Sex after cancer : women renegotiating sex outside the coital imperative

Cancer is the leading cause of burden of disease in Australia, with more than 100,000 new cases diagnosed each year (Australian Institute of Health and Welfare [AIHW], 2010). However, five-year survival currently stands at more than 60 percent (AIHW, 2010), which has led to an increasing body of survivorship research examining the profound and enduring impact that cancer can have upon quality of life (QoL) and embodied subjectivity, leaving “no aspect of identity untouched” (Little, Jordens, & Sayers, 2003, p. 76; Little & Sayers, 2004). Indeed it has been suggested that following cancer, an individual’s experience of embodied subjectivity as functional, intact, and “normal” can move to a state of “dys-embodiment” (Williams, 1996, p. 23), in which the body and self are experienced as dysfunctional, ill, and at odds with the desired presentation of the self (Kelly & Field, 1996). Sexual well-being is a central component of QoL and embodied subjectivity, and it is now recognized that changes to sexuality can be the most problematic aspect of women’s life post-cancer (Burwell, Case, Kaelin, & Avis, 2006), with the impact lasting for many years after successful treatment (Andersen, 2009, Bertero & Wilmoth, 2007) and often associated with serious physical and emotional side effects (Gilbert, Ussher, & Perz, 2010b; Gilbert, Ussher, & Perz, 2011). The purpose of this chapter is to draw on the findings of a recent research study to examine women’s experience and construction of sexual well-being and intimacy after cancer, the impact of such changes on embodied subjectivity, and women’s strategies of sexual renegotiation.