Opening up about breast cancer and sexuality: an active tool to promote women’s health

Authors: Isac Lucca Frota Boriz, José Armando Pessôa Neto

National Member Organization: IFMSA Brazil

University: Universidade Federal do Ceara (UFC)

Theme: Short Articles related to Standing Committee (SCORA)

Email: [email protected]

Keywords: breast neoplasms; sexuality; quality of life.

The development of sexuality is a biopsychosocial process and, considered as a socio-cultural component, is still seen as a taboo. When it comes to cancer diagnosis, sexuality is a neglected topic in terms of therapeutic management. In that perspective, the World Health Organization recognizes the impact of a healthy sexual life in the well-being of patients and in the behalf of their relationships, by recognizing the concept of ‘oncosexology’. Breast cancer is a multifactorial condition that remains with increased fatality rate. In 2008, it’s estimated that there were approximately 458,000 deceased patients in the world. In Brazil, it’s projected that 53.000 new cases are to be discovered annually¹. Considering the aggressive treatment, evidence shows that women with breast cancer experience a range of negative emotional changes as a result of disturbances to their sexuality, including negative body image, loss of femininity, fear of loss of fertility as well as physiological alterations in their bodies induced by chemotherapy². In Brazil, almost a third of women with breast cancer experience sexual dysfunction³. 

Within this context, the local committee IFMSA Brazil UFC Fortaleza promoted an activity in October 2019 in partnership with the non-governmental organization Rosa Viva, that gathers 20 women that are mastectomized and/or treating breast cancer with ages from 52 to 74 years old. Throughout the planning of the activity, a psychologist from the Cancer Institute of Ceará gave the committee a lecture about ‘Sexuality and Cancer’ to empower the students to perform the action. Through subject discussion and experience sharing between the students and the Rosa Viva’s women, the activity aimed to build the group’s knowledge about breast cancer impacts on a woman’s sexuality.

Initially, the group exposed feelings and expectations to create a safe space for opening up. Then, a box with questions about sexuality and cancer passed among the participants, aiming to promote reflection and dialogue. To stimulate the self-awareness and the verbalizing of their perceptions about themselves, a mirror was given to them and they were asked ‘What do you see?’. And, to conclude the activity, they wrote down kind statements about themselves to strengthen a positive self-image.

For impact measurement, the participants reported their feelings and thoughts of the activity through adjectives, which they described as “necessary” and “fulfilling”. It was noticed that the group had a significant amount of doubts, mainly about relationships with their partners and family. In addition, the socio-cultural perceptions, specially related to the breasts and the hair loss as tools of femininity, are a cause frustration that can lead to anxiety and depression. Furthermore, the participants agreed that, even when their sexual health is not ignored in the therapeutic process, the information provided about it is insufficient. These findings converge with the analysis of Ouden (2018) that researched the communication between health providers and patients in this condition. Therefore, it’s crucial to develop the necessary skills to improve the understanding and knowledge about sexuality in women with breast cancer in order to provide comprehensive health care to these patients.

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