How do I approach dating with no hair? When do I bring up that I had cancer?
How do I talk to my partner about sex after cancer?
with Sage Bolte, PhD, LCSW, CST
Sage Bolte is the Chief Philanthropy Officer and President of the Inova Health Foundation. She joined Inova 15 years ago as an oncology counselor and most recently served as Executive Director of Life with Cancer and Patient Experience for the Inova Schar Cancer Institute. She is known nationally for her work in sexual health and cancer and is respected as a leader in the field of oncology social work.
Sage received her bachelor’s degree in both psychology and social work at Hope College in Holland, Michigan, and later continued her studies at the University of Michigan, where she received her master’s degree in social work. She received the American Cancer Society’s Doctoral Training Grant in 2008 and obtained her PhD in social work from The National School of Social Services at the Catholic University of America in 2010.
How and when do I disclose I have or have had cancer when I want to date?
With dating and disclosure, we have to keep in mind our own personalities and who we are.
For some people, they tend to open up about everything in their world on the first date and cancer shouldn’t change that.
I don’t want to ever advise someone to change who they are or how they communicate; however, typically I would say let the person get to know who you are through the lens of you being you rather than the lens of having cancer, because that lens can distort how they see you unintentionally.
So if they don’t know your sense of humor and what you like and the kind of family you come from, before they know the basics of who you are, your cancer story doesn’t have to be disclosed, unless you can’t hide it.
If the cancer is visible, you may have to disclose it. But if you are out of treatment or in treatment and you don’t have hair loss or visible scars, then I would say by date five you can disclose.
Dates one through four are really in the exploration stage and trying to know if you like each other, and by date five you know that you like this person.
If you can’t hide the visible effects of cancer, it’s not wise to lie. If you have a scar, don’t say that “I was attacked by a shark.”
The best way to disclose—yes, timing has something to do with it—but how you disclose has more impact than what you disclose.
And what I mean by that is, if you’re able to tell your cancer story in a way that is clear, that shows that you’ve processed it, that you know all the information about long term effects, what you learned from your experience—the person sitting across from you, regardless of what you tell them, is going to see that confidence and competence.
They will respond in a similar way rather than with anxiety or doubt.
Should you only step into the dating world when you feel confident?
It depends on what you want.
If you’re looking just to have fun, I don’t know if you have to wait.
But if what you’re looking for is a long-term relationship, what you put out is going to influence what you’ll bring in.
If you still haven’t processed it, you are probably not ready to enter a serious relationship because you don’t know what you’re going to learn from that process.
Also, who you are attracted to might change throughout this process. Maybe looks are not as important to you and you’re looking for compassion. Or before, you wanted someone more playful, but now you want someone who’s driven.
The experience of cancer teaches us many things and can influence who you want to partner up with.
How do I disclose fertility challenges or long term side effects from treatment?
If you are willing to disclose your cancer history, you should be willing and able to disclose late and long term effects of fertility.
When they say, “Oh my god, what does that mean for you?” You need to be able to say, “Well, I may not physically or biologically be able to carry a child, or I may need to adopt.”
This also connects back to how who you date may be influenced by that. If you wanted kids before but you are infertile now, you need to partner up with someone who is open to adoption or IVF or donors.
This conversation typically happens later in the relationship, but it’s an important piece to disclose. It’s important to know what you want and that the person you’re dating is aligned with that.
Anything that might impact day-to-day stuff—that goes back to being comfortable with your story—that disclosure and discussion needs to happen before sexual intimacy.
Some women who may have had a mastectomy at a young age have a lot of fear and anxiety around being naked in front of their partner.
In those instances, I say, “Until you are comfortable looking at your own body, don’t let in another body.”
How do I manage the physical changes from cancer (i.e. dating without hair)?
One, know that physical changes may change and nothing is permanent.
Two, before getting into a new sexual relationship, during or after the cancer experience, it is really important to understand how your body has changed—whether that’s a port scar, radiation burn, amputation, medically induced menopause, gaining or losing weight.
Being able to comfortably look at your scars, explain them, touch your scars, it may be triggering.
It’s important to know what triggers you before being physical with someone.
Physical cues may have changed. If you are comfortable with it, try to touch yourself in a sensual way and try to understand any changes in your body.
Women who are going through medically induced menopause may not get wet in the same way that they are used to.
If a woman doesn’t know that, she won’t be able to anticipate this happening with someone, use lubrication, and communicate that change to her partner.
Guys also can experience changes in their body, maybe because of steroids or anxiety. This all goes back to knowing your body and how to communicate such changes.
If you still feel uncomfortable, you need to talk to a professional. You need to work through what is creating that barrier within yourself.
Don’t tough it out and suck it up when something hurts—don’t just power through it.
If you have pain or anxiety, talk to someone about it. It is important to acknowledge it.
If you’re female, talk to your OBGYN who will coordinate with an oncologist if there’s pain. If you’re male, see your primary care physician for an assessment.
How do my partner and I navigate the changes cancer has brought? (Including infertility)
Communication is so critical. For example, if you’re told at 35 that you’re going through menopause, you typically won’t know what that means or what the physiological symptoms of menopause are. It is important for both partners to be educated on what these changes mean.
Communication is key—talk about what feels good and what doesn’t feel good.
Communication is really important. Maybe talking to a counselor or physician about those changes could help.
Navigating sexual changes comes down to talking about them.
If fertility has been affected, early and often conversations about family should happen.
Ask questions like, “Are we open to adoption? Would we want to do preservation? Would we want to go to a bank? Are there any conflicts with faith practices?”
It’s really, really important for a couple where one or both partners are religious to talk to their pastor, their rabbi, or whomever, and bring their faith community into the conversation and consider what options they might have.
It’s also really important couples keep touching, during and after treatment.
It doesn’t just mean sex. Touch is so important. That could be massaging, laying naked together, holding hands, kissing.
If all touch ceases throughout treatment, it may feel awkward to reintroduce six months later.
Touch should be an ongoing thing, even if it may need to change day-to-day based on how someone is feeling. But touch is so critical.
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