There is sex after mastectomy, wonderful, beautiful, glorious sex. And, in the beginning, it can be simultaneously exquisite and painful. There is nothing that can quite prepare a man for making love, and having intercourse, with the love of his life who he fears losing. The threat hung over our heads and was part of our thoughts for days, months and years. Shirley would be embarrassed were I to say any more about our sex life. It is intimate and remains a joy.

I have spoken on this subject to women’s groups and social workers. Most rewarding was being part of a panel in Stamford, Connecticut with a professional sex therapist speaking ahead of me. I listened attentively and was pleased to find that Shirley and I had figured out on our own what she described in theory. She was a theoretician explaining the principles underlying sexuality and the impact of breast surgery and cancer treatment. Shirley and I had lived it and muddled through on our own just fine, thank you.

8. She is your trophy wife

You need to understand that your bride, your wife, the woman you promised to cherish, the love of your life and your best friend is also the answer to your caricature male mid-life crisis. The answer is not a young intern wearing a thong who’s young enough to be your daughter. It is not a young bimbo or young colleague with whom to start your next marriage, or your next family. It is not a sports car, a speedboat or a new set of golf clubs. It is your wife.

I encountered this attitude and understanding observing the marriage of friends Joe and Shirley, two “adolescents in love” after more than 40 years of marriage. Rather than have a midlife crisis alternative relationship, whether sexual or emotional, how about a fling with your wife. Take her away for a comfy weekend at a romantic bed and breakfast. In our case, it can be some quiet time together in the Berkshires, preferably paddling a canoe. Or take in a Broadway show, or a good movie and an after show dessert. Fall in love. Stay in love. Be in love.

9. Lemonade from lemons

When life gives you lemons, make lemonade. See the silver lining. You are not a Pollyanna to find something exquisite, profound and meaningful in facing cancer, facing death and facing loss. Can you imagine yourself in the shoes or the psyche of a person with cancer? Or as the husband, lover and lifetime partner of a woman with breast cancer? Can you understand deep in your soul what intimacy is like, sexual and otherwise, when all your senses are stretched and heightened by the knowledge you’re making love to a woman you could lose?

You find joy to the point of pain. You discover a profound sense of being one with each other, and yet there is awareness that it could be fleeting and transitory. Reality may break in and shatter the moment, but you persevere. I have often said in the years since “our” treatment for Shirley’s breast cancer that a good marriage, or a solid relationship, will not only get through the trauma of breast cancer, the marriage will be strengthened and be the better for it. Go figure.

10. She is not damaged goods

A man attending a prostate cancer support group expressed concern about being “damaged goods” following prostate cancer treatment. Your bride is not damaged goods with or without breast reconstruction. She remains the woman you fell in love with, the woman you committed to for a lifetime together. Get beyond the inner thoughts never expressed, wondering whether your lovemaking was altered forever. You, too, may miss her breast, as it has brought you both pleasure in the past. Whether or not

Breast cancer is a life and relationship threatening trauma. Peter J. Flierl, M.S.W., offers insights and common sense for husbands of patients with breast cancer

When we marry the man or woman of our dreams, our soul mate and best friend, we expect to be together for a lifetime despite the odds against it with 6 of 10 marriages today ending in divorce. We truly believe that we will be together “for richer, for poorer, in sickness and in health, ‘til death us do part.” And then life intrudes: becoming a couple, learning to balance needs, the joy and awesome responsibility of becoming and being parents, managing careers and handling money.

If a marriage is sound, it can weather any storm, survive virtually any trauma. If the relationship is not on solid ground, a trauma, almost any trauma or stress, can lead to its demise. That may account for the fact that nearly seven in ten marriages touched by breast cancer do not survive.

There is no magic bullet, no panacea or formula, for surviving and indeed thriving despite of or in part due to facing breast cancer diagnosis and treatment, and subsequent life together.

God it is said gives us challenges to build character, so you as a husband and the two of you as a couple have a great opportunity to build character, to create a lifetime love story. My bride of 28 years, Shirley, is a 22-year survivor of breast cancer. However, that does not define her. She is also a mother, a businesswoman, an educator, a lover, a community volunteer, and my lifetime partner. She was treated at age 37 for an aggressive, Stage 3 tumor that had extensive lymph node involvement. She is alive and well, still sexy with just one breast, and is an inspiration to other women facing this disease, particularly young women.

Following are suggestions to other husbands on how to be there for your wife, how to help her become and remain a survivor.

1. Tell her you love her.

In a marriage or any intimate relationship, silence is not golden. The strong silent type need not apply for the position of husband, lover, best friend, confidante and supporter of a woman with breast cancer. Your bride, your wife, needs and wants to hear from you. Actions may speak louder than words, and you may take all the right actions, but speaking words brings comfort, reassurance and knowledge of your inner feelings. She cannot read your mind. Being there for her is more than physical or economic security. Words have meaning. And the three most important words in the English language at this time, at this moment, when together you are facing her mortality, are: “I love you.”

The late Louise Crisafi, a saint here on Earth who always gave of herself for others in need, taught me this lesson on the Friday my wife, Shirley Ann, had her biopsy and was diagnosed. Shirley had opted for a two-step process for diagnosis one day and treatment, i.e., surgical removal of her right breast, a mastectomy, on a second day. This meant we knew on Friday she would have a mastectomy on Monday, a weekend together, scared, anxious, frightened. Shirley was confronting her death and the imminent loss of a part of her womanhood. I was clueless, at a loss, overwhelmed and scared. I didn’t know what to do, how to act or what to say.

Louise was an American Cancer Society Reach to Recovery volunteer devoted to helping other women face breast cancer diagnosis and treatment. She was a good friend. When I asked her what to do feeling as helpless and overwhelmed as I was, she said simply: “Tell her you love her.” I was off to the races. I spent that weekend saying those three magic, powerful words over and over, as frequently as possible, perhaps more than I had done in weeks, months or years previously.

A year or so later on a television talk show featuring three women who had had breast cancer, Shirley reminisced about how verbal I had become that fateful weekend. Those words brought comfort and made a difference. Remember to say: “I love you.” It works. And I hope I am as verbal and loving today as I was in the midst of crisis.

2. Say “Yes”

We all know the joke about Moses and the tribes of Israel wandering for 40 years in the desert after their miraculous escape from bondage in Egypt. It took 40 long years to reach the land of milk and honey, the Promised Land. And why, why did it take so long? Moses was a man. He refused to ask for directions. Ten Commandments, maybe; asking for help, never. If you’re married or have dated a man for any length of time, you’ve spent time in a car lost. You suggest, perhaps timidly and quietly, that it might be a good idea to stop and ask for directions. He is offended. He, after all, is a man. He has a good, no, a great sense of direction. That will become apparent to you, a mere woman with no sense of direction, momentarily. The moments tick by. He is becoming exasperated and hitting the gas. Finally, in disgust, he pulls into a gas station and asks for help. It pains him to do so.

Louise added another lesson when I was asking what to do knowing that Shirley and I were facing her cancer together, a cancer that we seemed to have faint hope of beat-ing. Her advice was powerful and insightful. When someone, anyone, asks if they can do anything to help, just say “Yes.” Friends, family, neighbors, colleagues and others want to be there for you and for themselves.

I know, I know. You’re a man and never ask for help, not even simple directions. Understand that the people asking to help need your “Yes” as much as you. It gives them some sense of being able to do something positive about this insidious disease that seems beyond their control.

Shirley and I were blessed. We did not have to cook a meal for 3-4 months following her surgery thanks to the chicken dishes, casseroles, lasagnas and other assorted goodies constantly flowing through our front door. Needing a brief childcare stint for our daughter, Alison, it was there. Thank you, Greenwich. Thank you in particular First Congregational Church in Old Greenwich. Thank you special friends, particularly Betsy, who taught me I could get through anything, even this. You are a compassionate community. You are a healing church. You are true friends. Your love, prayers and support made a difference for all three of us in our recovery.

Ask for help. Say “yes” when it’s offered. You’ll be better for it.

3. Humor Heals

Norman Cousins taught the country this lesson many years ago and we are often reminded of this truth by Loretta Laroche and others. We know that the act of laughing is itself healing. It makes us feel better and helps us get better. It is very easy to take ourselves and our careers much too seriously.

Close friends have experienced our occasional over-the-top, out of control laughing, true guffaws. Can anything feel better? You cannot laugh while feeling sorry for yourself. Seeing the humor in any situation brings relief and release. Did you hear about the drunk who got a “speeding” ticket after passing out at the wheel of his car? Tragedy, yes. Being able to laugh at the incident in hindsight brings understanding and relief.

Our favorite apocryphal joke is about hitting a pig, reporting the accident anonymously and getting a ticket in the mail for $500. And how did they find us, you ask, “the pig squealed.”

Shirley set the stage for our approach to her treatment for breast cancer, which included humor and lots of it. Shirley had met Linda McWhorter, her surgeon’s wife, about two weeks before her diagnosis and surgery. On the way in to the operating room for her mastectomy, lying on a gurney in a local community hospital, she looked up and said: “Hey, Phil, you ought to charge me half price. I’m pretty small.” Courage, strength, fortitude.

A year later, Shirley told the hospital’s President & CEO that she was being over charged for her mammogram, that she should get a 50% discount. After all, with one remaining breast, they only had to take a single x-ray image, not two. What’s fair is fair. She left him speechless. It just made sense to me.

And there was her relationship with her oncologist, Dick Hollister, and his incredible staff. Do you realize that over 95% of cancer treatment takes place in physicians’ private office, not in hospitals. If you choose to practice in oncology, you know from the get go that at least 50% of your patients will die. Yet Dick and his staff always provided hope, comfort, and, best of all, laughter and humor.

Dick had made the choice to become a doctor and treat patients with cancer at age 13 according to his mother, at age 11 according to him. He was the perfect match for Shirley, who turned him bright red (fairly easy given his red-head’s freckled complexion), when she whipped out her temporary breast prosthesis during his first visit to her hospital room. He was speechless. He knew he had a live one, despite the poor prognosis. Shirley was an interesting and challenging case for a new oncologist in his first few years of practice. Jokes were a staple in his office during the course of our year of treatment.

Humor is healing to body, mind, and spirit.

4. I love you, not your breasts

Despite our nation’s growing obesity, we are a breast and body image fixated society, from Betty Grable pinups in World War II, Marilyn Monroe and Jane Mansfield in the 1950’s and 1960’s to Salma Hayek, Paris Hilton and Pamela Anderson today. Men talk about being “leg men” or “breast men” with bravado and sophomoric stupidity, as if large breasts or great legs have anything to do with being a woman, a lifetime companion, and a long-term, intimate lover.

Now, don’t get me wrong. I love to look at and admire beautiful women from the gorgeous 76-year-old former model taking my smoking cessation class in 1982 to the stars on screen and women around me today. However, it is my bride, my lover, and my lifetime partner who is my sexual and sensual interest today. Your bride, your lover, your wife needs to know that you love who she is, not what type of body she has or the size of her breasts.

Shirley is as beautiful and sexy today as she was on our first date, if not more so. Our love making then and today was not and is not hampered by her having one breast instead of two. Rather, it enriches our intimacy. When we make love, she completes me, makes me whole and alive. God created a matching set that fits together nicely. Your bride needs reassurance in the face of an assault on her femininity and sense of womanhood. She needs to know by what you say and what you do that this set of circumstances is not the end of your sex life, but rather a new, sometimes frightening, and exciting sex life with heightened sensitivity and caring.

5. Go to her appointments

Go to the multitude of appointments with your wife, your partner, as much as you can, holding her hand literally and figuratively. I had the luxury and blessing of relative independence in my job as the CEO of a community health and wellness center. I built my professional and community calendar around Shirley’s treatment schedule. I went with Shirley to virtually every physician visit, every chemotherapy appointment. I felt a bit guilty about sitting in the waiting room, not going into the exam room with her for the actual treatments. Perhaps a bit of a wimp or squeamish, but I was with her in mind, body and spirit every step of the way. If it were possible, I would have taken it for her, and traded places with her.

It is not what you do when you accompany her to treatment, but rather the act itself that speaks volumes to her. It also gives you some sense of empowerment. You are more than a helpless spectator cursing the damned disease. You have joined the battle. You are helping wrest control from the cancer along with your wife, your family and friends, your treatment team and all of the support system around you.

There is also a practical side. Hearing a diagnosis of cancer overwhelms the senses. Doctors try to help you understand, but their daily jargon, the language of medicine, might as well be classical Greek or Latin. With two of you there, there are two sets of ears to hear what is said. There are two mouths to ask questions. This helps avoid the tendency to hear what you want to hear. Being with her each time will reassure her, help her overcome, and make you feel good about yourself. She’ll love you for it.

6. She is not an invalid

Your wife or partner is not fragile. She won’t break. Treatment can be grueling and tiring, but you both need to live your life as fully as possible. Continue to enjoy what you enjoy individually and as a couple, particularly the latter. One of our best friends and an inspiration for many jogged to her chemotherapy appointments when battling a recurrence of breast cancer. It is called zest for living, being in the now. Let your bride do anything she is up to trying. In Shirley’s case over the course of her year of treatment, that included walks at Greenwich Point, skiing, putting up with some golf with me, puttering with flowers, and even on occasion agreeing to go sailing with me. You need to take your cues from her. She knows what she can do, or how tired she may be feeling, whether it’s a good day or not. When she’s ready, encourage and support her without pushing her. Get out when she’s ready.

As I reflect, it was important for Shirley and I to live life fully as a couple and as a family with Alison. We knew our time together here might be very short and we wanted to live our life together fully. We did not anticipate the length of life we’ve been blessed with together. Shirley is a miracle and so is your wife or partner, no matter what the ultimate outcome.

7. Sex After Breast Cancer

This is another place where a man needs to let his partner lead. She will let you know what works now and what doesn’t, what she’s ready for, and what she’s not. I suppose I mourned the loss of her breast as she did, as well as the change in some aspects of love-making that result. The important thing to learn is that life goes on and sex goes on. In the first weeks, months and even years, your sex life may take on an added dimension that is simultaneously painful and exquisite. Imagine how it feels to make love to someone you feel you might lose. You don’t want to hurt her. Remember, she is not fragile. You can giver her bear hugs both during and outside your lovemaking.

Shirley found a new gynecologist as she went through treatment, Ed Jacobson, a warm man, the kind of physician whose presence and demeanor is comforting and reassuring by nature. He enriched our lives, specifically our sex lives, by suggesting we try jellies and creams to make intercourse easier and more comfortable. When your part-ner experiences menopause, whether naturally as she ages, or, as in Shirley’s case, early menopause brought on at age 37 by chemotherapy and hormone therapy, there are issues to be addressed. This includes hot flashes, vaginal dryness, pain during intercourse, lack of lubrication, lowered libido. In explaining the use of jellies and creams to Shirley during an office visit, Ed described it as “the stuff used by the prostitutes in Stamford.” Sounded like good advice to her and to me. And, by the way, it does work.

There is sex after mastectomy, wonderful, beautiful, glorious sex. And, in the beginning, it can be simultaneously exquisite and painful. There is nothing that can quite prepare a man for making love, and having intercourse, with the love of his life who he fears losing. The threat hung over our heads and was part of our thoughts for days, months and years. Shirley would be embarrassed were I to say any more about our sex life. It is intimate and remains a joy.

I have spoken on this subject to women’s groups and social workers. Most rewarding was being part of a panel in Stamford, Connecticut with a professional sex therapist speaking ahead of me. I listened attentively and was pleased to find that Shirley and I had figured out on our own what she described in theory. She was a theoretician explaining the principles underlying sexuality and the impact of breast surgery and cancer treatment. Shirley and I had lived it and muddled through on our own just fine, thank you.

8. She is your trophy wife

You need to understand that your bride, your wife, the woman you promised to cherish, the love of your life and your best friend is also the answer to your caricature male mid-life crisis. The answer is not a young intern wearing a thong who’s young enough to be your daughter. It is not a young bimbo or young colleague with whom to start your next marriage, or your next family. It is not a sports car, a speedboat or a new set of golf clubs. It is your wife.

I encountered this attitude and understanding observing the marriage of friends Joe and Shirley, two “adolescents in love” after more than 40 years of marriage. Rather than have a midlife crisis alternative relationship, whether sexual or emotional, how about a fling with your wife. Take her away for a comfy weekend at a romantic bed and breakfast. In our case, it can be some quiet time together in the Berkshires, preferably paddling a canoe. Or take in a Broadway show, or a good movie and an after show dessert. Fall in love. Stay in love. Be in love.

9. Lemonade from lemons

When life gives you lemons, make lemonade. See the silver lining. You are not a Pollyanna to find something exquisite, profound and meaningful in facing cancer, facing death and facing loss. Can you imagine yourself in the shoes or the psyche of a person with cancer? Or as the husband, lover and lifetime partner of a woman with breast cancer? Can you understand deep in your soul what intimacy is like, sexual and otherwise, when all your senses are stretched and heightened by the knowledge you’re making love to a woman you could lose?

You find joy to the point of pain. You discover a profound sense of being one with each other, and yet there is awareness that it could be fleeting and transitory. Reality may break in and shatter the moment, but you persevere. I have often said in the years since “our” treatment for Shirley’s breast cancer that a good marriage, or a solid relationship, will not only get through the trauma of breast cancer, the marriage will be strengthened and be the better for it. Go figure.

10. She is not damaged goods

A man attending a prostate cancer support group expressed concern about being “damaged goods” following prostate cancer treatment. Your bride is not damaged goods with or without breast reconstruction. She remains the woman you fell in love with, the woman you committed to for a lifetime together. Get beyond the inner thoughts never expressed, wondering whether your lovemaking was altered forever. You, too, may miss her breast, as it has brought you both pleasure in the past. Whether or not

A year or so later on a television talk show featuring three women who had had breast cancer, Shirley reminisced about how verbal I had become that fateful weekend. Those words brought comfort and made a difference. Remember to say: “I love you.” It works. And I hope I am as verbal and loving today as I was in the midst of crisis.

2. Say “Yes”

We all know the joke about Moses and the tribes of Israel wandering for 40 years in the desert after their miraculous escape from bondage in Egypt. It took 40 long years to reach the land of milk and honey, the Promised Land. And why, why did it take so long? Moses was a man. He refused to ask for directions. Ten Commandments, maybe; asking for help, never. If you’re married or have dated a man for any length of time, you’ve spent time in a car lost. You suggest, perhaps timidly and quietly, that it might be a good idea to stop and ask for directions. He is offended. He, after all, is a man. He has a good, no, a great sense of direction. That will become apparent to you, a mere woman with no sense of direction, momentarily. The moments tick by. He is becoming exasperated and hitting the gas. Finally, in disgust, he pulls into a gas station and asks for help. It pains him to do so.

Louise added another lesson when I was asking what to do knowing that Shirley and I were facing her cancer together, a cancer that we seemed to have faint hope of beat-ing. Her advice was powerful and insightful. When someone, anyone, asks if they can do anything to help, just say “Yes.” Friends, family, neighbors, colleagues and others want to be there for you and for themselves.

I know, I know. You’re a man and never ask for help, not even simple directions. Understand that the people asking to help need your “Yes” as much as you. It gives them some sense of being able to do something positive about this insidious disease that seems beyond their control.

Shirley and I were blessed. We did not have to cook a meal for 3-4 months following her surgery thanks to the chicken dishes, casseroles, lasagnas and other assorted goodies constantly flowing through our front door. Needing a brief childcare stint for our daughter, Alison, it was there. Thank you, Greenwich. Thank you in particular First Congregational Church in Old Greenwich. Thank you special friends, particularly Betsy, who taught me I could get through anything, even this. You are a compassionate community. You are a healing church. You are true friends. Your love, prayers and support made a difference for all three of us in our recovery.

Ask for help. Say “yes” when it’s offered. You’ll be better for it.

3. Humor Heals

Norman Cousins taught the country this lesson many years ago and we are often reminded of this truth by Loretta Laroche and others. We know that the act of laughing is itself healing. It makes us feel better and helps us get better. It is very easy to take ourselves and our careers much too seriously.

Close friends have experienced our occasional over-the-top, out of control laughing, true guffaws. Can anything feel better? You cannot laugh while feeling sorry for yourself. Seeing the humor in any situation brings relief and release. Did you hear about the drunk who got a “speeding” ticket after passing out at the wheel of his car? Tragedy, yes. Being able to laugh at the incident in hindsight brings understanding and relief.

Our favorite apocryphal joke is about hitting a pig, reporting the accident anonymously and getting a ticket in the mail for $500. And how did they find us, you ask, “the pig squealed.”

Shirley set the stage for our approach to her treatment for breast cancer, which included humor and lots of it. Shirley had met Linda McWhorter, her surgeon’s wife, about two weeks before her diagnosis and surgery. On the way in to the operating room for her mastectomy, lying on a gurney in a local community hospital, she looked up and said: “Hey, Phil, you ought to charge me half price. I’m pretty small.” Courage, strength, fortitude.

A year later, Shirley told the hospital’s President & CEO that she was being over charged for her mammogram, that she should get a 50% discount. After all, with one remaining breast, they only had to take a single x-ray image, not two. What’s fair is fair. She left him speechless. It just made sense to me.

And there was her relationship with her oncologist, Dick Hollister, and his incredible staff. Do you realize that over 95% of cancer treatment takes place in physicians’ private office, not in hospitals. If you choose to practice in oncology, you know from the get go that at least 50% of your patients will die. Yet Dick and his staff always provided hope, comfort, and, best of all, laughter and humor.

Dick had made the choice to become a doctor and treat patients with cancer at age 13 according to his mother, at age 11 according to him. He was the perfect match for Shirley, who turned him bright red (fairly easy given his red-head’s freckled complexion), when she whipped out her temporary breast prosthesis during his first visit to her hospital room. He was speechless. He knew he had a live one, despite the poor prognosis. Shirley was an interesting and challenging case for a new oncologist in his first few years of practice. Jokes were a staple in his office during the course of our year of treatment.

Humor is healing to body, mind, and spirit.

4. I love you, not your breasts

Despite our nation’s growing obesity, we are a breast and body image fixated society, from Betty Grable pinups in World War II, Marilyn Monroe and Jane Mansfield in the 1950’s and 1960’s to Salma Hayek, Paris Hilton and Pamela Anderson today. Men talk about being “leg men” or “breast men” with bravado and sophomoric stupidity, as if large breasts or great legs have anything to do with being a woman, a lifetime companion, and a long-term, intimate lover.

Now, don’t get me wrong. I love to look at and admire beautiful women from the gorgeous 76-year-old former model taking my smoking cessation class in 1982 to the stars on screen and women around me today. However, it is my bride, my lover, and my lifetime partner who is my sexual and sensual interest today. Your bride, your lover, your wife needs to know that you love who she is, not what type of body she has or the size of her breasts.

Shirley is as beautiful and sexy today as she was on our first date, if not more so. Our love making then and today was not and is not hampered by her having one breast instead of two. Rather, it enriches our intimacy. When we make love, she completes me, makes me whole and alive. God created a matching set that fits together nicely. Your bride needs reassurance in the face of an assault on her femininity and sense of womanhood. She needs to know by what you say and what you do that this set of circumstances is not the end of your sex life, but rather a new, sometimes frightening, and exciting sex life with heightened sensitivity and caring.

5. Go to her appointments

Go to the multitude of appointments with your wife, your partner, as much as you can, holding her hand literally and figuratively. I had the luxury and blessing of relative independence in my job as the CEO of a community health and wellness center. I built my professional and community calendar around Shirley’s treatment schedule. I went with Shirley to virtually every physician visit, every chemotherapy appointment. I felt a bit guilty about sitting in the waiting room, not going into the exam room with her for the actual treatments. Perhaps a bit of a wimp or squeamish, but I was with her in mind, body and spirit every step of the way. If it were possible, I would have taken it for her, and traded places with her.

It is not what you do when you accompany her to treatment, but rather the act itself that speaks volumes to her. It also gives you some sense of empowerment. You are more than a helpless spectator cursing the damned disease. You have joined the battle. You are helping wrest control from the cancer along with your wife, your family and friends, your treatment team and all of the support system around you.

There is also a practical side. Hearing a diagnosis of cancer overwhelms the senses. Doctors try to help you understand, but their daily jargon, the language of medicine, might as well be classical Greek or Latin. With two of you there, there are two sets of ears to hear what is said. There are two mouths to ask questions. This helps avoid the tendency to hear what you want to hear. Being with her each time will reassure her, help her overcome, and make you feel good about yourself. She’ll love you for it.

6. She is not an invalid

Your wife or partner is not fragile. She won’t break. Treatment can be grueling and tiring, but you both need to live your life as fully as possible. Continue to enjoy what you enjoy individually and as a couple, particularly the latter. One of our best friends and an inspiration for many jogged to her chemotherapy appointments when battling a recurrence of breast cancer. It is called zest for living, being in the now. Let your bride do anything she is up to trying. In Shirley’s case over the course of her year of treatment, that included walks at Greenwich Point, skiing, putting up with some golf with me, puttering with flowers, and even on occasion agreeing to go sailing with me. You need to take your cues from her. She knows what she can do, or how tired she may be feeling, whether it’s a good day or not. When she’s ready, encourage and support her without pushing her. Get out when she’s ready.

As I reflect, it was important for Shirley and I to live life fully as a couple and as a family with Alison. We knew our time together here might be very short and we wanted to live our life together fully. We did not anticipate the length of life we’ve been blessed with together. Shirley is a miracle and so is your wife or partner, no matter what the ultimate outcome.

7. Sex After Breast Cancer

This is another place where a man needs to let his partner lead. She will let you know what works now and what doesn’t, what she’s ready for, and what she’s not. I suppose I mourned the loss of her breast as she did, as well as the change in some aspects of love-making that result. The important thing to learn is that life goes on and sex goes on. In the first weeks, months and even years, your sex life may take on an added dimension that is simultaneously painful and exquisite. Imagine how it feels to make love to someone you feel you might lose. You don’t want to hurt her. Remember, she is not fragile. You can giver her bear hugs both during and outside your lovemaking.

Shirley found a new gynecologist as she went through treatment, Ed Jacobson, a warm man, the kind of physician whose presence and demeanor is comforting and reassuring by nature. He enriched our lives, specifically our sex lives, by suggesting we try jellies and creams to make intercourse easier and more comfortable. When your part-ner experiences menopause, whether naturally as she ages, or, as in Shirley’s case, early menopause brought on at age 37 by chemotherapy and hormone therapy, there are issues to be addressed. This includes hot flashes, vaginal dryness, pain during intercourse, lack of lubrication, lowered libido. In explaining the use of jellies and creams to Shirley during an office visit, Ed described it as “the stuff used by the prostitutes in Stamford.” Sounded like good advice to her and to me. And, by the way, it does work.

There is sex after mastectomy, wonderful, beautiful, glorious sex. And, in the beginning, it can be simultaneously exquisite and painful. There is nothing that can quite prepare a man for making love, and having intercourse, with the love of his life who he fears losing. The threat hung over our heads and was part of our thoughts for days, months and years. Shirley would be embarrassed were I to say any more about our sex life. It is intimate and remains a joy.

I have spoken on this subject to women’s groups and social workers. Most rewarding was being part of a panel in Stamford, Connecticut with a professional sex therapist speaking ahead of me. I listened attentively and was pleased to find that Shirley and I had figured out on our own what she described in theory. She was a theoretician explaining the principles underlying sexuality and the impact of breast surgery and cancer treatment. Shirley and I had lived it and muddled through on our own just fine, thank you.

8. She is your trophy wife

You need to understand that your bride, your wife, the woman you promised to cherish, the love of your life and your best friend is also the answer to your caricature male mid-life crisis. The answer is not a young intern wearing a thong who’s young enough to be your daughter. It is not a young bimbo or young colleague with whom to start your next marriage, or your next family. It is not a sports car, a speedboat or a new set of golf clubs. It is your wife.

I encountered this attitude and understanding observing the marriage of friends Joe and Shirley, two “adolescents in love” after more than 40 years of marriage. Rather than have a midlife crisis alternative relationship, whether sexual or emotional, how about a fling with your wife. Take her away for a comfy weekend at a romantic bed and breakfast. In our case, it can be some quiet time together in the Berkshires, preferably paddling a canoe. Or take in a Broadway show, or a good movie and an after show dessert. Fall in love. Stay in love. Be in love.

9. Lemonade from lemons

When life gives you lemons, make lemonade. See the silver lining. You are not a Pollyanna to find something exquisite, profound and meaningful in facing cancer, facing death and facing loss. Can you imagine yourself in the shoes or the psyche of a person with cancer? Or as the husband, lover and lifetime partner of a woman with breast cancer? Can you understand deep in your soul what intimacy is like, sexual and otherwise, when all your senses are stretched and heightened by the knowledge you’re making love to a woman you could lose?

You find joy to the point of pain. You discover a profound sense of being one with each other, and yet there is awareness that it could be fleeting and transitory. Reality may break in and shatter the moment, but you persevere. I have often said in the years since “our” treatment for Shirley’s breast cancer that a good marriage, or a solid relationship, will not only get through the trauma of breast cancer, the marriage will be strengthened and be the better for it. Go figure.

10. She is not damaged goods

A man attending a prostate cancer support group expressed concern about being “damaged goods” following prostate cancer treatment. Your bride is not damaged goods with or without breast reconstruction. She remains the woman you fell in love with, the woman you committed to for a lifetime together. Get beyond the inner thoughts never expressed, wondering whether your lovemaking was altered forever. You, too, may miss her breast, as it has brought you both pleasure in the past. Whether or not

A year later, Shirley told the hospital’s President & CEO that she was being over charged for her mammogram, that she should get a 50% discount. After all, with one remaining breast, they only had to take a single x-ray image, not two. What’s fair is fair. She left him speechless. It just made sense to me.

And there was her relationship with her oncologist, Dick Hollister, and his incredible staff. Do you realize that over 95% of cancer treatment takes place in physicians’ private office, not in hospitals. If you choose to practice in oncology, you know from the get go that at least 50% of your patients will die. Yet Dick and his staff always provided hope, comfort, and, best of all, laughter and humor.

Dick had made the choice to become a doctor and treat patients with cancer at age 13 according to his mother, at age 11 according to him. He was the perfect match for Shirley, who turned him bright red (fairly easy given his red-head’s freckled complexion), when she whipped out her temporary breast prosthesis during his first visit to her hospital room. He was speechless. He knew he had a live one, despite the poor prognosis. Shirley was an interesting and challenging case for a new oncologist in his first few years of practice. Jokes were a staple in his office during the course of our year of treatment.

Humor is healing to body, mind, and spirit.

4. I love you, not your breasts

Despite our nation’s growing obesity, we are a breast and body image fixated society, from Betty Grable pinups in World War II, Marilyn Monroe and Jane Mansfield in the 1950’s and 1960’s to Salma Hayek, Paris Hilton and Pamela Anderson today. Men talk about being “leg men” or “breast men” with bravado and sophomoric stupidity, as if large breasts or great legs have anything to do with being a woman, a lifetime companion, and a long-term, intimate lover.

Now, don’t get me wrong. I love to look at and admire beautiful women from the gorgeous 76-year-old former model taking my smoking cessation class in 1982 to the stars on screen and women around me today. However, it is my bride, my lover, and my lifetime partner who is my sexual and sensual interest today. Your bride, your lover, your wife needs to know that you love who she is, not what type of body she has or the size of her breasts.

Shirley is as beautiful and sexy today as she was on our first date, if not more so. Our love making then and today was not and is not hampered by her having one breast instead of two. Rather, it enriches our intimacy. When we make love, she completes me, makes me whole and alive. God created a matching set that fits together nicely. Your bride needs reassurance in the face of an assault on her femininity and sense of womanhood. She needs to know by what you say and what you do that this set of circumstances is not the end of your sex life, but rather a new, sometimes frightening, and exciting sex life with heightened sensitivity and caring.

5. Go to her appointments

Go to the multitude of appointments with your wife, your partner, as much as you can, holding her hand literally and figuratively. I had the luxury and blessing of relative independence in my job as the CEO of a community health and wellness center. I built my professional and community calendar around Shirley’s treatment schedule. I went with Shirley to virtually every physician visit, every chemotherapy appointment. I felt a bit guilty about sitting in the waiting room, not going into the exam room with her for the actual treatments. Perhaps a bit of a wimp or squeamish, but I was with her in mind, body and spirit every step of the way. If it were possible, I would have taken it for her, and traded places with her.

It is not what you do when you accompany her to treatment, but rather the act itself that speaks volumes to her. It also gives you some sense of empowerment. You are more than a helpless spectator cursing the damned disease. You have joined the battle. You are helping wrest control from the cancer along with your wife, your family and friends, your treatment team and all of the support system around you.

There is also a practical side. Hearing a diagnosis of cancer overwhelms the senses. Doctors try to help you understand, but their daily jargon, the language of medicine, might as well be classical Greek or Latin. With two of you there, there are two sets of ears to hear what is said. There are two mouths to ask questions. This helps avoid the tendency to hear what you want to hear. Being with her each time will reassure her, help her overcome, and make you feel good about yourself. She’ll love you for it.

6. She is not an invalid

Your wife or partner is not fragile. She won’t break. Treatment can be grueling and tiring, but you both need to live your life as fully as possible. Continue to enjoy what you enjoy individually and as a couple, particularly the latter. One of our best friends and an inspiration for many jogged to her chemotherapy appointments when battling a recurrence of breast cancer. It is called zest for living, being in the now. Let your bride do anything she is up to trying. In Shirley’s case over the course of her year of treatment, that included walks at Greenwich Point, skiing, putting up with some golf with me, puttering with flowers, and even on occasion agreeing to go sailing with me. You need to take your cues from her. She knows what she can do, or how tired she may be feeling, whether it’s a good day or not. When she’s ready, encourage and support her without pushing her. Get out when she’s ready.

As I reflect, it was important for Shirley and I to live life fully as a couple and as a family with Alison. We knew our time together here might be very short and we wanted to live our life together fully. We did not anticipate the length of life we’ve been blessed with together. Shirley is a miracle and so is your wife or partner, no matter what the ultimate outcome.

7. Sex After Breast Cancer

This is another place where a man needs to let his partner lead. She will let you know what works now and what doesn’t, what she’s ready for, and what she’s not. I suppose I mourned the loss of her breast as she did, as well as the change in some aspects of love-making that result. The important thing to learn is that life goes on and sex goes on. In the first weeks, months and even years, your sex life may take on an added dimension that is simultaneously painful and exquisite. Imagine how it feels to make love to someone you feel you might lose. You don’t want to hurt her. Remember, she is not fragile. You can giver her bear hugs both during and outside your lovemaking.

Shirley found a new gynecologist as she went through treatment, Ed Jacobson, a warm man, the kind of physician whose presence and demeanor is comforting and reassuring by nature. He enriched our lives, specifically our sex lives, by suggesting we try jellies and creams to make intercourse easier and more comfortable. When your part-ner experiences menopause, whether naturally as she ages, or, as in Shirley’s case, early menopause brought on at age 37 by chemotherapy and hormone therapy, there are issues to be addressed. This includes hot flashes, vaginal dryness, pain during intercourse, lack of lubrication, lowered libido. In explaining the use of jellies and creams to Shirley during an office visit, Ed described it as “the stuff used by the prostitutes in Stamford.” Sounded like good advice to her and to me. And, by the way, it does work.

There is sex after mastectomy, wonderful, beautiful, glorious sex. And, in the beginning, it can be simultaneously exquisite and painful. There is nothing that can quite prepare a man for making love, and having intercourse, with the love of his life who he fears losing. The threat hung over our heads and was part of our thoughts for days, months and years. Shirley would be embarrassed were I to say any more about our sex life. It is intimate and remains a joy.

I have spoken on this subject to women’s groups and social workers. Most rewarding was being part of a panel in Stamford, Connecticut with a professional sex therapist speaking ahead of me. I listened attentively and was pleased to find that Shirley and I had figured out on our own what she described in theory. She was a theoretician explaining the principles underlying sexuality and the impact of breast surgery and cancer treatment. Shirley and I had lived it and muddled through on our own just fine, thank you.

8. She is your trophy wife

You need to understand that your bride, your wife, the woman you promised to cherish, the love of your life and your best friend is also the answer to your caricature male mid-life crisis. The answer is not a young intern wearing a thong who’s young enough to be your daughter. It is not a young bimbo or young colleague with whom to start your next marriage, or your next family. It is not a sports car, a speedboat or a new set of golf clubs. It is your wife.

I encountered this attitude and understanding observing the marriage of friends Joe and Shirley, two “adolescents in love” after more than 40 years of marriage. Rather than have a midlife crisis alternative relationship, whether sexual or emotional, how about a fling with your wife. Take her away for a comfy weekend at a romantic bed and breakfast. In our case, it can be some quiet time together in the Berkshires, preferably paddling a canoe. Or take in a Broadway show, or a good movie and an after show dessert. Fall in love. Stay in love. Be in love.

9. Lemonade from lemons

When life gives you lemons, make lemonade. See the silver lining. You are not a Pollyanna to find something exquisite, profound and meaningful in facing cancer, facing death and facing loss. Can you imagine yourself in the shoes or the psyche of a person with cancer? Or as the husband, lover and lifetime partner of a woman with breast cancer? Can you understand deep in your soul what intimacy is like, sexual and otherwise, when all your senses are stretched and heightened by the knowledge you’re making love to a woman you could lose?

You find joy to the point of pain. You discover a profound sense of being one with each other, and yet there is awareness that it could be fleeting and transitory. Reality may break in and shatter the moment, but you persevere. I have often said in the years since “our” treatment for Shirley’s breast cancer that a good marriage, or a solid relationship, will not only get through the trauma of breast cancer, the marriage will be strengthened and be the better for it. Go figure.

10. She is not damaged goods

A man attending a prostate cancer support group expressed concern about being “damaged goods” following prostate cancer treatment. Your bride is not damaged goods with or without breast reconstruction. She remains the woman you fell in love with, the woman you committed to for a lifetime together. Get beyond the inner thoughts never expressed, wondering whether your lovemaking was altered forever. You, too, may miss her breast, as it has brought you both pleasure in the past. Whether or not

It is not what you do when you accompany her to treatment, but rather the act itself that speaks volumes to her. It also gives you some sense of empowerment. You are more than a helpless spectator cursing the damned disease. You have joined the battle. You are helping wrest control from the cancer along with your wife, your family and friends, your treatment team and all of the support system around you.

There is also a practical side. Hearing a diagnosis of cancer overwhelms the senses. Doctors try to help you understand, but their daily jargon, the language of medicine, might as well be classical Greek or Latin. With two of you there, there are two sets of ears to hear what is said. There are two mouths to ask questions. This helps avoid the tendency to hear what you want to hear. Being with her each time will reassure her, help her overcome, and make you feel good about yourself. She’ll love you for it.

6. She is not an invalid

Your wife or partner is not fragile. She won’t break. Treatment can be grueling and tiring, but you both need to live your life as fully as possible. Continue to enjoy what you enjoy individually and as a couple, particularly the latter. One of our best friends and an inspiration for many jogged to her chemotherapy appointments when battling a recurrence of breast cancer. It is called zest for living, being in the now. Let your bride do anything she is up to trying. In Shirley’s case over the course of her year of treatment, that included walks at Greenwich Point, skiing, putting up with some golf with me, puttering with flowers, and even on occasion agreeing to go sailing with me. You need to take your cues from her. She knows what she can do, or how tired she may be feeling, whether it’s a good day or not. When she’s ready, encourage and support her without pushing her. Get out when she’s ready.

As I reflect, it was important for Shirley and I to live life fully as a couple and as a family with Alison. We knew our time together here might be very short and we wanted to live our life together fully. We did not anticipate the length of life we’ve been blessed with together. Shirley is a miracle and so is your wife or partner, no matter what the ultimate outcome.

7. Sex After Breast Cancer

This is another place where a man needs to let his partner lead. She will let you know what works now and what doesn’t, what she’s ready for, and what she’s not. I suppose I mourned the loss of her breast as she did, as well as the change in some aspects of love-making that result. The important thing to learn is that life goes on and sex goes on. In the first weeks, months and even years, your sex life may take on an added dimension that is simultaneously painful and exquisite. Imagine how it feels to make love to someone you feel you might lose. You don’t want to hurt her. Remember, she is not fragile. You can giver her bear hugs both during and outside your lovemaking.

Shirley found a new gynecologist as she went through treatment, Ed Jacobson, a warm man, the kind of physician whose presence and demeanor is comforting and reassuring by nature. He enriched our lives, specifically our sex lives, by suggesting we try jellies and creams to make intercourse easier and more comfortable. When your part-ner experiences menopause, whether naturally as she ages, or, as in Shirley’s case, early menopause brought on at age 37 by chemotherapy and hormone therapy, there are issues to be addressed. This includes hot flashes, vaginal dryness, pain during intercourse, lack of lubrication, lowered libido. In explaining the use of jellies and creams to Shirley during an office visit, Ed described it as “the stuff used by the prostitutes in Stamford.” Sounded like good advice to her and to me. And, by the way, it does work.

There is sex after mastectomy, wonderful, beautiful, glorious sex. And, in the beginning, it can be simultaneously exquisite and painful. There is nothing that can quite prepare a man for making love, and having intercourse, with the love of his life who he fears losing. The threat hung over our heads and was part of our thoughts for days, months and years. Shirley would be embarrassed were I to say any more about our sex life. It is intimate and remains a joy.

I have spoken on this subject to women’s groups and social workers. Most rewarding was being part of a panel in Stamford, Connecticut with a professional sex therapist speaking ahead of me. I listened attentively and was pleased to find that Shirley and I had figured out on our own what she described in theory. She was a theoretician explaining the principles underlying sexuality and the impact of breast surgery and cancer treatment. Shirley and I had lived it and muddled through on our own just fine, thank you.

8. She is your trophy wife

You need to understand that your bride, your wife, the woman you promised to cherish, the love of your life and your best friend is also the answer to your caricature male mid-life crisis. The answer is not a young intern wearing a thong who’s young enough to be your daughter. It is not a young bimbo or young colleague with whom to start your next marriage, or your next family. It is not a sports car, a speedboat or a new set of golf clubs. It is your wife.

I encountered this attitude and understanding observing the marriage of friends Joe and Shirley, two “adolescents in love” after more than 40 years of marriage. Rather than have a midlife crisis alternative relationship, whether sexual or emotional, how about a fling with your wife. Take her away for a comfy weekend at a romantic bed and breakfast. In our case, it can be some quiet time together in the Berkshires, preferably paddling a canoe. Or take in a Broadway show, or a good movie and an after show dessert. Fall in love. Stay in love. Be in love.

9. Lemonade from lemons

When life gives you lemons, make lemonade. See the silver lining. You are not a Pollyanna to find something exquisite, profound and meaningful in facing cancer, facing death and facing loss. Can you imagine yourself in the shoes or the psyche of a person with cancer? Or as the husband, lover and lifetime partner of a woman with breast cancer? Can you understand deep in your soul what intimacy is like, sexual and otherwise, when all your senses are stretched and heightened by the knowledge you’re making love to a woman you could lose?

You find joy to the point of pain. You discover a profound sense of being one with each other, and yet there is awareness that it could be fleeting and transitory. Reality may break in and shatter the moment, but you persevere. I have often said in the years since “our” treatment for Shirley’s breast cancer that a good marriage, or a solid relationship, will not only get through the trauma of breast cancer, the marriage will be strengthened and be the better for it. Go figure.

10. She is not damaged goods

A man attending a prostate cancer support group expressed concern about being “damaged goods” following prostate cancer treatment. Your bride is not damaged goods with or without breast reconstruction. She remains the woman you fell in love with, the woman you committed to for a lifetime together. Get beyond the inner thoughts never expressed, wondering whether your lovemaking was altered forever. You, too, may miss her breast, as it has brought you both pleasure in the past. Whether or not

There is sex after mastectomy, wonderful, beautiful, glorious sex. And, in the beginning, it can be simultaneously exquisite and painful. There is nothing that can quite prepare a man for making love, and having intercourse, with the love of his life who he fears losing. The threat hung over our heads and was part of our thoughts for days, months and years. Shirley would be embarrassed were I to say any more about our sex life. It is intimate and remains a joy.

I have spoken on this subject to women’s groups and social workers. Most rewarding was being part of a panel in Stamford, Connecticut with a professional sex therapist speaking ahead of me. I listened attentively and was pleased to find that Shirley and I had figured out on our own what she described in theory. She was a theoretician explaining the principles underlying sexuality and the impact of breast surgery and cancer treatment. Shirley and I had lived it and muddled through on our own just fine, thank you.

8. She is your trophy wife

You need to understand that your bride, your wife, the woman you promised to cherish, the love of your life and your best friend is also the answer to your caricature male mid-life crisis. The answer is not a young intern wearing a thong who’s young enough to be your daughter. It is not a young bimbo or young colleague with whom to start your next marriage, or your next family. It is not a sports car, a speedboat or a new set of golf clubs. It is your wife.

I encountered this attitude and understanding observing the marriage of friends Joe and Shirley, two “adolescents in love” after more than 40 years of marriage. Rather than have a midlife crisis alternative relationship, whether sexual or emotional, how about a fling with your wife. Take her away for a comfy weekend at a romantic bed and breakfast. In our case, it can be some quiet time together in the Berkshires, preferably paddling a canoe. Or take in a Broadway show, or a good movie and an after show dessert. Fall in love. Stay in love. Be in love.

9. Lemonade from lemons

When life gives you lemons, make lemonade. See the silver lining. You are not a Pollyanna to find something exquisite, profound and meaningful in facing cancer, facing death and facing loss. Can you imagine yourself in the shoes or the psyche of a person with cancer? Or as the husband, lover and lifetime partner of a woman with breast cancer? Can you understand deep in your soul what intimacy is like, sexual and otherwise, when all your senses are stretched and heightened by the knowledge you’re making love to a woman you could lose?

You find joy to the point of pain. You discover a profound sense of being one with each other, and yet there is awareness that it could be fleeting and transitory. Reality may break in and shatter the moment, but you persevere. I have often said in the years since “our” treatment for Shirley’s breast cancer that a good marriage, or a solid relationship, will not only get through the trauma of breast cancer, the marriage will be strengthened and be the better for it. Go figure.

10. She is not damaged goods

A man attending a prostate cancer support group expressed concern about being “damaged goods” following prostate cancer treatment. Your bride is not damaged goods with or without breast reconstruction. She remains the woman you fell in love with, the woman you committed to for a lifetime together. Get beyond the inner thoughts never expressed, wondering whether your lovemaking was altered forever. You, too, may miss her breast, as it has brought you both pleasure in the past. Whether or not to have breast reconstruction is a personal choice, her choice. Shirley chose not to do so, in part I believe to avoid furthering tampering with and “awakening” of any missed cancer cells.

Now is the time to live your life to its fullest together. Cleave to her. Hold her. Love her. Smell her. Taste her. Smile with her. Laugh with her. Cry with her. Get angry with her. Yes, you still have “negative” feelings and emotions. You are still human beings in the ebb and flow of a love relationship that is more intense than most of those around you. You’ll both survive and thrive if you stay together.