Love in the time of breast cancer

The reality of how life had changed began to sink in when Katheke Mbithi moved out of her sister-in-law’s house and back to her home. She had a young family to go back to: A husband, a two-year-old daughter, and a five-month-old baby.

Katheke had been diagnosed with breast cancer while pregnant months before and after a mastectomy, her sister-in-law helped to look after her and her family. Katheke had been adequately counselled before and after treatment, but her husband, Mbithi Silla, had not equally been prepared for the changes she had undergone.

“He was coming home to a woman with one breast and I was not sure how he would take it. I did not feel very attractive … the drugs I was taking for the cancer affected my libido and I thought he might start looking for another woman, so I told him he could leave if he wanted. I pushed him away, but he was adamant and supportive,” she recalls.

On his part, Mbithi says that leaving was out of the question. “How would I feel if she walked out on me when I needed her most? Even though she had lost a breast, nothing was going to change.”

Now eight years later, Katheke and her husband are still together, and throughout the interview they joke about the diagnosis that is now a distant memory. What this couple and many others who have been in a similar situation know is that a cancer diagnosis will take your relationships through a test, be they friendships, family ties, or romance.

SUPPORTIVE PARTNER

The last type of relationship was the focus of a survivors’ conference at the Aga Khan University Hospital in Nairobi to mark breast cancer awareness earlier this month. Since more young women (aged 40 and below) are being diagnosed with cancer, the Kenya Cancer Association wanted to address sexuality, fertility and relationships — issues that young survivors have to face after fighting breast cancer.

Flora Wachira, 30, attended the conference with many questions. She was diagnosed with breast cancer during early pregnancy and chose to delay treatment until after her baby was born (doctors had advised her to terminate the pregnancy so that she could get a mastectomy and start on chemotherapy immediately).

Her now five-month-old son was born healthy and she completed chemotherapy a few weeks ago. She is due to start radiation therapy, but there are still many questions she needed answers for. Will this affect her sex life long after the treatment? Will she be able to have more children?

And will her boyfriend, who lives in the UK, stand by her through all this? So far their relationship has been better than she expected. Her boyfriend dropped everything to be with her for three months while she was being treated, attends all her medical reviews, and follows up on her progress every day.

“I never thought he would stick around and be so supportive … but even though he has assured me by word and action that he will stand by me, I still worry that he might leave.” This fear sounds familiar to Caroline Achieng, a travel executive in her early thirties who had a mastectomy almost a decade ago.

Carol had a boyfriend back then, but he cut off communication not long after her diagnosis. She moved on, but wondered how she would broach the subject of her brush with breast cancer, which cost her one breast, in a new relationship.

“I would tell men during our first date that I had a mastectomy and they would disappear soon afterwards. I changed tack and started waiting a while before disclosing that I was a breast cancer survivor, but they still left. “I have now left it in God’s hands. I trusted Him for my treatment and recovery and now I trust Him to bring along the right man,” she says.

In her view, the right man will understand and accept her as she is. She adds that he will also not be swayed by peer pressure, like one of the men she dated who left her after she started talking openly about her fight with breast cancer. His friends and family put pressure on him to leave her.

“Many men are ignorant about breast cancer. They believe it is a death sentence and fear that a woman who has had it and survived cannot have children. Such misconceptions and the stigma they bring about make young cancer survivors fear to reveal that they had cancer or a mastectomy.

Still, Caroline wishes to settle down some day and have children of her own, and after years of meeting women who survived breast cancer just like her, she is convinced that with the right man, there will be no need to worry.

“I used to think that chemotherapy had affected my fertility, but I have met cancer survivors who went through the same treatment and later gave birth to up to three children and breastfed on one breast. I believe my eggs are still intact. Men need to know that; we are normal women.”

PREGNANCY TERMINATION?

Anthony Gitau is a man who knows that a cancer survivor is normal and adds that women who have had cancer need not resign themselves to eternal loneliness. When Dorcas Wachira, his wife, told him that she was a breast cancer survivor who had a lumpectomy* when she was 26, seven years ago, he was scared at first, but that did not deter him.

“Most of us know of cancer as a death sentence, but getting to know Dorcas gave me courage to go through with my plans to marry her. She is energetic, funny, and has a sunny outlook. What’s more, she fought this disease and made it alive — she is a strong woman — who wouldn’t want a woman like that?” he asks.

But even as he was marrying Dorcas, Anthony knew that she might not be able to have children and when she did get pregnant, doctors advised her to go for a termination to reduce the chances of cancer recurrence since most incidents of breast cancer are thought to be triggered and worsened by the presence of female hormones, which are elevated during pregnancy.

“We weighed the pros and cons, but the thought that she would have no child to leave behind made her so sad. So I told her that whatever decision she made, I would support it,” he recalls. Now they have a 19-month-old son and Anthony says he has not seen any negative effect of his wife’s previous fight with cancer on their intimacy and relationship.

Katheke and Mbithi agree: “You can have a fulfilling love life after breast cancer and a mastectomy,” Katheke says.

While Katheke is narrating the side effects of breast cancer drugs and how they weakened her libido and affected her weight, Mbithi interjects. “Look at her, doesn’t she look good? I knew I would fatten her one day,” he says amid laughter from both of them.

In fact, instead of driving them apart the way it does some couples, cancer brought them closer together.

“We had never confronted the possibility of death before and it made me reassess my values. Katheke is my soulmate – I really love this girl and I had to be strong for her.

“She also made it easy for me to support her because she did not play the victim or wallow in pity parties. We had our tensions but now we don’t sweat the small stuff anymore. What could be bigger than the cancer?” he asks.

Katheke adds, “Marrying my friend made it all easier. If we were not friends before we started dating, who knows… love can fade, but friendship is permanent and helps you weather the storms together.”

Does he mind that she does not have a breast? Does it affect their intimacy?

“It is just a breast! I never gave it any prominence and I can say that things couldn’t be better.”

Rebuilding a healthy self-esteem and body image after a mastectomy also helps keep the sex life alive.

“How you carry yourself really matters. You don’t have to neglect yourself. Make an effort to look good; you are still feminine. Nothing should change,” Katheke says.

And even for the survivors who are still single and searching, confidence is a plus, as Caroline Achieng has discovered. “Losing a breast really tears down one’s sense of confidence, but one has to find a way to build it up again and to love herself if she wants to find love.

“Who wants to date a woman who is not confident of herself? If you act so unsure, it does not make it any easier for the man who wants to date you. It repels them.”

This attitude is epitomised by Waithera Kabiru, a cancer survivor who had a lumpectomy and completed her final radiotherapy session in July this year. The 37-year-old single mother of two is not too worried about any stigma she might face when she begins dating again.

“I suppose some people might be worried about a recurrence, but what I have been through has made me a stronger person. I am leading a healthier lifestyle and I am confident I will not have a recurrence. And if I do, I know I have the strength and resources to fight it. My history with breast cancer really should not be a problem, and if it is, then we shouldn’t be in a relationship.”

*A lumpectomy removes the cancerous and surrounding tissue from the breast but keeps most of the breast intact. The lumpectomy may be followed by breast reconstruction.