How breast cancer can affect your libido, and 8 other questions we've never really thought about.

Breast cancer is something you really may not want to know a lot about.             

Because, if you do, it's likely yourself or someone you know and love has it, and is going through treatment.

...But the thing is, learning about breast cancer can't give you it. We promise. Having knowledge surrounding a condition that affects one in seven women (yes, one in seven), means you are equipped to help one of those women that need it, and can approach their illness with empathy and understanding. 

As it turns out, there are a lot of details about breast cancer that people have absolutely no idea about. And they are pretty damn massive. 

Watch: Why you should talk to your family about their health history. Post continues after video. 

To help start the conversation, we spoke to Dr Belinda Kiely, to find out all the information we've been hiding from.

She's a member of the Breast Cancer Trials Scientific Advisory Committee, and an incredible oncologist based in Sydney.

So, from sex drive to body image, here's 9 breast cancer questions we all need to be asking.

Dr Belinda Kiely. Image: Supplied.

1. Can breast cancer just be cut out in surgery? Is that the cure?

Perhaps one of the most common misconceptions is that breast cancer can be 'fixed' with surgery, and surgery alone. Sure, this can be the case if intervened early enough, but for most breast cancer patients, this isn't the entire journey.

Breast cancer treatments and surgery aftercare can often be the hardest part for patients. 

2. You're only at risk of breast cancer if you've had it in your family history, right?

Unfortunately, this is completely wrong. 

Dr Belinda explains that so many women are shocked when they hear their diagnosis because they had ruled it out as a threat to them.

"So often, we get someone coming in and saying, 'I don't understand this. I've got no breast cancer in my family. I don't smoke; I do all the right things – how has this happened?'" explains Dr Belinda. 

"It is sad to say, but with most people, we don't actually know why they've got breast cancer. It's just that breast cancer is really common. One in seven women get diagnosed with breast cancer, and most of those people don't have a family history."

3. Are breast cancer checks and mammograms something you don't need to worry about until you're in your 60s?

In Australia, the breast screening program promotes mammograms to women from the age of 50 to 74.

"However, they do accept women from the age of 40," says Dr Belinda. "And you can go beyond the age of 74!"

It's a free service, so don't be afraid to utilise it and talk to your doctor about your options, because mammograms are such a good way of detecting cancers early. 

Image: Getty.

4. Is there any correlation between COVID-19 and breast cancer?

Medically, no. But the 'new normal' way of life, with multiple lockdowns and infrequent appointments with doctors, has definitely had a devastating impact. 

Over the past 18 months, oncologists have seen a huge drop-off in appointment attendance and early detection of breast cancer – meaning women are getting diagnosed later on when their cancer is trickier to treat. 

If there's one thing that Dr Belinda wants you to know, it's this: "If you've got a symptom, you've got to do a mammogram. Radiology practices are still open, and they're still doing mammograms. So you can still see your GP and get a referral. 

"I don't want women who have got lumps or symptoms to wait for COVID to be over. We're all still treating and diagnosing cancer, even with COVID. So, go and see your doctor and get referred."

5. How big of an impact does breast cancer have on body image?

Breast cancer is quite often not an invisible disease. Sure, some women will have lumps removed and small scars left behind, but for the majority of breast cancer patients, they'll see a huge amount of change to their body – and that means their relationship with it will change too.

"It's a really cruel disease," says Dr Belinda. "To lose a breast, part of their breasts, or sometimes both breasts is something heavy to deal with straight away. They've got scars, and they've often got swelling or pain associated with the surgery too."

And beyond the operation and recovery, breast cancer treatments can alter appearances dramatically too. 

"If they have chemotherapy, they lose their hair. And sometimes they lose eyelashes and eyebrows, which really changes how their face looks," says Dr Belinda. 

"I think, losing your hair, that can be massive. Your hair can be so important in how you feel about yourself. Plus, a lot of breast cancer treatments cause weight gain and tiredness, so people may start to feel less attractive and that means losing their confidence too."

Imagining all of these changes happening to your body in a really short period of time, you can probably understand why breast cancer patients go through a big adjustment in their relationship with their body.

"Breast cancer has huge implications. And body image is a big problem."

6. Does everyone get breast implants if they've had their breasts removed in surgery?

Not everyone chooses this, but it is an option that lots of patients take up.

"People can actually choose to have their implants added at the same time they have their breasts removed, so immediately have reconstruction. So many do wake up still with breasts, which can help a lot of women not have to deal with the alternative scenario."

We literally had NO IDEA this was possible, and wow, science is amazing. 

For those who choose to wait a little longer following their mastectomy, it can be a mental journey that allows you a bit more time to "get over the whole cancer shock and the treatment," before diving into a reconstruction.

"Replacing your breasts can make a big difference," says Dr Belinda. "I have women that come in and have had reconstructions maybe a few years later and just say that they actually feel a bit more 'normal' now that they, sort of, have their "shape back", and they can wear clothes that make them feel good again."

Image: Getty.

7. Does Medicare cover breast implants for breast cancer patients?

Now, we've heard the mental benefits of reconstruction, we want to check it's all covered on Medicare. But, sadly it's bad news folks: it actually isn't.  

"There is the ability to do it through the public system without any costs, but it is a very long waiting list. And it's limited," shares Dr Belinda. "So a lot of women end up doing this privately and they're spending lots of money. Sometimes it's up to $20,000, which is out of reach for a lot of people. 

"This is a big area of concern that there should be more access to better funded breast reconstruction options."

8. How does breast cancer affect your sex life? 

Now, this is a topic that barely anyone discusses, but during this conversation with Dr Belinda (and soon to be dived into during the Breast Cancer Trials Q&A with Dr Belinda Kiely herself!), it's becoming apparent that EVERYONE needs to know more about this topic on the intersection of breast cancer and sex.

So how does breast cancer actually impact one's time in the bedroom?

Firstly, libido can mentally take a dip due to the aforementioned body image battles lots of patients can go through. If you're not feeling great about yourself or confident in the way you look, then mustering up the enthusiasm for physical intimacy can be damn hard.

Secondly, breast cancer treatments have physical side effects that sound anything but arousing.

"A lot of the treatments we give to breast cancer patients cause menopausal side effects," explains Dr Belinda. 

"So, the largest, most common type of breast cancer is hormone receptor-positive breast cancer. And we treat that with hormone blocking medications. The side effects of those are fun things like menopause, hot flashes, decreased libido and vaginal dryness."

All of which, we're sure many menopausal women will agree, may not make for great sexual adventures. 

Psst! Listen to this episode of Sealed Section, Mamamia's sex education series. Post continues after podcast.

Dr Belinda is keen to note too, that women going through this treatment are often nowhere near the average menopausal age. 

"These treatments are putting women in their 30s and 40s into an early menopausal state, which they would not have been expecting at all. They've had no preparation for it and it's been very sudden – overnight, often. And so, they're dealing with sudden vaginal dryness, weight gain, hot flashes and low libido."

This massive life and health change is often missed off the list of Things Your Doctor Talks About, when you have breast cancer. Medical professionals volunteer information about recovery, returning cancer, fatigue, fertility, physical symptoms, though so often the conversation about the impacts of sex and intimacy is lower on the priority list.

Why? Dr Belinda reckons it's potentially down to the taboo and perceived embarrassing nature of the topic, for all parties involved. 

"I think we're not good at telling people the implications the treatments are going to have on their sex life. It's definitely an area where we fail. And I think that's because it's one of those topics that people aren't 100% comfortable talking about." 

"Like when we talk about heavy things like, 'Your life may be at risk here', no one enjoys sharing that news, but I think sex is the other thing that some doctors are frankly embarrassed to talk about."

"I know some women feel they can't bring it up, because they see it as unimportant. It seems the stance that patients take is thinking, 'I'm lucky I haven't died from my cancer, how can I worry about sex?' But actually, it's an important part of you and your quality of life."

9. So do women who have breast cancer go on to lead sexless lives?

Now, we don't want to be dramatic, but some might. Though, some definitely do not!

"So I've definitely had patients who come to me and say, 'look, sex is just not important to me'," shares Dr Belinda. "But there are others who do want sex back in their lives, and I think they just think there's nothing that can be done to help them, or they are too embarrassed to try to find something to help."

"They say, 'I don't want to go and see a counsellor because it's embarrassing' – and that to me is so sad." 

This can be devastating for single women going through breast cancer alone, but it can also have a heartbreaking impact on breast cancer patients in a partnership.

"I see a lot of relationships break down, I see marriages and their partners leaving because they couldn't communicate and, and often the partner thinks: 'Oh, well, they don't like me anymore because they don't want to have sex with me'. But in reality, there may be fear involved and they're just not talking enough about it. It has a really big impact on relationships."

There are practical solutions that your doctor can assist with for these issues (like finding the right solution for your vaginal dryness), but also know that emotional support, therapy and counselling are also available so you never have to tackle an issue like this on your own. 

We know you've just had a whole of questions about breast cancer answered right here.

But is there more you want to know? Of course there is! 

Knowledge is power, so be sure to load yourself up with information at the free online Breast Cancer Trials: Let’s Talk About Sex Q&A event.

Hosted by journalist Annabel Crabb, this incredible event allows all attendees to submit their questions to be answered by a panel of expert oncologists in partnership with Breast Cancer Trials. So be sure to register and submit your question to have it answered during the session.

Breast Cancer Trials: Let’s Talk About Sex, 5-6:30pm, Thursday 30 September (AEST). Register free here.

Feature: Mamamia/Getty.