From Communication to Connection: Rebuilding Intimacy and Sexual Wellness After Breast Cancer

For many women, intimacy after breast cancer can feel like unfamiliar ground. Your body has changed, emotions have shifted, and the idea of pleasure may feel distant. Yet intimacy isn’t lost, it’s transformed. Rebuilding closeness begins with understanding these changes, communicating openly, and learning to define pleasure on your own terms—in new, meaningful ways. Listening to Your Body’s New Language Breast cancer surgery may alter the look and feel of your breasts [1]. Treatments like chemotherapy and hormone therapy can cause vaginal dryness, fatigue or reduced desire [1] [2]. These physical shifts can affect how you relate to your body, and how confident you feel about resuming intimacy. It’s common to wonder: “Will my partner still find me attractive?” “Will sex feel the same?” [3] [4] Partners may also hesitate, afraid of causing pain or not knowing what’s “okay” [4] [5] [6]. Over time, silence and assumptions can create distance—even when love remains strong [7] [8].  Acknowledging these changes—in your body, your sense of self and your relationships—is a vital step in healing. Your body has carried you through cancer. Listening to it, with kindness instead of judgement, is an act of self-compassion. Boundaries as Bridges, Not Barriers Rebuilding intimacy begins with open communication. After treatment, your needs and comfort levels may have changed, and sharing them honestly helps strengthen trust and deepen connection [9].  Boundaries aren’t walls. They’re bridges that help you and your partner meet each other where you are.  Research shows that couples who communicate openly about fears, desires and limitations experience greater satisfaction and less distress [10].  You can also speak with your doctor about symptoms like pain, dryness or loss of sensation [1]. Your care team can suggest ways to manage these and make intimacy more comfortable for you.  It’s normal to feel shy about discussing sexuality. But remember: talking about sex is a natural, healthy part of reclaiming yourself [11]. The first conversation may feel awkward—but it opens the door to healing closeness.  Redefining What Closeness Means When you think of sexuality, you may first think of intercourse. But pleasure can be found in small acts of connection—holding hands, gentle touch, laughter or emotional intimacy [1] [7] [9]. Exploring touch gradually and broadening your idea of connection beyond penetrative sex can reduce anxiety and help you rediscover comfort in your body in new ways [7] [9]. Studies show that couples who approach intimacy with openness, flexibility and acceptance rebuild stronger connections [12].  If pain or numbness occurs, try different positions that take the pressure off your chest, or take breaks [7] [13].  Remember: pleasure is about comfort and connection, not performance.  Moving Forward and Finding Your Rhythm Again Desire may not feel as spontaneous, but closeness is always within reach. Whether through gentle touch, warm conversation or shared laughter, intimacy begins when you feel safe, seen and loved.  Be patient with yourself. Some days, you will crave closeness; others, rest will be what you need most. Both are forms of healing.  At Solis and Luma, we believe that living well after breast cancer means nurturing joy, confidence, and intimacy—in a way that works for you. Every journey is unique. Don’t be discouraged if something that works for others doesn’t feel right for you [14]. Let this new chapter be where you redefine intimacy—not as something lost, but as something newly yours.   Article reviewed by Ms Dian Handayani, Sexologist and Certified Sex Coach at Nambani. Dian is also a contributing author of The Breast Years of Your Life: Living Well After Cancer. From emotional resilience and fertility to nutrition and exercise, the book offers compassionate, practical guidance for survivors rediscovering wellness and confidence after treatment. To learn more or grab a copy, visit https://www.solis.sg/the-breast-years-of-your-life/ References: [1] Solis Breast Care & Surgery Centre, The Breast Years of Your Life: Living Well After Cancer [2] American Cancer Society, Body Image and Sexuality After Breast Cancer  [3] Breastcancer.org, Sexual Health During and After Breast Cancer  [4] Current Opinion in Supportive and Palliative Care, Sexual identity after breast cancer: sexuality, body image, and relationship repercussions [5] MD Anderson Cancer Center, Sexuality and Cancer: A Guide for Patients and Their Partners [6] Women's Health, Care for breast cancer survivors in Asian countries: A review of sexual dysfunction [7] Breast Cancer Now, Your Body, Intimacy and Sex [8] Psychooncology, Everyday Protective Buffering Predicts Intimacy and Fear of Cancer Recurrence in Couples Coping with Early-Stage Breast Cancer [9] BMC Cancer, Constructions of sex and intimacy after cancer: Q methodology study of people with cancer, their partners, and health professionals [10] European Journal of Oncology Nursing, Factors contributing to sexual dissatisfaction in women with breast cancer: The specific role of conjugal relationship quality [11] American Cancer Society, How Cancer Can Affect Sex and Intimacy [12] Frontiers in Psychology, Coping With Changes to Sex and Intimacy After a Diagnosis of Metastatic Breast Cancer: Results From a Qualitative Investigation With Patients and Partners [13] The Oncologist, From diagnosis to survivorship addressing the sexuality of women during cancer [14] Psycho-Oncology, Wearing my heart on my chest: dating, new relationships, and the reconfiguration of self-esteem after breast cancer
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From Screening to Strength: Courage in the Face of the Unexpected

Breast cancer can strike unexpectedly, often without warning. For Tracy*, a 53-year-old mother of four and passionate hobbyist potter, a routine MRI changed everything. What began as curiosity about advanced screening became a journey of discovery, courage, and empowerment - showing that knowledge, vigilance, and support can make all the difference in living well after cancer. Please share your name, age, and a little about yourself. My name is Tracy, I’m 53 years old, a mother of four boys, and a hobbyist potter. Can you tell us about your journey with breast cancer — how you first discovered it and what went through your mind at diagnosis? I had no physical symptoms and no family history of breast cancer. Living abroad, I had been told during regular mammogram screenings that my dense breast tissue was common and “nothing to worry about,” though I was advised to continue six-monthly mammograms. These frequent screenings were inconvenient, so when I read that MRI was considered the “gold standard” for dense breasts, I decided to try it while visiting Singapore. I expected a clear MRI that would allow me to reduce the frequency of mammograms. My doctor at Solis was curious why I wanted an MRI, as my mammogram and ultrasound showed nothing concerning, but she agreed to order it. To my surprise, the MRI revealed a suspicious non-mass enhancement in my right breast, visible only on MRI. A biopsy followed, initially showing atypical ductal hyperplasia (ADH), which surgery later upgraded to Ductal Carcinoma In Situ (DCIS). Within two weeks, I went from reassurance to shock. I questioned why this had happened to me despite having no risk factors or symptoms. I berated myself for assuming the MRI would be clear and panicked over how much time I might have left with my children and husband. Why me? What was your biggest concern or worry at that time, and how did you go about finding information or support? My foremost concern was to remove all the traces of cancer from my body. I followed my doctor’s advice and underwent radiotherapy and endocrine therapy. I read every report, learned every medical term, asked informed questions, and explored ways to reduce the risk of recurrence. Knowledge became my way of regaining control.  What helped you find strength during your treatment and recovery? I was mostly alone in Singapore with one of my sons who was serving National Service, while my husband and other sons remained abroad. But my extended family and friends came out in full force for me. They jostled to accompany me to doctor visits and radiotherapy sessions, waited for me before and after surgery, surrounded me with prayers, nourished me with food, and gave me space to cry and ruminate — always making sure I knew I was not alone. What does “survivorship” mean to you, and how do you define “living well” after cancer? Survivorship means living intentionally. It has been just over a year since my diagnosis, and I take comfort in knowing the cancer was localised and treated accordingly.This experience has taught me to live more purposefully – to see each encounter and interaction as a meaningful step toward the next chapter of my life. Each year of living cancer-free is a blessing and an accomplishment.I’ve also become more conscious of my lifestyle. I now eat less red meat and focus on more vegetables, fruits, legumes, and soy. Taking ownership of my health feels empowering. How has this experience changed your outlook on life, family, or work? I’ve learned to let go of control and trust that life is molded through challenges, much like clay on my pottery wheel. Every experience shapes us. I now focus on what truly matters: meaningful relationships, gratitude and moments of joy. What advice would you give to other women going through a similar journey - or to young women about breast health and screening? Many Asian women have dense breast tissue, which can make cancer hard to detect. Family history and lack of symptoms do not guarantee safety. Be proactive, ask questions, and ensure your screening is thorough. Trust the expertise of your surgeons, radiologists interpreting your scans, and pathologists – and trust your instincts. What mantra or lesson do you carry with you today? Know and trust your gut instinct. If something seems off or keeps bothering you, ask questions until you find peace of mind. From diagnosis through treatment and into survivorship, Tracy’s story reminds us that life after cancer is not just about recovery - it’s about reclaiming control, finding purpose, and living fully. With determination, knowledge, and the support of loved ones, survivors can face uncertainty with confidence and grace.  Her journey is a testament to resilience and the power of trusting oneself – inspiring others to prioritise their health, seek understanding, and define their own path to living well.  *Name has been changed to protect the individual’s privacy.
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Good Nutrition for Living with and Beyond Breast Cancer

Breast cancer treatments have become more and more successful, with a huge number of women studied beyond breast cancer, discovering what lifestyle factors may reduce the risk of recurrence.   The current recommendations supported by research are:  Maintain a normal body weight, but if you are overweight, losing just 5%-10% of your weight is beneficial.  Do not drink alcohol. Alcohol is one of the greatest risk factors for breast cancer and there is no safe limit as far as breast cancer is concerned. If you do choose to drink alcohol, limit your intake to no more than 7 units a week. Of note, 1 unit is not the same as 1 drink.   175ml wine 13% ABV is 2.3 units  125ml champagne 12% AVB is 1.5 units  330ml beer 5% ABV is 1.7 units  25ml spirit 40% ABV is 1 unit  Limit saturated fat by avoiding or rarely eating fast food and highly processed convenience foods.   Do eat foods that contain healthy unsaturated fat, and this includes nuts, seeds, nut butter, olives, avocado, oily fish such as salmon, sardines and mackerel and use extra virgin olive oil.   Limit red meat (beef, lamb, pork) to no more than 500g per week, which in practice is about 3  times a week, and avoid or rarely eat processed meat such as bacon, ham and salami. These  foods do not directly increase breast cancer risk but do tend to be high in saturated fat and are linked with increased colon cancer risk.  Eat a high fibre diet. Foods high in fibre include beans and lentils, nuts and seeds, fruit and vegetables, wholemeal bread and flour, brown, red and wild rice, barley, spelt, quinoa, freekeh, kamut and other wholegrains. If you are not used to a high fibre diet, you may notice some bloating and more wind than usual, this is nothing to worry about and is a normal process that shows that your gut microbes are active and keeping your gut healthy, but if it’s uncomfortable, gradually increase your fibre intake over a period of a few weeks. Beans and lentils are especially high in fibre, so try to eat meals containing them at least 4 times a week. Eat dairy and high calcium foods. Dairy foods are often a cause of controversy, and many people mistakenly believe they are linked with increased breast cancer risk, however, research  shows the opposite to be true and that women who include dairy and high calcium foods in their diet have a reduced breast cancer risk. If you dislike dairy foods or are intolerant to them, ensure  your diet is rich in high calcium non-dairy foods.  Include soy in your diet. As with dairy, this group of foods can be controversial, but research does show that women who eat soy have a reduced breast cancer risk and reduced risk of recurrence compared to women who do not eat soy. This is the same for both hormone receptor negative and positive breast cancer. You may have heard that soy contains a group of  compounds called phyto-oestrogens, and this is where much of the fear arises, however, phyto oestrogens are not the same as the oestrogen that your body makes, they have a different chemical structure and attach to different receptors in the body.   You may choose not to eat soy, maybe because you dislike it, are intolerant or don’t feel comfortable eating it, and that is fine, it is still possible to eat a healthy diet that reduces breast cancer risk by following some of the other guidelines included in this article.  Be physically active. Whilst this is not in the realm of healthy eating, being physically active has clearly been shown to reduce breast cancer risk. Aim to be moderately active for a minimum of 150 minutes a week, so approximately 30 minutes a day, or vigorously active for at least 75 minutes a week. Moderate and vigorous will be different for everyone, so be your own guide as far as effort goes.   The final and very important piece of advice is do not fear food. Eating should be enjoyable and free from stress. A healthy diet can look different from one person to the next. Your friend, relative or fellow breast cancer friend may feel great eating one way and eating certain foods, but that doesn’t mean you have to do the same. Make adaptations to your diet gradually and enjoy the process, this is much more likely to lead to sustainable change.  *Article contributed by Jackie Green, Dietitian & Nutritionist at The Family Dietitian   Jackie is also a contributing author of The Breast Years of Your Life: Living Well After Cancer. To  learn more about this empowering book for breast cancer survivors, or to get your copy, visit https://www.solis.sg/the-breast-years-of-your-life/ Recipes https://www.wcrf-uk.org/healthy-eating/recipes/  References and further reading WCRF: Continuous Update Project 2018: Survivors of breast and other cancers  Messina M et al Neither soy foods nor isoflavones warrant classification as endocrine disruptors:  a technical review of the observational and clinical data. Crit Rev Food Sci Nutr. 2022;62(21):5824-5885. doi: 10.1080/10408398.2021.1895054. Epub 2021 Mar 27. PMID:  33775173.  Arafat HM et al The association between breast cancer and consumption of dairy products: a  systematic review. Ann Med. 2023 Dec;55(1):2198256. doi: 10.1080/07853890.2023.2198256. PMID: 37078247; PMCID: PMC10120447  Bodai B et al Breast Cancer: Lifestyle, the Human Gut Microbiota/Microbiome, and Survivorship. Perm J. 2020; 24:19.129. doi: 10.7812/TPP/19.129. PMID: 32589577; PMCID: PMC7319098. 
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