Lung Cancer and Sexuality

How Will Lung Cancer Affect My Sex Life?

By Lynne Eldridge MD, About.com Guide

Updated March 27, 2012

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Sexuality is an important part of what makes us human, but with lung cancer, the rigors of treatment can push physical intimacy to the back burner. You may be tired from treatments, or your loved one may feel uncomfortable broaching the subject as she focuses on concerns about your health. Despite its importance, healthcare professionals are often hesitant to bring up the subject of sex due to time constraints, consideration of privacy, and even their own comfort level in discussing sexuality. But we know that sexuality affects quality of life and psychological well-being for those living with cancer. What are the issues that affect sexuality with lung cancer, and what can you do to foster sexual (and subsequently emotional) intimacy during cancer treatment?

Issues That Can Affect Sexuality If You Have Lung Cancer
Lung cancer can affect sexuality in many ways, both due to the disease itself and the side effects of treatment. Understanding some of the issues can help you address those that you have some control over, and help your loved one know how he or she can best support you. Some of these include:

Physical issues: 

Changes in physical appearance – Your physical appearance (for example hair loss or weight changes) during treatment may make you feel less attractive or desirable as an intimate partner.

Symptoms of lung cancer – Common symptoms of lung cancer, such as a cough or shortness of breath, may worsen during sexual activity.

Fatigue – Fatigue is an almost universal concern with lung cancer. This can stem not only from the cancer itself and side effects of treatments, but from the demands of doctors visits and traveling for treatment.

The presence of visitors – Time spent with family and friends is very important, but they may forget that you need time to be alone with your partner.

Psychological issues: 

Anxiety about your condition, your treatments or more.

Depression and grief – Studies show that mood has a significant effect on physical function.

Loneliness – You may feel emotionally separated from your loved one as you now face different challenges.

Role changes – Taking on the role of caregiver changes the dynamics of intimate relationships. A spouse may view a cancer patient more as a child than as a sexual partner, and feel uncomfortable with physical intimacy. You, the patient, can also be affected by assuming a role of accepting care more than giving it.

Guilt – Guilt due to the stigma of lung cancer, feeling that somehow an individual caused their disease and somehow deserves it, is common with lung cancer and can interfere with sexuality.

Tips For Enjoying Your Sexuality During Lung Cancer Treatment

Talk openly with your loved one
Share your needs and acknowledge one another's concerns. Anticipate that physical intimacy may need to be expressed in a different way as time goes on. Talk about how you can express your love if you are too fatigued for intercourse, or if coughing requires you to engage in quieter activities.

• How to Talk to Your Partner About Sexual Issues or Concerns

Share intimate physical moments that don’t involve intercourse
Be generous with touch. Hold hands during doctor’s visits. Sneak a kiss while the lab tech draws blood. Look back to the days when you first fell in love, and the special “little things” you did that drew you closer.

• Sexual Activities That Don't Involve Intercourse

Adapt according to your limitations
Positions such as side-by-side may require less energy. Have the partner without cancer take the more active role. Plan to have sex when you are well-rested and not directly following a heavy meal.

Give yourselves a special treat
Think of things that make you feel good and attractive to each other. A new outfit, a pampering massage, a special cologne, even a new hair color (assuming you have hair) may add a little spice. This is important for both of you, as caregivers often feel guilty pampering themselves while caring for a loved one with cancer.

Skip the booze
Alcohol can interfere with a healthy sex life even if you don't have lung cancer. That said, a glass of red wine might add a sparkle to the moment.

• Sexual Effects of Alcohol

Set “visiting hours”
One lung cancer survivor told me that trying to find time alone with her husband reminded her of when they had young children. Now they ask friends not to call or visit during “nap time.”

Nurture your spiritual life
An active spiritual life is associated with a healthier mood and greater emotional well-being, which in turn are linked with a more satisfying sex life with cancer. Spirituality means different things to different people -- organized religion, communing with nature, meditation, or the like.

Most importantly, express your love daily in as many ways as you can. A relationship that is based on love and respect and that is continually nurtured is the best foundation for sexual intimacy during cancer treatment.

Sources:
Gilbert, E. et al. Renegotiating Sexuality and Intimacy in the Context of Cancer: The Experiences of Carers. Archives of Sexual Behavior. 2008. Dec 9. (Epub ahead of Print).

Goodell, T. Sexuality in chronic lung disease. The Nursing Clinics of North America. 2007. 42(4):631-8; viii.

Kotronoulas, G. et al. Nurses’ knowledge, attitudes, and practices regarding provision of sexual health care in patients with cancer: critical review of the evidence. Supportive Care in Cancer. 2009. Jan 9. (Epub ahead of print).

Lindau, S. et al. Communication about sexuality and intimacy in couples affected by lung cancer and their clinical-care providers. Psychooncology. 2011. 20(2):179-85.

Shell, J. et al. The longitudinal effects of cancer treatment and sexuality in individuals with lung cancer. Oncology Nursing Forum. 2008. 35(1):73-9

Shwartz, S. and J. Plawecki. Consequences of chemotherapy on the sexuality of patients with lung cancer. Clinical Journal of Oncology Nursing. 2002. 6(4):212-6.

gotquestions  http://lungcancer.about.com/od/livingwithlungcancer/a/sexuality.htm

How Weather Can Affect Your COPD

Weather and temperature changes can trigger COPD symptoms. Here's what you can do.

By Krisha McCoy

Medically reviewed by Cynthia Haines, MD

Weather changes are one of many factors that can trigger your COPD symptoms. Symptoms of COPD, which include shortness of breath, cough, and phlegm production, tend to get worse for some people when the air is very cold and when it is hot and humid.

"Weather extremes are not good," says Barry Make, MD, co-director of the COPD program at National Jewish Health and professor of medicine at the University of Colorado in Denver. Dr. Make says that temperatures below freezing or above 90 degrees Fahrenheit tend to cause COPD symptoms to flare up.

COPD and Weather: When It's Cold and Windy

Cold air and strong winds are known triggers for the worsening of COPD symptoms. Many people with COPD find that cold air can make it harder to breathe, leading to shortness of breath and wheezing. Frigid temperatures can also cause fatigue. "COPD patients just feel like they are more tired after they've been in the cold," explains Make.

Windy days can be practically problematic. "If COPD patients go out when it is windy and have to walk against the wind, there is more resistance," says Make. Therefore, it requires more exertion to walk, which can be difficult for someone with COPD.

If cold and windy climates bother you, try wearing a scarf or face mask loosely over your nose and mouth, and breathe through your nose on wintry days. The winter muffler and breathing through your nose warms the air before it enters your lungs, which can help prevent your symptoms from worsening.

Dealing With Hot, Humid Air

While there are a few people whose COPD symptoms improve in humid weather, most people's symptoms flare up on days of high heat, humidity, or smog. This can especially be an issue when a front moves in that brings humidity, says Make. "A lot of people with COPD tell you that they know when a front is going to come because of a change in their symptoms," he says.

To prevent a flare-up on the hottest and most humid days of the year, stay indoors in an air-conditioned room. "If it is a high-pollution day, we suggest that our COPD patients stay inside and limit their activities," notes Make. "If it is really hot or really cold, we would say the same."

Should You Move?

Seasonal exacerbations of COPD symptoms can be so bad that people will move across the country in an effort to manage their condition. "One of the most common questions we get is what part of the country is best to live in because of the weather," says Make.

In the past, physicians commonly recommended moving to the western United States, where the air is less humid. But it is now known that the COPD-weather connection is very individualized. "It is variable from person to person," says Make. "Some people prefer more humidity and some less."

It is usually not necessary to move when you have COPD, but if you live in a climate with extreme weather changes and moving is an option for you, talk with your doctor. If you decide to move, spend an extended vacation in the new area before you permanently relocate there.

"If people are going to think about moving somewhere for the weather," Make says, "be there during each season of the year." That way you will know if the move will provide year-round improvement of your symptoms.

The best advice for people with COPD is to pay attention to your symptoms during different weather conditions. With help from your doctor, you can learn how to minimize weather-related flare-ups.

http://www.everydayhealth.com/health-report/chronic-obstructive-pulmonary-disease/weather-and-copd.aspx

How to Prevent a COPD Flare-Up

Find out how to prevent a COPD exacerbation and what to do if you experience one.

By Madeline Vann, MPH

Medically reviewed by Cynthia Haines, MD

In most cases, patients who have chronic obstructive pulmonary disease (COPD) can keep symptoms such as cough, shortness of breath, or sputum under control. But there are times when COPD patients can experience exacerbations, a worsening of symptoms that is also called a flare-up.

"An exacerbation is when a chronic disease gets worse for some reason. With COPD, this is usually because of infection,” explains Richard Castriotta, MD, professor at the University of Texas Medical School at Houston.

COPD exacerbations result in about 1.5 million emergency room visits every year in the United States. The risk of an exacerbation varies according to the severity of your COPD. People with severe COPD have about 3.43 exacerbations a year compared with 2.68 on average for people with moderate COPD.

COPD Exacerbations: Signs and Causes

The COPD symptoms that you will recognize as an exacerbation are:

• Worsening cough
• Worsening feeling of being short of breath (dyspnea)
• Changes in sputum, such as changing color (clear to yellow, green, brown, or red) or quantity (either more or less than usual)

Many COPD flare-ups occur without any known cause. However, the most commonly understood causes of COPD exacerbations are respiratory infections such as colds or the flu.

If you have increased COPD symptoms such as a fever, chills, and "purulent" sputum (yellow in color), you should call your doctor immediately. You may need a prescription for antibiotics to help fight the infection.

COPD Exacerbations: How to Handle an Occurrence

How you handle a COPD flare-up will depend on how well you have your symptoms under control under normal circumstances and how severe the exacerbation is. If your symptoms are usually under control and your exacerbation is not severe, you should talk to your doctor about how to treat an increase in symptoms at home. You may be able to use your bronchodilator or steroids to address some symptoms under a doctor's supervision.

If you have followed your doctor's instructions and your efforts to control symptoms at home have not worked, do not take more medication. Instead, call your doctor's office or go to the ER.

If you're having trouble breathing, you should go to the ER immediately. At the hospital you may receive ventilator treatments or medication to help you breathe. In some instances, you may be hospitalized until you get better.

COPD Exacerbations: Prevention Strategies

There are several ways that you can prevent exacerbations or reduce their severity:

• Stop smoking. The more years you smoke, the worse your exacerbations are likely to be. Chronic and heavy smokers are at increased risk for severe exacerbations.
• Take antibiotics as prescribed. If your doctor gives you antibiotics to treat an infection that might lead to an flare-up, make sure you take all the medication as your doctor instructs, even if you feel better before you have finished every dose.
• Get your flu shot. Get a flu vaccine every year when flu season begins and make sure that you are up-to-date with your pneumococcal vaccine.
• Find a primary care doctor you can stick with. Data from a study of 388 COPD patients showed that those who did not have a regular doctor were more likely to need to go to the ER. The researchers estimate that 10 percent of visits could be prevented if more people with COPD had regular doctors. You also can reduce the risk of having to go back to the ER with a relapse if you have a doctor you can visit about a week after you go to the hospital with an exacerbation.

If you understand which COPD symptoms to watch out for, you will be able to respond to COPD exacerbations quickly and learn how to prevent them in the future.

http://www.everydayhealth.com/health-report/chronic-obstructive-pulmonary-disease/prevent-copd-flare.aspx

Gravity and Its Effects on Women

By Amy S. D. Lee, MS, WHCRNP, Nurse Practitioner

When I start thinking about how the force of gravity tugs and pulls on the female body, I usually reflect on the various parts of me that I can see have begun to sag!

Unfortunately, gravity can cause some of our organs, such as the uterus, to fall down or slip out of place. But there are ways to handle this condition, which we in medicine commonly refer to by the catchall term, prolapse. Prolapse literally means "to fall out of place," and it affects the vagina and the bladder as well.

What is prolapse?

Prolapse is a condition in which the pelvic organs begin to sag into, and even out of, the vagina. There are varying degrees of severity of prolapse, and the severity of the symptoms a woman will experience are usually related to the degree or extent of the prolapse.

Women who have never had children may have prolapse, but it's more common in women who have had vaginal deliveries. Other factors contributing to prolapse include

• older age
• heavier weight
• constipation
• prolonged cough
• pelvic tumors (like heavy uterine fibroids)
• perhaps a genetic predisposition

Common Symptoms of Prolapse

• pelvic pressure
• feeling of vaginal fullness
• leakage of urine
• pain with sex
• constipation (both a cause and a symptom)

Diagnosis

Diagnosis of mild prolapse can be made during a pelvic exam at your GYN visit. A more severe prolapse sometimes will become evident when the pelvic organs can be seen or felt protruding from the vagina. Your healthcare provider should then confirm the diagnosis with a pelvic exam.

While it can be quite alarming to discover that you have prolapse, it’s usually a pretty benign condition that can be corrected.

Treatment

Treatment of a prolapse often depends on the severity of both the prolapse and the symptoms. Mild prolapse can often be treated with vaginal topical estrogen andvaginal exercises (Kegel exercises), both of which strengthen the vaginal walls. Other tactics for treating milder prolapses include avoiding heavy lifting and avoiding caffeine (which acts as a diuretic).

More severe prolapse can be treated with a device called a pessary. Pessaries come in a variety of designs and are fitted by your healthcare provider. They stay in the vagina and lift the organs back into normal position. (No, you can't feel them.)

Last, the most severe cases of prolapse can be addressed with surgery. Severe uterine prolapse may require a hysterectomy, followed by repair of the vaginal muscles to lift the bladder back into position. There are also surgical procedures that can be done to suspend the bladder to or from other parts of the abdomen. Women who do not plan to ever be sexually active again may choose to have a procedure that closes the vagina, thereby lifting the organs into place and preventing them from falling back down.

What if you think you have prolapse?

The first thing ALL women should be doing--whether they have a prolapse condition or not--is the Kegel exercises. We should start doing them early (even as teens and young adults) to keep the vaginal muscles strong. Practice by squeezing the vaginal muscles (like starting and stopping the stream of urine) 10 times at least 10 times per day. If you are concerned that you have prolapse, or are at risk of prolapse, discuss your situation with your healthcare provider. Early intervention is an important part of prevention.

http://health.yahoo.net/experts/womentoday/gravity-and-its-effects-women