How the Sex Industry is Raising Awareness on Breast Cancer

New adult content genre tackles cancer survival

"It's not your average porn film, this is an educational film more than anything," film producer and cancer survivor Rebecca Stewart explains in a Zoom interview about her new movie Wash Me, released on the sex-positive pornography platform Erika Lust in October 2021. Wash Me came to Stewart following her own experience battling with breast cancer. She was diagnosed in 2019 at age 29 and her treatment lasted ten months overall.

Starring adult performers Victoria Rose and Jonte, Wash Me portrays a breast cancer survivor's rediscovery of her body. The first adult film in history to tackle this topic, Wash Me bridges boundaries in the porn industry that usually erases what Stewart calls more "serious topics." She says that sex is often considered as fun and frivolous so it doesn't work with the "life or death seriousness of cancer."

"People assume that cancer and sexuality don't go together. We don't cease to be sexual human beings just because we've become patients," she says. Wash Me is about reappropriating her body. The movie is set in a bathtub, a reminder of her personal experience after she came out of her lumpectomy operation, which is the removal of the breast tumor and some of the normal tissue that surrounds it.

"My partner bathed me for a week or two when I was out of my operation. It was intimate and sensual, he sat next to the tub and touched my body in a way that he wouldn't usually do."

How cancer affects sex has become a growing concern for patients and doctors. This year's Pink October (month to raise awareness about breast cancer) showed cancer patients like Stewart opening up about cancer and sexuality by creating a new genre of adult content, including pornography and sex toys. Former cancer patients Brian Lobel and Joon-Lynn Goh just opened the first online sex shop for cancer patients called Sex With Cancer, selling products and toys that combat side effects of cancer treatment like erectile dysfunction and vaginal dryness.

According to Dr.Anne Katz, who specializes in how cancer treatment affects sexuality and has written wrote 15 books on the topic, up to 80% of men and women will experience body image and hormonal changes that impact their ability to have sex. Clinical psychologist Dr. Sharon Bober, founder and director of the Sexual Health Program at the Dana-Farber Cancer Institute in Boston, says that all types of cancer treatment (chemotherapy, surgery, radiation or hormonal therapy) can have direct impacts on sexual function.

@sexwithcancer on Instagram

Many cancer patients are concerned about safety and making sure that the products they use won't cause them further harm. Sex With Cancer provides, for example, a vagina mosterizing gel for women with vagina dryness, a possible side effect of cancer treatment.

For co-founder Brian Lobel, the dehumanizing treatment process contributes to the reason why "people living with and beyond cancer aren't seen as sexual, empowered beings."

Patients undergoing treatment are "shuffled about, pricked, poked and are the site of so much medicine, treatments and conversation. After pills and pills and pills, it's sometimes hard to know where treatment stops and your own body begins," he says in an interview.

Sex with Cancer is also an advocacy campaign, normalizing the conversation about sex by enabling and encouraging cancer patients to talk about their experiences, especially since many didn't know about the extent of the effects of cancer treatment on their sexual lives.

Like many cancer patients, Stewart didn't really think about how her sex life would be affected by her diagnosis. She was mostly concerned about the "obvious stuff" or what the media usually portrays happens to cancer patients.

"The only thing mentioned in the media is hair loss. They're obsessed with it. It's the only thing people see so it's the only thing people seem to care about," she says.

Hair and appetite loss are the most commonly mentioned symptoms of chemotherapy, a specific type of cancer treatment that involves using medicine to kill cancer cells. She recalls reading something about vaginal dryness but says that when getting a pamphlet that mentions all possible side effects of cancer treatment, it's easy to get lost in all the information. The American Cancer Society mentions 17 possible side effects, ranging from fatigue to fertility problems.

"It's shocking how impactful it is on the sex life and yet how it's really not flagged up at all," she says. "It's this vicious cycle of doctors never bringing it up and me never thinking to bring it up."

Stewart started to notice some side effects to her sexual life after two months of treatment. Loss of energy, tiredness, vaginal dryness and, all of a sudden, vaginismus, which is when the vaginal muscles involuntarily or persistently contract when they attempt vaginal penetration. It can be quite painful. For Stewart, vaginismus lasted until the end of her chemotherapy.

"I'd never had it before. I didn't know what it was. It was kind of terrifying, I wondered if it was ever going to go back to normal. I thought I cannot physcially have sex now. What's going on!" she says.

Very quickly, despite her doctors' support, it became quite clear to Stewart that they had no resources on this.

"They said it was probably normal but the problem they had was that so few patients talk about this, and so it was difficult for them to tell me how common it is. No data, no treatment," she says.

There is, in fact, some data about cancer and sex. Dr.Katz says that there's been an increasing amount of research in recent years. The American Cancer Society has a whole page with information and references about it.

The main issue seems to be that both patients and doctors are unwilling to bring it up. Bronte Palmer, of the Candid Cancer Collective, a group of former cancer patients who were commissioned by Sex With Cancer to write a Zine on their experiences with cancer, says she can't remember any specific conversations about sexual intimacy she had with health professionals. She was diagnosed with Acute Lymphoblastic Lymphoma, a type of leukemia in 2015, when she was 21.

She says that the issue is that patients don't necessarily know how to start the conversation with their doctors. "I would've felt embarrassed to ask at the time because I wasn’t seeing anyone talking about it," she says.

Brian Lobel explains that the problem with doctors and nurses is that they are not always "well trained in seeing people in their whole self [which includes a sexual self]" and that they need more specific training and guidance.

He says that "we shouldn't be surprised that our country [England], which is terrible at talking about sex in mature ways, would have nurses and doctors that would be bad at talking about sex and sexuality."

Working on Sex with Cancer showed Lobel that all people needed was a safe space to talk about cancer and sex. Publicly, Lobel says the conversation remains quiet because cancer charities raising awareness often frame public conversation about cancer around inspirational narratives which are usually desexualised. Scratch the surface and people are actually bursting to talk about these things. Unfortunately, many still feel they're 'not allowed' in some way.

Dr. Jessica Gorman from the College of Public Health and Human Sciences at Oregon State University talks about a "perceived stigma" surrounding surrounding sex and sexuality that can make it more difficult for cancer survivors and healthcare providers to communicate about sexual problems and can make it more difficult for survivors to get the help they need.

Palmer wished a platform like Sex with Cancer existed when she was diagnosed to help her reconnet with "yourself, your body and your sexual side." She says that "from weight gain, to new stretch marks, scars and my bald head, I didn’t feel sexy and I certainly didn’t think my partner would find me sexy or want to be intimate with me.” Dr.Gorman explains that it's common for cancer patients to experience feelings of loss of sexual self.

Wash Me touches on the same topic of body rediscovery. For Stewart, sex was a sanctuary. In fact, at first, cancer treatment immediately affected her sex life in the sense that it boosted her libido.

"There's nothing like being faced with your own mortality to make you see things that make you feel alive. That and going on runs were things I needed to do psychologically to remind myself that my body was still mine, that it was still working and that I was still alive," she says, adding that sex was therapeudic for her. But then the cancer treatment side effects kicked in and Stewart saw her sex life drastically change.

So where the movie also features a couple, Stewart highlights that the movie isn't about both partners. It's about her. She does so cleverly by making the camera stay with the female lead a lot more than with her partner, and by focusing solely on female pleasure. In fact, her partner never joins her in the bathtub. The bathtub remains her own space to explore herself. He's just a helping hand.

"I struggled with the idea of having the partner there altogether because it's not about him, it's not about them. It's about her rediscovery and her body coming back to her, and he's just present in the moment for it. Helping out and happy for her," she says.

When it comes to sex and cancer, she explains that the issue is less about maintaining a relationship, and more about maintaining a relationship with oneself. Especially since many cancer patients do not go through the same experience of having a partner by their side.

"The issue wasn't 'oh no my boyfriend doesn't want to stay with me if I can't have sex with him for a couple of months'. It was more like for fuck's sake sex was this peaceful sanctuary where I could get away from being sick for 10-15 mins and just enjoy my body for once and now this sanctuary's been taken away from me," she says.

Wash Me film poster, curtesy of ErikaLustFilms

Wash Me is Stewart's way of reclaiming that safe intimacy and her relationship with her body. The movie ends with the female lead in her bathtub, surrounded by a thick and luscious forest, a reminder that life thrives even in sickness. And so can sex.

"I wanted to show that there is hope, that it does come back."