Sex education for cancer patients (with cucumbers)

PERSPECTIVE | It’s a long road to getting your sex life back as a young cancer patient

Rebecca Ritzel
The Lily
5 min readSep 22, 2017

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(Toni Rica and Lydia Ortiz for The Lily)

OOne sunny morning in June 2015, I began my Saturday with a trip to my neighborhood farmers market. I made decaf coffee, smeared on some sunscreen and strolled down the street. It was summer in Northern Virginia, and the market was a colorful orgy of fresh flowers and early-season produce. There were green leafy lettuces, strawberries galore, herbs to be planted and doughnuts to be popped immediately into mouths.

One stand featured a particularly elaborate display of mini Persian cucumbers, arranged by fives and sixes and sticking upright like green phalluses in cardboard cartons.

I pulled out my phone, shot a picture and sent it off to my friends Lauren and Lizzie with the caption, “Saturday morning cucumber shopping!”

“Bwahaha!” Lizzie texted.

“OMG,” wrote Lauren, “I tried to cut up cucumbers for my husband’s salad and I just couldn’t do it.”

As both Lauren and Lizzie knew, the cucumbers in my basket weren’t destined for crudité. A few days before, a physical therapist from Johns Hopkins Hospital in Baltimore instructed me to go buy some cucumbers, peel them and push them up my vagina.

Yes, my vagina.

According to physical therapist Julie Everett, cancer patients receiving chemotherapy should insert a peeled cucumber into their vaginas to neutralize a rise in pH level and soothe irritated tissue. It makes sense if you imagine a smiling woman in spa mode resting cucumber slices on her eyelids to reduce puffiness. I had already learned lots of rules for taking care of my chemically altered body during chemotherapy, rules like, “no caffeine” and “always wear sunscreen.”

So far, no one had said a thing about cucumbers, but maybe that’s because most patients I saw in the chemo suite at Johns Hopkins were either middle-aged or senior citizens. I was in my mid-30s, and thankfully had been invited to a “Sex and Intimacy” night that Everett was leading for young adult cancer patients.

A social worker and two other female cancer patients in their 20s and 30s joined me for the gathering at the Ulman Cancer Fund for Young Adults. Only one significant other had shown. The kind-faced young man kept his hand on the small of girlfriend’s back the whole time.

“What a prince,” I thought. I was jealous.

The other girl, a brain tumor patient, had brought along her best friend instead of her boyfriend. “He was too embarrassed,” the friend said. She went on to boast about her vagina’s Kegel prowess like she was talking about how much she could bench press.

And me? I was single, not great at lifting weights and I had mixed clear cell carcinoma in my ovaries, arising from out-of-control endometriosis. So far, I’d survived two abdominal surgeries and two rounds of chemo.

Everett began the session by passing out white sheets of paper. She asked us to write down words to describe how we felt about our bodies. I wrote “betrayed” and “bisected” (dedicated to the nine-inch scar running down my stomach). Then she asked us to tear up the papers.

Everett held up the shreds.

“This is your sex life after cancer,” she said.

She was right. All the normalcy in my life was slipping away like water through a sieve.

To my mind, I was losing everything that made me a “dateable” young woman — my fertility, my ballerina-like body and my ability to get wet, that is, to feel any sort of hormonal arousal.

Gently jamming a cucumber up my vagina was not going to restore those losses. But sitting around that table that night, I felt understood, and I felt camaraderie. Like when Everett told me and two other women to go cucumber shopping.

“How about just using those little pickling cucumbers?” asked the brain cancer patient.

“You can use those, but make sure they haven’t been pickled first,” she said. “That will really hurt.”

As would anything. Chemo wrecks a woman’s vaginal pH, and even trace amounts of semen might sting like hydrogen peroxide. To test our vaginal pH, Everett suggested that we go buy pH test strips.

“You can get them at PetSmart,” she added.

Great. And what would I say to a chipper cashier who inquired about an aquarium? That I had a goldfish named VJJ? (I didn’t make that joke aloud.) When Everett moved on to her next topic, and this time she addressed me and my vagina directly.

“So you had endometrial cancer in your ovaries. Did you have your vagina ablated?”

Six weeks earlier, my oncologist had indeed used a surgical blowtorch to burn off the outer layer of my vagina’s lining, which had been coated in endometrioses. Now, as Everett was explaining to me, if I ever wanted to have sex again, I would need to stretch my vagina with something called a vaginal dilator.

Like ablation and carcinoma and peritoneum and so many other gynecological cancer buzzwords, “vaginal dilator” was a new one for me. Everett pulled out her phone and showed me a picture of what looked like five pink plastic fingers in graduated sizes. My oncologist should also have a set of these stiff, un-fun medical dildos in his office.

“Or you can just use cucumbers,” Everett said. “Or carrots.”

“Okay then! I think it’s time to go shopping for penis-shaped vegetables now,” the brain tumor patient interrupted. I was grateful to her for realizing I’d had as much sex-education-for-cancer-patients in one session as I could take.

The rest of us began gathering our debris and belongings. As part of her demo, Everett had passed around packets of Slippery Stuff, her favorite lubricant, and had us each roll our fingers in it. The table was a mess. Kind of like my insides.

The night hadn’t put me back together, but it was start. If nothing else, I was leaving feeling much less scared to talk about my malfunctioning body parts. I wasn’t alone. I could even text my friends while cucumber shopping.

I offered to help clean up, but the social worker said she would take care of the mess.

“It’s just some lube on the table,” she said. “It happens.”

I had a harder job. I had to go take care of myself.

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Rebecca Ritzel
The Lily

Freelance journalist who frequently contributes arts and culture writing to The Washington Post and other publications.