Book Reviews

Sexuality and Fertility After Cancer

By Leslie Schover, Ph.D.
John Wiley & Sons, New York 1997
ISBN 0-471-18194-3 $15.95

Reviewed by Lorraine Johnston

Leslie Schover's 1997 book, Sexuality and Fertility After Cancer, is an excellent, thoroughly detailed resource for colon cancer survivors confronting sexual issues during diagnosis, treatment, and recovery. Dr. Schover, who is a clinical psychologist and sex therapist at the Cleveland Clinic, is recognized as an authority on cancer and sexuality. In 28 chapters and 288 pages, Dr. Schover describes almost everything you might have experienced–or hoped you will never experience. Her discussion of the possible differences in sexuality caused by cancer is grounded in a comprehensive introductory discussion of sexual function in the absence of cancer.

In Part One, consisting of six chapters, she discusses the variety of possible sexual and psychosexual changes during treatment, the spectrum of feelings about sex after cancer treatment, what to expect physically and emotionally in the afterlife of cancer, how to communicate with loved ones, issues specific to gender, feeling unattractive, divorce, depression, birth control, and numerous other issues.

In Part Two, eight chapters address specific physical sexual problems and how to resolve them. Dr. Schover describes techniques and technologies for restoring diminished libido, hormonal imbalances, problems with achieving orgasm, relieving pain during intercourse, restoring erection, medications that interfere with sexual pleasure and function, and many other problems that are all too often borne silently. Her detailed treatment of female sexual problems during intercourse is especially appreciated, in contrast to one colon cancer book still in print which contains, amidst a nine-page chapter discussing male erection, only one paragraph on female genital problems during intercourse. She discusses the possible development of painful radiation fibrosis in the years following pelvic radiotherapy, and how to avoid it. Radiation fibrosis is a potential late effect of cancer therapy, discussion of which often is omitted by radiation oncologists, urologists, and gynecologists.

Part Three consists of fifty pages of information on fertility and pregnancy, covering in depth the latest technologies available for restoring lost fertility, sustaining high-risk pregnancies, harvesting and concentrating sperm, risks that children of cancer survivors might face, premature menopause, surrogate parenthood, and adoption.

In Part Four she discusses sexual adaptation by those minus genitals, breasts, those living with an ostomy, emotional and sexual effects of physical scarring, childhood cancer survivors and their unique adaptations, and gay and lesbian cancer survivors. She offers finely wrought suggestions for the timing and content of the single cancer survivor's discussion of sexual issues with prospective partners. Especially impressive is her sensitivity toward those over age 65, whose sexual needs sometimes are neglected by the medical community.

Over forty pages of resources, bibliographic information, glossary and indexed entries contribute to this book's usefulness.

This is an extraordinarily thorough, sound, compassionate, current book. The reader can be assured that he or she is indeed in very good hands.

Ms. Johnston is a member of CCA and author of two cancer-related books: Non-Hodgkins Lymphoma: Making Sense of Diagnosis, Treatment, and Options, and Colon and Rectal Cancer: A Comprehensive Guide for Patients and Families. She is the wife of a lymphoma survivor, the daughter of a lymphoma survivor and has two friends with CRC. Ms. Johnston has a BS in Life Sciences.

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