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Sexuality, Breast Cancer Survivorship, and Script Theory

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Abstract

Introduction

With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the USA, a large percentage of whom are breast cancer survivors. These new technologies and treatments have side effects that impact women’s sexual health during treatment and throughout long-term survivorship from the disease. The purpose of this research was to understand the intersection of breast cancer survivorship and sexuality, including expressions and performance of gender, relationships, and sexual behavior in women in the Midwestern region of the USA.

Methods

This study used semi-structured interviews, conducted in 2015 and 2016 with 21 Midwestern women at least 6 months post-treatment. Following traditions of narrative and phenomenological qualitative research, the women’s own stories were used to explore the impact that survivorship, diagnosis, and treatment may have on a woman’s sexual self.

Results

Overarching themes included the role of care-giving, impact of the loss of breast tissue, and survival from breast cancer. These themes represent sexual scripts used specifically by women breast cancer survivors to understand and navigate their sexuality, including gender perceptions and performances, experiences of sexual pleasure and satisfaction, and their romantic and sexual relationships.

Conclusions

New scripts need to be encouraged with survivors and introduced into the social worlds that surround these individuals. Such scripts would include the importance of self-care throughout life and the importance of an individual’s quality of life beyond mere survival.

Policy Implications

More and better education needs to be provided to both healthcare providers and patients with regard to sexual side effects. Policies around standard of care must be adapted to go beyond survival.

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References

  • Alteri, R., Priti, B., Brinton, C., Casares, C. V., & Gansler, T. (2011). Breast cancer facts & figures 2011–2012. American Cancer Society Inc.

    Google Scholar 

  • Avis, N. E., Johnson, A., Canzona, M. R., & Levine, B. J. (2018). Sexual functioning among early post-treatment breast cancer survivors. Supportive Care in Cancer, 26(8), 2605–2613.

    Article  PubMed  PubMed Central  Google Scholar 

  • Barbera, L., Fitch, M., Adams, L., Doyle, C., DasGupta, T., & Blake, J. (2011). Improving care for women after gynecological cancer: The development of a sexuality clinic. Menopause, 18(12), 1327–1333.

    Article  PubMed  Google Scholar 

  • Barton-Burke, M., & Gustason, C. J. (2007). Sexuality in women with cancer. Nursing Clinics of North America, 42(4), 531–554.

    Article  PubMed  Google Scholar 

  • Cesario, B. (2020). Attitudes about victims of workplace sexual harassment based on sex. Current Research in Behavioral Sciences, 1, 100006.

  • Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches. SAGE Publications.

    Google Scholar 

  • Dempsey, J. M., & Reichert, T. (2000). Portrayal of married sex in the movies. Sexuality and Culture, 4(3), 21–36.

    Article  Google Scholar 

  • Dizon, D. S. (2009). Quality of life after breast cancer: Survivorship and sexuality. The Breast Journal, 15(5), 500–504.

    Article  PubMed  Google Scholar 

  • Dorval, M., Maunsell, E., Deschenes, L., Brisson, J., & Masse, B. (1998). Long-term quality of life after breast cancer: Comparison of 8-year survivors with population controls. Journal of Clinical Oncology, 16(2), 487–494.

    Article  PubMed  Google Scholar 

  • Ferguson, S. E., Urowitz, S., Massey, C., Wegener, M., Quartey, N., Wiljer, D., & Classen, C. C. (2012). Confirmatory factor analysis of the sexual adjustment and body image scale in women with gynecologic cancer. Cancer, 118(12), 3095–3104.

    Article  PubMed  Google Scholar 

  • Frith, H., & Kitzinger, C. (2001). Reformulating sexual script theory: Developing a discursive psychology of sexual negotiation. Theory & Psychology, 11(2), 209–232.

    Article  Google Scholar 

  • Ganz, P. A., Rowland, J. H., Desmond, K., Meyerowitz, B. E., & Wyatt, G. E. (1998). Life after breast cancer: Understanding women’s health-related quality of life and sexual functioning. Journal of Clinical Oncology, 16(2), 501–514.

    Article  PubMed  Google Scholar 

  • Ganz, P. A., Desmond, K. A., Leedham, B., Rowland, J. H., Meyerowitz, B. E., & Belin, T. R. (2002). Quality of life in long-term, disease-free survivors of breast cancer: A follow-up study. Journal of the National Cancer Institute, 94(1), 39–49.

    Article  PubMed  Google Scholar 

  • Henson, H. K. (2002). Breast cancer and sexuality. Sexuality and Disability, 20(4), 261–275.

    Article  Google Scholar 

  • Hopwood, P., Fletcher, I., Lee, A., & Al Ghazal, S. (2001). A body image scale for use with cancer patients. European Journal of Cancer, 37(2), 189–197.

    Article  PubMed  Google Scholar 

  • Hordern, A. J., & Street, A. F. (2007). Constructions of sexuality and intimacy after cancer: patient and health professional perspectives. Social Science & Medicine, 64(8), 1704–1718.

    Article  Google Scholar 

  • Juhl, A. A., Christensen, S., Zachariae, R., & Damsgaard, T. E. (2017). Unilateral breast reconstruction after mastectomy–patient satisfaction, aesthetic outcome and quality of life. Acta Oncologica, 56(2), 225–231.

    Article  PubMed  Google Scholar 

  • Katz, A. (2009). Woman cancer sex. Hygeia Media, An imprint of the Oncology Nursing Society.

    Google Scholar 

  • Kim, J. L., Lynn Sorsoli, C., Collins, K., Zylbergold, B. A., Schooler, D., & Tolman, D. L. (2007). From sex to sexuality: Exposing the heterosexual script on primetime network television. Journal of Sex Research, 44(2), 145–157.

    Article  PubMed  Google Scholar 

  • Kirkman, M., Winship, I., Stern, C., Neil, S., Mann, G. B., & Fisher, J. R. W. (2014). Women’s reflections on fertility and motherhood after breast cancer and its treatment. European Journal of Cancer Care, 23(4), 502–513.

    Article  PubMed  Google Scholar 

  • Kornblith, A. B., & Ligibel, J. (2003). Psychosocial and sexual functioning of survivors of breast cancer." In Seminars in Oncology, 30(6), 799–813. WB Saunders.

  • Li, C. C., & Rew, L. (2010). A feminist perspective on sexuality and body image in females with colorectal cancer: An integrative review. Journal of Wound Ostomy & Continence Nursing, 37(5), 519–525.

    Article  Google Scholar 

  • Ménard, A. D., & Cabrera, C. (2011). ‘Whatever the approach, tab B still fits into slot A’: Twenty years of sex scripts in romance novels. Sexuality & Culture, 15(3), 240–255.

    Article  Google Scholar 

  • Ménard, A. D., & Kleinplatz, P. J. (2008). Twenty-one moves guaranteed to make his thighs go up in flames: Depictions of “great sex” in popular magazines. Sexuality & Culture, 12(1), 1–20.

    Article  Google Scholar 

  • Merriam, S. B. (2009). Qualitative research: A guide to design and implementation. Jossey-Bass.

    Google Scholar 

  • Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., Stein, K. D., Alteri, R., & Jemal, A. (2016). Cancer treatment and survivorship statistics, 2016. CA: A Cancer Journal for Clinicians, 66(4), 271–289.

  • Moustakas, C. (1994). Phenomenological research methods. SAGE Publications.

    Book  Google Scholar 

  • Mullan, F. (1985). Seasons of survival: Reflections of a physician with cancer. New England Journal of Medicine, 313, 270–273.

    Article  PubMed  Google Scholar 

  • Nobre, P. J., & Pinto-Gouveia, J. (2006). Dysfunctional sexual beliefs as vulnerability factors for sexual dysfunction. Journal of Sex Research, 43(1), 68–75.

    Article  PubMed  Google Scholar 

  • Norsigian, J. (2011). Our bodies, ourselves. Simon and Schuster.

    Google Scholar 

  • Patton, M. (2005). Qualitative research and evaluation methods. Sage Publications Inc.

    Google Scholar 

  • Reagan, L. J. (1997). Engendering the dread disease: Women, men, and cancer. American Journal of Public Health, 87(11), 1779–1787.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rowland, J. H., Holland, J. C., Chaglassian, T., & Kinne, D. (1993). Psychological response to breast reconstruction: Expectations for and impact on postmastectomy functioning. Psychosomatics, 34(3), 241–250.

    Article  PubMed  Google Scholar 

  • Sakaluk, J. K., Todd, L. M., Milhausen, R., Lachowsky, N. J., & Undergraduate Research Group in Sexuality (URGiS). (2014). Dominant heterosexual sexual scripts in emerging adulthood: Conceptualization and measurement. The Journal of Sex Research, 51(5), 516–531.

    Article  Google Scholar 

  • Schultz, P. N., Klein, M. J., Beck, M. L., Stava, C., & Sellin, R. V. (2005). Breast cancer: Relationship between menopausal symptoms, physiologic health effects of cancer treatment and physical constraints on quality of life in long-term survivors. Journal of Clinical Nursing, 14(2), 204–211.

    Article  PubMed  Google Scholar 

  • Simon, S. (2006, June 2). ACS report: Number of US cancer survivors expected to exceed 20 million by 2026. American Cancer Society. https://www.cancer.org/latest-news/report-number-of-cancer-survivors-continues-to-grow.html

  • Simon, W., & Gagnon, J. H. (1986). Sexual scripts: Permanence and change. Archives of Sexual Behavior, 15(2), 97–120.

    Article  PubMed  Google Scholar 

  • Swami, V., Gray, M., & Furnham, A. (2006). The female nude in Rubens: Disconfirmatory evidence of the waist-to-hip ratio hypothesis of female physical attractiveness. Imagination, Cognition and Personality, 26(1), 139–147.

    Article  Google Scholar 

  • Toliver, S. D. (2016). Feminization of love. The Wiley Blackwell Encyclopedia of Family Studies. Wiley Blackwell.

    Google Scholar 

  • Tomkins, S. S. (1978). Script theory: Differential magnification of affects. University of Nebraska Press.

    Google Scholar 

  • van Manen, M. (1990). Researching lived experience: Human science for an action sensitive pedagogy. Althouse Press.

    Google Scholar 

  • Verschuren, J. E., Enzlin, P., Dijkstra, P. U., Geertzen, J. H., & Dekker, R. (2010). Chronic disease and sexuality: A generic conceptual framework. Journal of Sex Research, 47(2–3), 153–170.

    Article  PubMed  Google Scholar 

  • Ward, L. M. (2003). Understanding the role of entertainment media in the sexual socialization of American youth: A review of empirical research. Developmental Review, 23(3), 347–388.

    Article  Google Scholar 

  • Weijmar Schultz, W. C. M., Van de Wiel, H. B. M., Hahn, D. E. E., & Wouda, J. (1995). Sexual adjustment of women after gynaecological and breast cancer. Sexual and Marital Therapy, 10(3), 293–306.

    Article  Google Scholar 

  • Wilmoth, M. C. (2007). Sexuality: A critical component of quality of life in chronic disease. Nursing Clinics of North America, 42(4), 507–514.

    Article  PubMed  Google Scholar 

  • Wilmoth, M. C., & Ross, J. A. (1997). Women's perception. Breast cancer treatment and sexuality. Cancer Practice, 5(6), 353–359.

  • Yalom, M. (1997). A history of the breast. Ballantine Books.

    Google Scholar 

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Authors and Affiliations

  1. School of Health & Kinesiology, University of Nebraska at Omaha, Omaha, NE, 68182-0216, USA

    Aja D. Kneip Pelster, Jason D. Coleman & Sofia Jawed-Wessel

  2. Department of Sociology and Anthropology, University of Nebraska at Omaha, Omaha, NE, 68182-0291, USA

    Jay A. Irwin

  3. Grace Abbott School of Social Work, University of Nebraska at Omaha, Omaha, NE, 68182, USA

    Liam Heerten-Rodriguez

  4. School of Psychology and Public Health, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia

    Christopher M. Fisher

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  1. Aja D. Kneip Pelster
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  2. Jason D. Coleman
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  3. Sofia Jawed-Wessel
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  4. Jay A. Irwin
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  5. Liam Heerten-Rodriguez
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  6. Christopher M. Fisher
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Correspondence to Sofia Jawed-Wessel.

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Kneip Pelster, A.D., Coleman, J.D., Jawed-Wessel, S. et al. Sexuality, Breast Cancer Survivorship, and Script Theory. Sex Res Soc Policy 20, 529–538 (2023). https://doi.org/10.1007/s13178-021-00672-w

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