{"id":10565,"date":"2017-05-25T11:42:41","date_gmt":"2017-05-25T17:42:41","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=10565"},"modified":"2023-04-20T14:27:49","modified_gmt":"2023-04-20T20:27:49","slug":"with-sex-and-cancer-finding-the-good-after-the-bad","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/with-sex-and-cancer-finding-the-good-after-the-bad\/","title":{"rendered":"With \u2018Sex and Cancer,\u2019 finding the good after the bad"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><p>&nbsp;<\/p>\n<figure id=\"attachment_10569\" aria-describedby=\"caption-attachment-10569\" style=\"width: 200px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-10569 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054612\/EXT_06XX17-SexandCancer.webp\" alt=\"Book cover of the new book, Sex and Cancer\" width=\"200\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054612\/EXT_06XX17-SexandCancer.webp 667w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054612\/EXT_06XX17-SexandCancer-200x300.webp 200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054612\/EXT_06XX17-SexandCancer-100x150.webp 100w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><figcaption id=\"caption-attachment-10569\" class=\"wp-caption-text\">Dr. Saketh Guntupalli, MD, and Marilyn Karinch, have co-authored the book Sex and Cancer: Intimacy, romance and love after diagnosis and treatment.<\/figcaption><\/figure>\n<p>Doctor helps patient.<\/p>\n<p>Patient helps doctor help a whole lot of other people.<\/p>\n<p>That sums up the story of Saketh Guntupalli, MD, and Marilyn Karinch, co-authors of the book Sex and Cancer: Intimacy, romance and love after diagnosis and treatment, available at bookstores everywhere on July 8. There is, of course, a whole lot more to it.<\/p>\n<p>Guntupalli is a University of Colorado School of Medicine gynecologic oncologist who practices at UCHealth University of Colorado Hospital. Karinch, who lives in Estes Park, is the author of 26 books, including this latest.<\/p>\n<p>They met in the medical world, long before they contributed to the literary one. Karinch was diagnosed with endometrial cancer in fall 2014. She had been referred to one of Guntupalli\u2019s colleagues, she said, but, \u201cFor some reason I just thought \u2013 no \u2013 it\u2019s got to be Saketh Guntupalli.\u201d<\/p>\n<p>\u201cHe\u2019s intensely gifted and very kind, and he\u2019s exactly the kind of cancer doctor you want when someone says, \u2018Oh, by the way, we have to remove your female organs,\u2019\u201d Karinch said.<\/p>\n<p>Her treatment, which indeed included a hysterectomy as well as chemotherapy and radiation, wrapped up in in early 2015, at which point she was cancer-free. She went on with her writing and other endeavors. He continued with his medical work.<\/p>\n<p><strong>Big win, big loss<\/strong><\/p>\n<p>In addition to seeing patients, his work included performing surgeries on complex gynecologic cancers, running a fellowship program, serving as vice-chair for quality and improvement, leading UCH\u2019s highly regarded Placenta Accreta Response Team, and doing medical research.<\/p>\n<p>His research was diverse, but often touched on surgical outcomes. A patient encounter led him down a different path. She had been treated for ovarian cancer and had come into see Guntupalli to confirm she was in the clear. She seemed distracted, sad, despondent. The exam showed neither disease nor other problems. Still, she started to cry. He asked her why she was so sad.<\/p>\n<figure id=\"attachment_10567\" aria-describedby=\"caption-attachment-10567\" style=\"width: 214px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-10567 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054424\/EXT_07XX17-SakethGuntupalli.webp\" alt=\"Saketh Guntupalli, MD, a University of Colorado School of Medicine surgeon and specilist in gynecologic oncology. Guntupalli's book, &quot;Sex and Cancer,&quot; is to be published on July 8, 2017.\" width=\"214\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054424\/EXT_07XX17-SakethGuntupalli.webp 714w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054424\/EXT_07XX17-SakethGuntupalli-214x300.webp 214w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054424\/EXT_07XX17-SakethGuntupalli-107x150.webp 107w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054424\/EXT_07XX17-SakethGuntupalli-200x280.webp 200w\" sizes=\"auto, (max-width: 214px) 100vw, 214px\" \/><figcaption id=\"caption-attachment-10567\" class=\"wp-caption-text\">Saketh Guntupalli, MD, a University of Colorado School of Medicine surgeon and specilist in gynecologic oncology. Guntupalli&#8217;s book, &#8220;Sex and Cancer,&#8221; is to be published on July 8, 2017.<\/figcaption><\/figure>\n<p>She told him that her husband hadn\u2019t touched her in any emotional or physical way since the diagnosis and she felt like she had beaten cancer but lost her marriage.<\/p>\n<p>That a woman who had done so well with a tough and ultimately successful cancer treatment regimen could be so despondent struck Guntupalli emotionally at first, and then intellectually, taking the form of a research question: \u201cDo we really know what is the incidence of marital and sexual dysfunction in people that have cancer?\u201d he asked.<\/p>\n<p><strong>Survey says\u2026<\/strong><\/p>\n<p>With CU clinical researchers Dina Flink, PhD, and Janelle Sheeder, PhD, Guntupalli designed a survey. Via Guntupalli and fellow oncologists, it went to 350 women around the United States. Among other things, the team found that 15 percent of women had what Guntupalli described as \u201csignificant problems with sexual and marital dysfunction\u201d after a gynecologic cancer diagnosis \u2013 and that fully 70 percent experienced sexual dysfunction, \u201cwhich is a huge number.\u201d<\/p>\n<p>\u201cSo it was like, whoa, this is a really, really big problem,\u201d Guntupalli said.<\/p>\n<p>He decided there should be a book about it. Given the combination of her personal experience with cancer, her track record, and that she and Guntupalli had hit it off personally Karinch was the logical choice as co-author.<\/p>\n<p>Guntupalli steered Karinch to several patients whose stories Karinch augmented with her own experience, Guntupalli\u2019s research and expert interviews. Her case was early-stage and, relatively speaking, not a difficult one, she said.<\/p>\n<p>\u201cBut by going through the surgery and the chemo and the radiation, I got to know all the phases of what people go through and all of the physical and self-esteem issues that are associated with the treatments,\u201d she said. \u201cSo it gave me a very up-close and personal perspective on what the people who have even more serious issues deal with.\u201d<\/p>\n<p>The idea was not only to document the problems cancer patients often face with intimacy, but also to highlight ways to tackle them. The main message, Karinch said, was that \u201cthere\u2019s a healing process on the intimacy front and the sex front, and if you want to, you can keep moving forward.\u201d<\/p>\n<p><strong>Overcoming \u201cdesexualization\u201d<\/strong><\/p>\n<figure id=\"attachment_10571\" aria-describedby=\"caption-attachment-10571\" style=\"width: 212px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-10571 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054950\/EXT_06XX17-MaryannKarinch.webp\" alt=\"Author Marilyn Karinch, who has written 26 books, teams up with Dr. Saketh Guntupalli for &quot;Sex and Cancer,'' her latest book.\" width=\"212\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054950\/EXT_06XX17-MaryannKarinch.webp 344w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054950\/EXT_06XX17-MaryannKarinch-212x300.webp 212w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054950\/EXT_06XX17-MaryannKarinch-106x150.webp 106w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/05\/25054950\/EXT_06XX17-MaryannKarinch-200x283.webp 200w\" sizes=\"auto, (max-width: 212px) 100vw, 212px\" \/><figcaption id=\"caption-attachment-10571\" class=\"wp-caption-text\">Author Marilyn Karinch, who has written 26 books, teams up with Dr. Saketh Guntupalli for &#8220;Sex and Cancer,&#8221; her latest book.<\/figcaption><\/figure>\n<p>The problems start with the physical changes to be overcome in the wake of surgery and radiation treatment. Then chemotherapy saps energy and cuts down on the production of the endorphins one needs to feel sexual, Guntupalli said. If that weren\u2019t desexualizing enough, chemotherapy generally costs women their hair. It\u2019s important that women and their partners understand that these things are the norm rather than the exception, and that they conspire to make them feel less sexual, he said. That understanding is a key to heading off the psychological challenges that come in the wake of cancer treatment\u2019s collateral damage.<\/p>\n<p>Through much of the book, Karinch and Guntupalli use the stories of cancer survivors as vehicles to highlight both potential pitfalls as well as things women have done to regain control of their sex lives after cancer. He wanted the book to not shy away from the problems, he said, but to emphasize solutions to the basic question: \u201cWhat are the things that women and men can do to regain their sexual identity after a diagnosis from cancer?\u201d<\/p>\n<p>Those things can be as diverse as personal lubricant and long rides on the back of a Harley Davidson with one\u2019s spouse \u2013 the latter which one patient found to be a satisfying alternative for both her and her partner, he said. But there are a few fundamentals. The most important of them, he said, is managing expectations about the nature and frequency of intimacy, both in the days and weeks after treatment and in what can be a new normal in terms of intimacy and sex drive.<\/p>\n<p>\u201cIt\u2019s really about exploring intimacy as a whole,\u201d Guntupalli said. \u201cIt\u2019s not all about intercourse.\u201d<\/p>\n<p><strong>Double standard?<\/strong><\/p>\n<p>Guntupalli said he hopes the book sparks conversations at UCHealth and beyond. He said he would like to see psychotherapists or specialists in sexual function\/dysfunction as part of care teams working with cancer patients. More broadly, he said, he would like Sex and Cancer to shed daylight on what he sees as the medical community\u2019s tendency to be far less concerned about the long-term consequences of removing a woman\u2019s ovaries than it seems to be about male castration.<\/p>\n<p>\u201cI think there\u2019s a dichotomy in health care \u2013 we treat women\u2019s sexuality so differently than that of men,\u201d he said. \u201cViagra is completely covered by insurance and erectile dysfunction is a well-recognized medical problem, but when we try to get birth control pills for women, oftentimes they\u2019re not covered.\u201d<\/p>\n<p>As for his collaboration with his former patient, Guntupalli said he couldn\u2019t be happier with how it turned out.<\/p>\n<p>\u201cThe idea was mine, but the soul is very much hers,\u201d Guntupalli said.<\/p>\n<p>Karinch felt the same way.<\/p>\n<p>\u201cI was just delighted,\u201d she said. \u201cHe had already saved my life and he\u2019s such a kind human being.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Doctor helps patient. Patient helps doctor help a whole lot of other people. That sums up the story of Saketh Guntupalli, MD, and Marilyn Karinch, co-authors of the book Sex and Cancer: Intimacy, romance and love after diagnosis and treatment, available at bookstores everywhere on July 8. There is, of course, a whole lot [&hellip;]<\/p>\n","protected":false},"author":23,"featured_media":10578,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[28,9073,9179],"class_list":["post-10565","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-cancer-care-oncology","tag-gynecologic-cancer-treatment","tag-urologic-cancer-treatment-2"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>With \u2018Sex and Cancer,\u2019 finding the good after the bad - UCHealth Today<\/title>\n<meta name=\"description\" content=\"&nbsp; Doctor helps patient. 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That sums up the story of Saketh Guntupalli, MD, and Marilyn Karinch, co-authors of the book Sex and Cancer: Intimacy, romance and love after diagnosis and treatment, available at bookstores everywhere on July 8. 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