’s body. Trading massage is sometimes helpful as foreplay. She will probably be worried that you no longer find her attractive. Be honest with her about your fear that you will hurt her if you show her all of your passion. I hope she  can be patient and allow you to gradually amp up, testing each step of the way.

Intensity can be restored, if that is what BOTH of you want. There had to be something special going on here if you were willing to see her through all this medical torture. You don’t have to just let this relationship happen to you, you know. You have a right to 50% of the decision-making power, but you have given away that power, and now you are paying the price for passivity. Your cock is paying the price, too. Men who abandon their share of the work in setting a relationship’s agenda are often literally impotent. If you want your dick back, you are going to have to take some risks. The first and hardest risk, it sounds like, is abandoning the pretense that you are just a hell of a nice guy.

If you say any of this out loud, I don’t think she will be surprised. She might even be relieved to get it out in the open. The best thing that could happen is for both of you to say all the things you are afraid to say, cry like hell, and then fuck as if you were making up from the worst argument ever. Trust me, she has also been saving up a few scandals and heresies of her own. If there is love here, it has been sealed off behind a thick wall of fear. If you want to tear that wall down, you need the power of desire. Desire can be released by honesty. If that honesty is connected to anger, so be it. Couples who can be angry with each other often have much better sex lives and feel closer than couples who never dare to disagree.

            I hope this advice is helpful. Your situation is really difficult. Please feel free to write again if things change and your concerns evolve. Most large cities have support services for women with breast cancer. These government agencies and non-profits may provide referrals to qualified therapists, and sometimes they even have funding subsidize treatment.