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100 Questions & Answers About Breast Cancer Sensuality, Sexuality and Intimacy

Author(s): Michael L. Krychman, MD, Medical Director of Sexual Medicine, Hoag Hospital, Executive Director, Southern California Center for Sexual Health and Survivorship Medicine, Associate Clinical Professor, University of Southern California
Susan Kellogg, PhD, CRNP, Co-Director, The Pevic & Sexual Health Institute of Philadelphia, Philadelphia, Pennsylvania
Sandra Finestone, PsyD, Executive Director, Hope Wellness Center
  • ISBN-13: 9780763779092
  • Paperback    192 pages      © 2011
Price: $19.95 US List
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There are almost 200,000 new cases of breast cancer diagnosed in the United States every year. Virtually all of the women who undergo treatment are plagued by questions of intimacy, sexuality, and personal and professional relationships. 100 Questions and Answers About Breast Cancer: Sensuality, Sexuality and Intimacy provides authoritative answers to the most common questions asked by women and their partners when coping with intimacy after the trauma of breast cancer. Written by renowned female sexuality and breast cancer physicians, this book offers encouragement and reassurance to those struggling to strengthen and rebuild relationships during and after breast cancer treatment. It is an invaluable guide for anyone dealing with the physical and emotional repercussions of this disease.
Part  1  The Basics
Part  2  Treatments
Part  3  Psychosocial Issues
Part  4  Sexuality and Sexual Function After Breast Cancer
Part  5  Reestablishing & Strengthening Your Sexual Relationship

Michael L. Krychman, MD-Medical Director of Sexual Medicine, Hoag Hospital, Executive Director, Southern California Center for Sexual Health and Survivorship Medicine, Associate Clinical Professor, University of Southern California

Michael L. Krychman, MD, FACOG, is the Medical Director of Sexual Medicine at Hoag Hospital, and the Executive Director of the Southern California Center for Sexual Health and Survivorship Medicine, both located in Newport Beach, CA. He is presently Associate Clinical Attending at the University of Southern California and the University of California Irvine. He is the former Co-Director of The Sexual Medicine and Rehabilitation Program at Memorial Sloan-Kettering Cancer Center.

Dr. Krychman holds licenses from 3 states (CA, PA, NY), and is a board certified OB/GYN. He is a clinical sexologist and AASECT-certified sexual counselor, with a Masters in Public Health and Human Sexuality.

Dr. Krychman is on the editorial board for the Journal of Sexual Medicine, Current Sexual Medicine Report, and is an associate editor for Sexuality for The Female Patient. In addition to these two outstanding books, Dr. Krychman is coauthor of 100 Questions & Answers About Cervical Cancer (also published by Jones & Bartlett Learning), and has written numerous chapters for leading sexual medicine textbooks.

Dr. Krychman’s clinical interests include breast cancer sexuality, the impact of chronic medical diseases like hypertension, diabetes and cardiovascular disease health and its implications on sexual function. He also has a focus on the impact of sexuality and overall quality of life.

Susan Kellogg, PhD, CRNP-Co-Director, The Pevic & Sexual Health Institute of Philadelphia, Philadelphia, Pennsylvania

Susan Kellogg, CRNP, PhD, is the co-founder of The Pelvic and Sexual Health Institute of Philadelphia, where she is managing partner and the director of Vulvar and Sexual Medicine. In this capacity, Dr. Kellogg performs direct patient care, consultative services as a vulvovaginal specialist, vulvoscopist, researcher and sexual dysfunction consultant.
Dr. Kellogg is professor of OB/GYN at Drexel University College of Medicine in Philadelphia, professor of Human Sexuality at Widener University in Chester, Pa., and clinical associate faculty at the University of Pennsylvania and Thomas Jefferson University in Philadelphia. She is the course director for the Pelvic & Sexual Health Preceptorship and faculty for the Pelvic & Reconstructive Surgery Fellowship at Drexel University. She is a member of the education and the scientific program committees of the International Society for the Study of Women’s Sexual Health and on the Editorial Board of the Journal of Sexual Medicine
Dr Kellogg is an American Association of Sexuality Educators Counselors and Therapists (AASECT)-certified sexuality educator. She has been a featured columnist and an author of more than 50 peer-reviewed articles and 10 book chapters on women’s health and sexuality, appearing in publications including: Journal of Sexual Medicine, Journal of Reproductive Medicine,  American Journal of Obstetrics and Gynecology, Urology, Women’s Health Care, Female Patient, Journal of Sex, Education and Therapy and  American Journal for Nurse Practitioners. She is the author/coauthor of two books on the topics of breast cancer and sexual wellness and clinical challenges in women’s health (publication 2010). Dr Kellogg speaks nationally and internationally on topics related to female sexuality, and has been featured in popular venues, including: The Today Show, CNN, 20/20 and Web MD.
Dr. Kellogg received her Ph.D. in Human Sexuality; her post-masters certificate as an OB/GYN nurse practitioner from the University of Pennsylvania; and her MSN in Maternal Child Health from Loyola University in Chicago. She is an active researcher and  investigator on a NIH trial and several industry trials investigating female sexual dysfunction and pelvic pain syndromes.

Sandra Finestone, PsyD-Executive Director, Hope Wellness Center

In January of 1983, Sandy Finestone was going to see the doctor for her annual check- up when he asked her what the lump was her was feeling in her breast while he was doing a clinical breast exam. He went on to say, he was sure it was nothing, after all, she was only in her thirties , and young women do not get breast cancer. But all the way back to her office her hand did not leave the area where he had found the lump. Now she could feel it too. She called him back and said she wanted to find out what it was.
It took until March 30th for everyone to agree that she did have breast cancer and needed surgery. At that time a woman signed a waiver giving the surgeon permission to perform whatever surgery was necessary. When she woke up, both of her breasts had been removed. She also had 32 lymph nodes removed, none of which contained cancer. No additional treatment was recommended. She was told she had to wait a full year before considering reconstruction.
She and her husband went to an informational meeting about breast reconstruction and she was shocked to see the ladies chatting with each other and the husbands sitting sadly in corners by themselves. She called the American Cancer Society and asked if they had groups for husbands, they said no, would she like to start one….that was the beginning of her journey.
She did form a group for husbands’ she also was the Reach to Recovery coordinator for Orange County and soon became active on a state level. She trained trainers to reach women to do breast self-exams and spoke on many panels and at symposiums about the importance of early detection.
She soon learned that patients are not taken seriously as those are called doctor. So she went back to school and earned a doctorate in Psychology. She was a founder of the Orange County Breast Cancer Coalition and of the Orange County Affiliate of the Susan G. Komen Foundation. She has been Race Chair, President, Secretary, Program Chair, Survivor Chair and whatever else needed to be done.
She was Vice Chair of Grants for Komen International and has reviewed scientific grants for the Komen Foundation, The Department of Defense, Avon Foundation, State of New York, State of Californian and the American Society of Clinical Oncologists. She has been an advocate for the American Association of Cancer Researchers and has attended numerous conferences as an advocate.
She is a steering committee member of Advocates in Science for Susan G. Komen for the Cure and sits on the Medscape Breast Cancer Advisory committee as an advocate. She is the Secretary of the Inland Empire Susan G. Komen for the Cure and is chair of Public Policy. She is also a Legislative Ambassador for the American Cancer Society and a board member of Breast Cancer Solutions.
In June 2009, Dr. Finestone went to Jordan to facilitate a meeting with healthcare providers to teach them about the concept of support and support groups for women with breast cancer. In November she returned to the middle- east to train women in Kuwait and Egypt about support and support groups. While in Egypt she participated in the first Race for the Cure in that country and participated in a scientific meeting as an advocate.
  • “ Drs. Michael Krychman, Susan Kellogg Spadt, and Sandra Finestone have brought together their collective wisdom and expertise to write an outstanding book about sexual and relational well-being for breast cancer survivors and their loved ones. They provide practical tips and accessible resources for maintaining sexual wellness throughout treatment and beyond. This comprehensive and compassionate guide is a ‘must read’ for breast cancer survivors, their partners, and the healthcare professionals who treat them.”

    Sabitha Pillai-Friedman, PhD, LCSW, CST
    Couple Therapist and AASECT-Certified Sex Therapist
    Director of Supervisors, Jefferson/Council for Relationships
    Couple and Family Therapy Program

    “ A breast cancer diagnosis can unravel your world. Maintaining or regaining intimacy and your sexuality after the treatment of cancer should not be a chore. 100 Questions & Answers About Breast Cancer Sensuality, Sexuality, and Intimacy is the resource every woman needs to not just survive the treatment of her cancer but to thrive in her interpersonal relationships. This is a ‘must read’ for every woman diagnosed with breast cancer and her doctors!”

    Beth Baughman DuPree, MD, FACS
    Chairman of the American Society of Breast Surgeons Board of Advocates
    Author of The Healing Consciousness: A Doctor’s Journey to Healing

    “ In just 100 answers, the authors of this book address many of the issues facing women with breast cancer. From decisions about surgery to hormones and sex toys, the authors address the many questions that these women have thought—or may need to think about.”

    Anne Katz, RN, PhD
    Author of Breaking the Silence on Cancer and
    Sexuality and Women Cancer Sex
    Clinical Nurse Specialist
    Cancer Care Manitoba

    “ Dr. Michael Krychman and his colleagues have done it again with another great book addressing key questions and answers about life after breast cancer. Many doctors often don’t have the time or the expertise to discuss sexuality, intimacy, and relationships after treatment of breast cancer. Michael Krychman, Susan Kellogg Spadt, and Sandy Finestone understand that sexuality after breast cancer is important and needs to be addressed. This fabulous book provides clear, easy-to-understand solutions for the reader who is often too embarrassed to raise these concerns with their own doctor. It is an excellent book not only for patients but also doctors and nurses who care for women after treatment of breast cancer.”

    John Boyages, MD
    Director, Westmead Breast Cancer Institute
    Sydney Australia
    Author of Breast Cancer: Taking Control

    “ This is a book filled with wisdom, compassion, and wise counsel from a phenomenal team of authors. I believe that every woman with breast cancer and her partner who reads this book will find hope and useful advice.”

    Dr. Stephanie Buehler
    Psychologist and Sex Therapist
    Director, The Buehler Institute

    “ This book is reminiscent of the necessary supportive companion through any woman’s struggle and journey with breast cancer. By answering 100 of the most common sexual health-related questions encountered by healthcare providers working with cancer survivors, Dr. Krychman, Dr. Kellogg Spadt, and Ms. Finestone offer one of the most comprehensive and accessible guides to understanding, learning, and growing from sexual struggles that women with breast cancer experience. This book is equally valuable to the healthcare provider with its evidence-based suggestions and rich clinical examples.”

    Dr. Lori Brotto, PhD, R Psych
    Assistant Professor
    University of British Columbia

    “ Breast cancer (BC), today, is more of a chronic than a fatal disease for the majority of affected women. This makes the quality of life of BC survivors a critical and yet neglected issue, when sexuality and intimacy are concerned. Indeed, many studies indicate that couples’ emotional intimacy may be reinforced by the sharing of solidarity the couple has when facing BC diagnosis and treatment, while physical intimacy and physical satisfaction appear to be definitely worsened, mostly because of biological factors usually overlooked in the clinical management of breast cancer patients.
    Women are left alone, sexuality being a persistent taboo among oncologic professionals, with a few exceptions. Think of it. The underlying message is just one: be happy that you are alive. This cannot be accepted anymore.
    Being back to a meaningful and fulfilling life, after a challenging diagnostic and therapeutic time, means that the happiness of a sexually happy body cannot be neglected anymore as a marginal issue. Michael Krychman, Susan Kellogg Spadt, and Sandy Finestones’ book is, therefore, timely and much needed; it goes to the heart of what intimacy and sexuality mean in real life for BC survivors and their partners.
    It will certainly be precious for women. My heartfelt wish is that it will be read and meditated upon by all healthcare professionals who work with BC survivors, to break the ‘collusion of silence’ about sexuality. The woman is too scared or afraid or shy to ask, the professional too busy to think of it. And yet, it is very difficult to provide an effective intervention if there is no mention of a problem!
    This is the best gift we can give to every woman who has gone through the dramatic months of breast cancer diagnosis and treatments: the beauty of feeling sensual and sexual, aroused and orgasmic, physically and emotionally happy again, with the partner she loves.”

    Alessandra Graziottin, MD
    Specialist in Gynecology, Oncology and Sexual Medicine
    Director, Center of Gynecology and Medical Sexology
    H. San Raffaele Resnati

    “ With one in seven American women being affected by breast cancer, it is about time someone finally tackled the intimacy issues that plague our survivors. The authors have demystified critical, yet often unspoken, concerns of our patients. They have created a vehicle to assist women in opening discussion and with the ultimate goal of facilitating treatment for sexual concerns that, if left unaddressed, have the potential to devastate the lives that they have fought so hard to keep.”

    Alison Amsterdam, MD, FACP
    Assistant Professor, Mount Sinai School of Medicine

    “ 100 Questions & Answers About Breast Cancer Sensuality, Sexuality, and Intimacy is an engaging work that should not only be provided to every woman at the time of her breast cancer diagnosis, but should be a staple of every healthcare provider’s library. Dr. Krychman, Dr. Kellogg Spadt, and Ms. Finestone should be applauded for their candid approach to the issue of breast cancer’s effect on sexuality.”

    Leah S. Millheiser, MD
    Clinical Assistant Professor, Department of Obstetrics/Gynecology,
    Director, Female Sexual Medicine Program
    Stanford University Medical Center

    “ Women often feel bereft of resources to help them understand and positively impact the intimate, sensual, and sexual aspects of their lives after a diagnosis of breast cancer. The authors have addressed 100 questions pondered with great frequency by women with breast cancer and offer depth and breadth in the easy-to-understand answers they provide. This very readable resource is sure to provide much that will be helpful as women look to renormalize their lives after their breast cancer diagnosis and treatment.”

    Barbara Rabinowitz, PhD, MSW, RN
    Psychotherapist and Sex Therapist, Private Practice
    Founder and Past President, National Consortium of Breast Centers
    Past President, American Society of Breast Disease
    Commissioner, New Jersey Commission on Cancer Research

    “ 100 Questions & Answers About Breast Cancer Sensuality, Sexuality, and Intimacy is an impressive compilation of easy to navigate tips and suggestions. It is an invaluable resource for both patients and clinicians alike who are interested in maintaining overall health and wellness throughout the survivorship journey. I recommend it for all my patients.”

    Laurie Bailey, MD
    Medical Director
    Center for Optimal Health & Wellness
    Aurora Women’s Pavilion

    “ Drs. Michael Krychman and Susan Kellogg Spadt provide an invaluable and inspirational resource for women who are on the journey through breast cancer diagnosis and beyond. This book is a practical guide for breast cancer survivors who are on the journey to recapturing intimacy and well-being, providing guidance for some of the most commonly asked questions that face cancer survivors.”

    Arti Hurria, MD
    Associate Professor of Medicine
    Director, Cancer and Aging Research Program
    Breast Cancer Oncologist, City of Hope Cancer Center

    “ In to the field of breast cancer and cancer survivorship comes a much needed resource for women and their partners. In writing 100 Questions & Answers About Breast Cancer Sensuality, Sexuality, and Intimacy, Drs. Krychman and Kellogg Spadt, alongside Ms. Finestone, have provided an educated, reasoned, and balanced resource for this community of women, one that constitutes the largest group of cancer survivors in the United States. This book is a testament to how breast cancer impacts more than just the patient. Breast cancer touches her partner, and affects, and indeed challenges, relationships. I hope that providers will see this as a resource for their own understanding on how to address and counsel patients whose partner relations have been affected by breast cancer. I applaud the authors on providing this timely resource. I am certain it will become a must-have for every survivorship center in the United States and worldwide.”

    Don S. Dizon, MD
    Director, Medical Oncology and Integrative Care
    Director, The Center for Sexuality, Intimacy, and Fertility
    The Program in Women’s Oncology at Women & Infants’ Hospital
    Assistant Professor, The Warren Alpert Medical School of Brown University

    “ Dr. Krychman, Dr. Kellogg Spadt, and Ms. Finestone have successfully integrated three very different perspectives on cancer and sexual medicine, the result of which is this user-friendly book to help women traverse the sexual problems that accompany cancer. They effectively synthesize a vast amount of information about the complexities of women’s sexuality and provide a thorough review of potential problems and treatment options including psychotherapy, physical therapy, pharmacotherapy, and herbal therapy. For cancer survivors and their lovers, this book will support and guide them.”

    Sheryl A. Kingsberg, PhD
    Chief of the Division of Behavioral Medicine
    Department of Obstetrics & Gynecology
    University Hospitals of Cleveland Case Medical Center
    Professor of Reproductive Biology and Psychiatry
    Case Western Reserve University
    President of The International Society for the Study of Women’s Sexual Health

    “ 100 Questions & Answers About Breast Cancer Sensuality, Sexuality, and Intimacy is a must read for patients and their partners facing a breast cancer diagnosis. As an organization that hears from tens of thousands of breast cancer patients seeking information and emotional support, this book is a great tool for before, during, and after treatment. No subject is off limits and ideas and facts are clearly explained to help patients and their partners find their new ‘normal’ and even enhance intimacy and quality of life.”

    The YourShoes Peer Counselors
    Breast Cancer Network of Strength

    “ This book provides much needed attention and information to help women re-discovering or maintain intimacy after a diagnosis of breast cancer.”

    Ann H. Partridge, MD, MPH
    Dana-Farber Cancer Institute

    “ ‘Breast cancer’ is a diagnosis that no woman wants to hear. She will worry about her doctors, her treatment decisions, side effects, disease recurrence, and yes, her very survival. But even beyond physical discomforts and survival, a breast is not simply an anatomic organ, like a colon or a thyroid. Although physicians are necessarily focused on curing or slowing malignant disease, they need to acknowledge that for many women and their partners, breasts are symbolically and even functionally important. Breasts are inextricably bound to a woman’s self image, to motherhood and nurturing, to attractiveness and sexuality . . .
    Fortunately, most breast cancers today are eminently treatable and women will have many years after diagnosis to grapple with evolving issues of self image and sexuality. A new book on intimacy and sexuality after a breast cancer diagnosis by Michael Krychman, Sandra Finestone, and Susan Kellogg Spadt, is a refreshing addition to the literature. The authors help women with breast cancer and their partners—and, hopefully, the professionals who treat and care for them—face these issues frankly, with advice, with information, and always with love and hope.”

    Margie Miller
    Group Scientific Director, Oncology

    “ As a former oncology nurse who now practices Eastern medicine including acupuncture and herbal therapy, I am always looking for resources that can aid my breast cancer patients in taking a more active role in their healing. An area that is commonly overlooked by both patient and practitioner at the outset of cancer treatment is what effect the illness and subsequent treatment may have on sexual health and vitality. This wonderful book is a very straight forward, no-nonsense approach to this often sensitive and complicated subject. I applaud the authors, particularly Dr. Michael Krychman, for their dedication to the sexual health of women with cancer.”

    Pamela Jacobson, LAc, Dipl OM
    The Healing Sanctuary

    “ We are comfortable talking about breast cancer today—women freely share their stories about how they were diagnosed, how they felt, what they did—with each other, in groups, even in the media. But the sensitive and private topics of intimacy and sexuality are often not comfortable topics of conversation—between patients and healthcare providers or between couples. This book will help start those conversations and serve as a guide to answers to questions that need to be discussed.”

    Susan Brown,RN
    Director of Education
    Susan G. Komen for the Cure

    “ Sexuality/intimacy and cancer diagnosis/treatment are words that are not often seen together. Each one of these words evoke various emotions in people living with a cancer diagnosis. Any discussion regarding sexuality and all its ramifications will be amazingly important to anyone past and present who has ever received that diagnosis. Having a book such as this helps educate an individual to understand feelings that are so often not discussed or pushed aside. It is a real gift.”

    Sue Winn, RN
    Patient Navigator

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