ABC South West Victoria, Australia
By Jean Bell
When Wilma La Greca and John Molinia tried to find sex and intimacy after cancer they say it took some experimentation, an understanding of each other and a change of mindset.
The couple has been together for more than a decade. During that time, Mr Molinia had prostate cancer and Hodgkin's lymphoma, while Ms La Greca beat breast cancer.
"You have to experiment together. It's scary at the start because it's a bit weird and it's not your normal," Ms La Greca said.
"People shouldn't think, 'Oh, that's my sex life over'. It's not over, it's just different."
Mr Molinia, 57, had already been successfully treated for Hodgkin's Lymphoma in 2021 when he was diagnosed with prostate cancer last year.
He said the decision to remove his prostate was an easy one as he'd watched his father die of it.
Ms La Greca was no stranger to cancer treatment either. The 55-year-old, mother-of-two was diagnosed with breast cancer in 2007.
Genetic testing revealed she carried the BRCA type 2 gene, meaning she was predisposed to having cancer again. In 2014, she opted for a double mastectomy, breast implants and removal of her ovaries.
Change of mindset
The latest data from Cancer Council Victoria showed 36,384 Victorians were diagnosed with cancer in 2021, with prostate and breast cancer as the two commonest diagnoses.
Mr Molinia said the prostate removal procedure has impacted on his erectile function.
While this common side effect of surgery was challenging to accept at times, it did not stopped the couple from being intimate.
"You don't feel any less of a man, it's just different," Mr Molinia said.
"You obviously can't have sex the way you used to, without the help of either injections or tablets or anything else.
"It's not a blow, you just have to have a change of mindset."
Wilma La Greca also had her worries during her cancer treatment. At the time of her mastectomy, the couple were in a relatively new relationship and she was concerned about the impact the procedure might have.
"I was worried about myself at first, but I was also worried about how he might react," Ms La Greca said.
"But I thought about myself, and I thought, 'I want to live'."
Sex educator and counsellor Amanda Hordern works with cancer patients to help them rebuild their intimate relationships after recovery.
"Just hearing the words, 'you have cancer', irrevocably changes how you feel about your body and self-esteem," she said.
Ms Hordern said intimacy and sexuality was more than the pre-conceived ideas of penetration, orgasm, or high libido. She said her clients often craved more than this.
"I often hear from the cancer community that they long to be touched, but also share reciprocal love and kindness with someone you've known for a long time," she said.
Ms Hordern said people often needed to work through mental barriers and build inner confidence.
"This looks like working on the inner critic that says, 'What if I'm no good at sex, what if I disappoint my partner?''' she said.
Sexologist Tori Bellentina said that often, cancer patient's concerns about sex and intimacy were often brushed over after cancer treatment.
"Some people feel really embarrassed while other people put it in the too hard basket as they feel they should feel lucky to be alive, but it comes back to haunt them a bit later," she said.
"There's often this disregard for their rights as a sexual being. They're often told, 'You're lucky to be here and you shouldn't be worrying about this', or 'you're too old and you're too unwell."
Cancer not the 'end of the world'
Ms Bellentina urged people exploring intimacy after cancer to seek help and talk about their experience.
"Throw out the shame and really focus on your personal needs and being able to verbalise what you want," she said.
Mr Molinia said other men should not be scared to remove their prostate because of the side effects.
"It's 2023. There's more things out there than you think there is to keep you and your partner intimate," he said. "Life doesn't end after your prostate is removed."