Often uncomfortable with the shock of diagnosis, oncologists focus on what they are best at: saving their lives. Too few of them dare to address the "collateral" damage of treatment on desire, and the image of the body turned upside down by their patients. As if it was a secondary question, even incongruous. A luxury.

Talk about it to reassure yourself

And yet, "first caught up in the urgency of survival, women need, after a few months, to talk about their diminished desire, the hot flashes induced by the treatments, the fear of pain, of not being to be desirable ... ", notes Dr. Bérangère Arnal, gynecologist and sophrologist.

Founder of the association Au sein des femmes , she animates, with a sexologist and a psychoanalyst, groups of speech. There, the words jostle to say the evils of the belly, the skin and the desire, the fear of the scar and the flight of the pleasure, the guilt of not experiencing the momentum "as before" for a companion, lover , husband ...

The fear, violent, also to disgust the other. "I was afraid that his desire would be permanently affected by the image of the flesh cut up, sewn, abused," says Lucie. For Dr. Anne Lesur, oncosenologist, the most important thing is to reassure patients .

"You have to tell them that it's not abnormal not to want to make love, that it's not always good.

Relieved, many say to me: "Then, the others, it's the same, it's banal, finally." I explain to them that it is a period to pass, the time to reconstitute itself. "

Make love ... with love

"Death will not have me! For some people, the drive to live and the visceral need to see oneself desirable , therefore alive, in the face of death that lurks, is expressed by an irrepressible desire and a thirst for physical contact. "A bit like a little kid needs to be cuddled, touched, hugged, reassured. Others, on the contrary, fall back on themselves. Every woman goes through "her" cancer as she can, "explains Catherine Adler-Tal, oncopsychologist at the Etincelle association.

But a recent survey of the Institut Curie (2) confirms for all the need to talk about it: nearly 30% of women surveyed say they have not found any sexual activity after the illness.

Of the 71% who make love again, 58% express an alteration of desire, or the ability to reach orgasm (51%) ... and 65% feel they have not been sufficiently informed about the effects of treatment on sexuality.

Especially since hormone therapy - recommended during the five years following hormone-dependent cancers, which affect 80% of breast cancers - may prove to some, not all fortunately, a "kills love" formidable, in causing nausea, fatigue, sharp joint pain ... And being experienced as a double punishment by Elizabeth, who "thought she had won the battle" and admits to feeling like a "prisoner of war".

"Sexuality is neither a luxury nor a taboo, but a fundamental right of quality of life of patients, defined by the WHO," recalls Professor Ivan Krakowski, oncologist, president of Afsos, aware of the work training to caregivers , to facilitate access to better information and to listen to patients.

"Making love with a vulva and a dry vagina is painful. You can improve things with herbal medicine, says Dr. Bérangère Arnal, but the best medicine to regain desire and pleasure is love, time, patience ... and speech. "

Attempt other caresses

"The unspoken is what weakens the most a couple, insists Dr. Claude Esturgie, sexologist who animates groups of speech. Breast cancer is special because it strongly affects a symbol of femininity and our image as a desirable woman.

How to keep the urge ... to want when it is hard to love oneself, that one feels dispossessed of his identity? Everything is played out in the partner's capacity to give confidence to the doubter. And for her, to trust him.

And then, desire does not have only an aesthetic dimension; it is also re-tamed by "playing" on the different levels of intimacy that make the richness of a relationship: sexual, but also sensual, emotional, intellectual and spiritual. And when one is missing, we can "catch up" on others to keep the link. What is also important is the contact with his body, massaging, playing sports ... "

Recovering pleasure to revive desire: accompaniment by touch is often a first step to "get to know" with this bruised body, which has betrayed, observes Marie-Anne Garcia Bour (3), plantar reflexotherapist, specialized in oncology.

A simple foot massage can have a liberating effect to help the body "at low tide" to regain the lost place, she explains, to find another energy and rediscover how to touch the other, how we would like to be affected , also say the gestures that are difficult.

And what we dare to ask more: caresses, tenderness, soft words ... without being obsessed with the idea of ​​performance. "

To be massaged with tenderness, to welcome the caress, a pleasant perfume. It is by accepting to let go that "the body advances" and we find "the key contact" of desire and pleasure . Neither quite the same, nor quite another.

1. To read on www.rosemagazine.fr: "Hormono, double punishment? "
2. "Prevalence and risk factors for sexual difficulties in women in remission of non-metastatic breast cancer" (2010).
3. Author of "Rebuilding Life After Cancer" (Frison-Roche ed.) With a "resource book", a wealth of practical information.