When life is dangling, the important thing is to save it and the rest is secondary.
But sometimes in that eagerness to survive we take care of basic issues that affect the quality of that same life.
Until relatively little, the goal when a person had cancer was to survive.
Over time, the psychological aspect of the disease began to take into account, but it has been obviously obviating something basic: sexuality.

“Many myths are intermingled and many taboos because talking about sexuality and talking about death precisely may be the two most universal emotions and the two most powerful emotions, we do not have a habit of facing them, we have rather a society focused on pills and shortcuts
And out there they come part of the denials or the difficulties or of the taboos. It costs us very much to talk about sex in a regular basis, normal, integrated – it talks about sex as a cosification, the porn appears, just like us
It costs a lot to talk about death. It is a serious problem because both things are necessary and we are going to find with them and are in our integral development, with which to leave them out is to leave a fundamental part of our lives, “says Guillermo Fouce, president
of psychology without borders and professor of social psychology at the UCM.

In the case of breast cancer it is not an emotional or psychological problem, but there are a series of physical changes that justify it, there is a medical explanation for estrogen deprivation. To the side effects of chemotherapy that everyone identifies (hair loss, nausea, vomiting, sores in the mouth, fatigue …), it joins that in breast cancer and in a very concrete subtype of tumor, which These are tumors that express hormonal receptors, “one of the therapeutic maneuvers that we use is to suppress estrogen stimulus to reduce the risk that this tumor reappears and this estrogenic decrease is the one that causes, not only all effects related to hot flashes, but also these sexual-gynecological-level effects of loss of libido, vaginal dryness, decrease in the elasticity of vaginal muscles, etc. “, explains Sònia Servitja, head of the Medical Oncology Service of the Hospital del Mar (Barcelona).

From the psychological point of view, breast cancer has a special component that can affect sexuality and relationships.
“In our society, the removal of one or the two breasts, which undoubtedly have an important erotic component, can pose a threat to the self-esteem of the woman and, by extension, fear of being rejected – especially in women who do not
They have a stable couple- in the face of the loss of physical appeal. If we add the context that in itself implies any oncological process -tristeza, discouragement, fatigue, etc. – and the side effects of treatments -Issmination of desire, pain in
penetration, vaginal dryness – can lead to the woman in a depressive picture that still limits it more. On the other hand, the feeling of guilt is also frequent at the feeling of not being able to offer everything that is ‘expected’ of her
“The psychooncologist and oncosesexologist Rosanna Mirapeix affects.

“Everything that has to do with the sexual organs has an added load,” says Fouce, who also alludes to a similar phenomenon when there is extirpation of the uterus and the ovaries (it can also happen to the men who are made by the
Vasectomy).
“It is generated impotences that are not only physical, they are also psychological, either because the person thinks or feels that it can not be excited and can not have desire. And then in particular with breast cancer, the question of lack of acceptance of acceptance occurs
the image that one projects, would even say not only not to show it to the couple or relatives, but not to show it to yourself, which is the first point on which you work, to accept what has happened, to accept the changes
In your body, being able to look at you in the mirror. One of the things that start doing, once the mastectomy occurs and others, it is to face you to look at you in the mirror and think who you are, “adds Fouce.

It is curious that having so clear effects on sexuality, this aspect has been neglected in the consultations.
Patients probably feel modesty and repair of what professionals can think, but neither doctors have traditionally paid attention to this aspect.
“Under my point of view, it is necessary to normalize sexuality, understand it as a part of human relationships, as an intimate form that people have to energize our communication. It is a human dimension to which it has not to be resigned for being happening
Or having passed an oncological process. The woman is often afraid to raise what happens to this level, for fear of being ‘frivolous’ when it is an important part of the human condition that we have to defend and vindicate actively “,
Includes Dr. Mirapeix.

This professional explains that although many professionals are still missing to cover real demand, psychooncology is a resource that is currently from practically all people who pass through an oncological process, but there are still aspects that are not always addressed in consultation and the
Sexuality is one of them.
“Obviously, in this case, it is not only due to lack of resources (the oncologist, although having knowledge in this area can not take charge of this issue because it needs to be treated with time and delicacy and their agendas are also very charged), but because
Both the patient and the doctor it is difficult for them to address this aspect, because it is a subject that is uncomfortable, which is still a taboo. ”

Dr. Servitja believes that “female sexuality has never been valued at the society level and it seems that sexuality is secondary, but not for all women.” The oncologist tells that she has to do much with the sexual education received. Thus, there are women in their 60-70 years old who do not want to hear about the subject. “There are few of this agenda that really express this concern in consultation and if they express it they do it when they take two or three years of treatment, not at the beginning. On the other hand, younger women who have had an education to what Better more open and more liberal, luckily, they pose it more, more precocated in the first visits, it is something that is not seen, with which the social impact is still minimal and it is still considered that this is secondary because what important is to survive. Yes, but how you pass this process that in the end is long because chemo is about six months, but the hormonal treatment is 5 years and in some patients we expand it to 10, with which there are many years of your life in this situation”.

“For example, men when they are diagnosed with prostate cancer, if it is not the first thing, it is the second one who speak with doctors. On the part of the same doctors tell them that they may have problems with the medication, they offer Viagra,
They do not expect patients to ask because it is unbearable in our society that a man has to be 10 years without an erection, but a woman if she has to be 10 years without being able to reach orgasm that is secondary, she should be grateful only to live.
It is a hypocrisy and a contradiction that we value for women and men, female pleasure is important and we have to value it as much as men, whether we are healthy and sick. ”
So forceful explains Rebecca Stewart, who has lived in her own skin her illness, diagnosed with only 28 years (she now has 31).

He received for six months chemotherapy, made a lumpectomy (removal of the tumor and part of the tissue around, but not the breast as in the mastectomy; some lymph nodes can be removed under the arm) and then submitted for a few weeks a radiation therapy.
After the intervention of her, she could not raise her arm or wet the bandages that covered her.
“I could not shower and asked my partner for help, he bathed me and took care of me, for me they were very intimate moments for us and that was the inspiration for the short. Even the band that carries the actress is one of which I had over
Of those who gave me in the hospital. ”

Rebecca talks about Wash Me, an erotic short film he has made to raise awareness about breast cancer. This British agreed in Spain for almost five years it indicates that with this short she wanted to show two things. “Make a story about cancer that does not focus and end in death, sadness or hair fall because there are many stories that focus alone on the tragedy of cancer, which is obviously important, there are many very sad stories but also There are many more positive stories or who do not end up like that, that’s what I wanted to show a little more. I did not know anyone in my environment that would have happened the disease, so all my knowledge was for movies and books, and it is Impossible to find some character that does not die, I remember Samantha of Sex and the City and little else, and the truth is that it is not like that, the chances of surviving today with breast cancer are very high [survival to the Five years, in very global data because some are above 90% and others at 50%, but the Global is above 75%, almost 80%, as directed by Dr. Servitja], but in movies and stories Most die. And I wanted to change that and add A story that spoke of something different. ”

The Director, Rebecca Stewart, and the producer, Erika Lust, announced that all new subscriptions to the Xconfessions platform during the month of October will be donated to the Amics Foundation of L’Hospital del Mar to support research in cancer immunotherapy
Breast at the Hospital del Mar and the Hospital Institute of Medical Research (IMIM).
At the same time, they will donate 1 euro each time it is shared in social networks from the platform.

To see it, you can click here

In addition, Rebecca points out that he also wanted to “talk about the issue of sex and sexuality because as I work in an erotic cinema company (Erika Lust Films) I am used to talking about sexuality, it is something important to me and I know it is important for
Many women, but in our society we do not talk about sex, to start. Less still of female sex and to top the sex of sick woman, it’s a triple taboo and it’s very difficult to encourage people to talk about this, both doctors
Like patients, and that’s something I wanted to do. For my own experience I know it is very shocking, but there is no knowledge or help on the subject. ”

Dr. Servitja explains that Rebecca was one of her patients and during the treatment the young woman asked her concerns. “Really, she crashed a lot that I told him many times that what I was asked, if he passed to other people, he had physiologically speaking sense but he could not tell him what percentage of women had those problems because people do not speak it. commented on the idea of the short and found a good initiative and thanks to his solidarity, and also to the Amics Foundation of the Hospital of the Sea that has also helped us a lot, has come forward. It is having enough resonance and the fact of normalizing it will make it People speak. In fact, since it has come out in press there are patients who dare to speak, lose the fear of thinking that as doctors we are going to value that this is secondary, it is a misperception and this will visible it, that sexuality is Just as important and that you can talk about it as any other aspect. ”

Stewart emphasizes how hard it is “the next”. “The treatment is hard but when it ended, at the psychological level, it is harder, they tell you ‘because you are already, to see how, we hope it does not come back’ and you have to start living as well, and it is hard. He looks at you as saying ‘You’re already cured, right?’ People are obsessed with the hair loss because it is what is seen, and I do not deny that it can be traumatic for many women, but for me and others is’ very well , it has fallen and it is already ‘. The treatment can last a year, but for many women if they are taking hormones they can be up to 10 years, that’s a long time to find out, you do not want to pause everything that a life full and sex is something important. We are focused on surviving, of blow we are survivors and people think that as we have spent a while looking at death and we have survived, with that is enough, and yes, of course we want to live, but also We want quality of life, please, and in this comes sex, food, friends, The work … There are many things that mean a life of quality and tell us that we should not think about sex and that is secondary is crazy for me. ”

The director of the short highlights that in addition to a “physiological need”, sex has great psychological importance.
“When you are diagnosed breast cancer, you can get to hate your body because you think ‘You failed me’ and there is something inside you that kills you. You spend time in the hospital with needles, medications, feeling fatal, you can hate your body and for
me sex was a way to reconnect with me and feel that my body was still mine and that I was on my team. When for the treatment for a while I lost the physical possibility of having sex, I lost my orgasm, I had vaginal dryness, vaginism and not
I could not even as a couple, it did not matter, when I lost it, I lost the possibility of connecting with my body and feeling that I can still give me pleasure, not just pain and problems. Having this is important for women. ”

“I remember when I went to chemotherapy, in the waiting room there was an image of a woman like that, sad, with scars, without hair … it was a poster warning of the importance of prevention or checking your chest or something like that, but That image scares a lot and was seeing her while she was waiting for my chemotherapy treatment. Obviously it is a reality of breast cancer and you have to normalize it, I do not want to hide that this can be a reality, but I would like to put all those other options on the table that there is because I have gone through breast cancer and I have not had a mastectomy, for example, and before that I did not know that it was not possible to go through breast cancer and not go through a mastectomy. In the future, I would like to do Also a photographic project of 10-15 women all with different experiences, with different treatments and scars to show the rainbow of this disease, which does not have to be the worst, do not have to hide the bad but it does show all L The possibilities that there are, “says Stewart.

The principal would also like to make a documentary movie. “In this producer we also make that format, we try to educate on a topic, for example, we made a movie about pregnancy and sexuality because it seems that when a woman is a mother there is nothing else, or you are a mother or a woman. And with this Go to the same, or you are a patient or a woman. I would like to do something with patients and that is my next job with Erika Lust, interviewing five different women, for example, with different types of breast cancer, different scars, different studies, different image. and that they talk about their process and what have happened all focused on the subject of sexuality, and also do a single sex scene or as a couple to show how beautiful it is to assume your body after this. I have spoken with many women already From this project and it is a thing that is paused. Wash is very good because he has opened the debate in some way, they have done a great job but are actors and I would like to tell real stories and talk with women and couples of women who It has happened and show it at much more personal. ”

For psychooncologist and oncosesexologist Rosanna Mirapeix, couple, family and friends are very important in any oncological process, “but if we talk about sexuality, the couple is key to facilitating a context in which women can express their fears, their concerns and their preferences
In this area. Quality communication is decisive for good sexual functioning throughout the process. It is necessary to promote sexual well-being and one of the premises for this is not to reduce our sexuality to penetration. ”

According to Mirapeix, “The health team can help women by addressing the issue (if they do not want to do it, it will already express it) and if necessary by deriving it to a professional who does not contemplate sexuality having only in mind the biological dimension (biological sex)
, but also explore the social dimension (family, beliefs, culture, education …), the psychological dimension (fantasies, subjective experience of love, affections, sexual identity …) and, of course, the clinical circumstance of the
Patient. All this will make it easy to establish an adequate intervention to the person in which, on many occasions, the couple will also have to participate. ”

Oncosesexologist underlines two more aspects: “Sexuality belongs to us, so it should not only be addressed in case of having a partner.”
And in terms of the most common sexual dysfunctions that breast cancer – sexual hypoactive and dispaurenia cancer – the expert indicates that taking into account that sexuality to use is coital, only these two side effects “will compromise
Foundary form Sexual relations. Sexologists advocate for optimizing sexual response beyond genitals. ”

Guillermo Fouce stands out that there is a part that is acceptance of what has happened and of the disease itself.
“There is also a part of evaluating if you can also address a reconstruction so that you feel as comfortable as possible, it is also your decision and we accompanied, and then there is a job about the surroundings so that you understand what has happened, understand it in
What situation is, it is understanding and also accompanies that process, give it time. With couples, it is also working so that they give them time to recover their desire, to recover their relationship, to rebuild that relationship. We work well with that they can
Seeing in the mirror, you can also reconstruct your autoimage. First of the self-image and then the projection towards others. ”
The psychologist indicates that, above all, patience is required, availability, time and destigmatizing them.

Rebecca Stewart asks for more research and information from doctors to discuss the subject, put the sexuality higher on the list of priorities, “Do not wait for patients to say something because they are usually not so open to it and can be ashamed “. As someone who has lived it in the first person, she insists that the image we have of cancer is very aggressive. “We talked about being soldiers who fight a battle against an enemy that you have inside, to have to be stronger … it’s a very aggressive vocabulary, you have to be hard and have a positive mind and each person has to find their own vocabulary for Understand what is happening because for me it was not a battle, I do not want to be in a battle with my own body, that does not help me anything, it is not just a battle for surviving, it is an experience that we live forever. The cancer is already My shadow, is there forever, it is a part with which I have to live, just return or not, hopefully not, but you have to live with all the consequences of it. Fortunately I do not have many side effects that have lasted, but For many women it is forever or for 10 years and we have to be aware that we can not say that of ‘how lucky, you have survived’. There is much more than just surviving. ”