Musings

In this episode, Dr Katz talks about the importance of communication in your sex life, and suggests some strategies for effective conversations

The young woman’s voice shook as she introduced herself to me on the phone. I had received a referral to see her from one of the nurses after she disclosed that she was having problems in her relationship. Over the course of an hour, Jamie* told me the story of her...

perform verb per·​form | \ pər-ˈfȯrm  , pə- \ performed; performing; performs Definition of perform 3a: to do in a formal manner or according to prescribed ritual b: to give a rendition of : PRESENT intransitive verb 1: to carry out an action or pattern of...

I wasn’t sure what his response would be to my suggestion, but I thought it was worth talking about. I have had numerous conversations with this man over the past 2 years. The first time I met him was about 2 weeks after his diagnosis of prostate cancer. He came to...

Many health care facilities are enacting policies during this time of COVID-19 that restrict the number of people attending appointments in person. Family care providers are asked to wait outside or to drop off the patient for their appointment and come back to pick...

We all have secrets. There are things that we don’t share with anyone, not our partner and especially not our children. We hold them close and hide them from the light of day or the dark of night. They are ours to keep because if let out, they can destroy things. Such...

“Assumptions are the mother of f@#$-ups!” My patient, a 60-something woman, made this declaration towards the end of a counselling session when we were trying to discover why she and her partner of more than 30 years were struggling to communicate. I laughed out loud...

Over the past 18 years, I have travelled far and wide, lecturing to oncology care providers as well as survivors and their caregivers. I love the travel, despite the hassles of airports and flight delays. I really do love sitting in my seat on the plane, feeling that...

I have been seeing this couple for a while. They both have a history of cancer; she was treated for breast cancer 2 years ago and he had testicular cancer in his 20s. They are now in their early 50s with a 17-year-old son who is in his final year of high school. She...

I have been seeing a couple regularly for 3 months. The man was diagnosed with lung cancer when the cancer was at a very early stage; today, he is well with no evidence of disease. He has been having some sexual problems that are causing conflict in his relationship...

What I saw in the crowded elevator is usually not that remarkable: a young couple standing close to each other, their eyes locked. She raised her right hand slowly and stroked his cheek, whispering “Oh, sweetheart.” I could not see his response as his back was to me,...

I see men for their survivorship transition visit after completing radiation therapy for prostate cancer. I have written about this before; I find these appointments enjoyable and usually less challenging as they do not require complex discussions. Some of these...

I first met JB* when the receptionist at the clinic called to tell me that a patient was asking to see me. His name did not ring a bell and on a quick review of my patient schedule for the week, his name did not appear. I went to the waiting room to see if I at least...

Mr. G* was diagnosed with advanced prostate cancer 2 years ago and has been on a succession of medications to control a progressive cancer. His PSA never nadired after surgery and adjuvant radiation only increased his urinary problems. Androgen deprivation therapy...

As we all know—vicariously, fortunately, for most of us—a diagnosis of cancer changes everything. The false sense of certainty of how life will play out is gone in an instant when the words “you have cancer” are spoken. A person becomes a patient in that moment and...

The patient was well over 6 feet tall and looked like he had recently lost weight. When he took off his winter coat and hung it over the back of the chair, I could see his scapulae like wings under his sweater. He folded himself into the chair and carefully crossed...

It’s become a common practice in oncology institutions across North America: A patient completes their prescribed course of treatment and they ring a bell. Usually it’s a large bell, like one that used to be rung in schools signaling the end of recess. Or it’s a...

Going through the process of diagnosis, treatment decision making, and often lengthy treatment without a partner can be challenging. While children, friends, and other family members are supportive, for the single individual, there is no one to talk to in the middle...

The woman waiting to see me looked every inch a lawyer or accountant in her black pencil skirt, pink shirt, and a Chanel-style houndstooth jacket. Her ankle boots were reminiscent of those worn by women in Victorian times with a row of small buttons up the side. She...

I recently attended a lunchtime session on the Choosing Wisely initiative. This public and professional awareness endeavor attempts to educate the public and health care providers about procedures that do not benefit patients and that may ultimately cause harm. It was...

It usually starts with a phone call: “Doc, can I come and talk to you about something?” The “something” might be erectile difficulties or other side effect(s) from prostate cancer treatment. It might be confusion or indecision about what treatment to agree to. I...

I have never seen myself as someone who cares for older patients. Most of my clinical career has focused on caring for young gay men in the early days of the HIV/AIDS crisis or high-risk pregnant women. Then I moved into a position in oncology and the fact that most...

Henry* is a 67-year-old man who was seen by one of our urologists and then referred to me by one of the nurses for help. His PSA was just over 5 ng/ml and the urologist had booked him for a prostate biopsy the following week. Henry had no idea why all of this was...

Sarah* is a new patient, referred to me because she is having difficulty deciding on treatment for breast cancer. I don’t know much else about her and a quick review of her electronic medical record tells me that she is 48 years old and has hormone-positive disease in...

As the patient talked, I found myself nodding my head. In so many ways, she was just like me. Highly educated, a professional, a woman who had worked hard and long to get where she was. And then cancer took it all away, or at least that’s the way she described it. She...

I am in the privileged and humbling position of hearing the stories of patients’ pasts. Sometimes the stories are so horrendous that it takes all my energy to stop myself from crying as they recount the brutality of their experiences. I have heard harrowing...

The couple that entered my office on a warm fall day seemed out of sorts. She looked nervous and he looked irritated. Before he sat down I heard why he felt that way: “I don’t even know why we’re here… “ I explained briefly what my role is but this did not seem to...

Do you ever wonder what the staff in hotel conference rooms think about what we talk about in presentations and lectures? I talk about sensitive stuff—sexuality, fertility, etc.—and I use words that many people have not said out loud in front of hundreds or thousands...

I see these couples quite often: the man has been prescribed androgen deprivation therapy and his partner is distressed. He no longer has erections, although for some that had been a problem for years. But even then, they tell me, he at least tried occasionally. Now...

JP* is a 65-year-old patient of mine who opted for a radical prostatectomy when he was diagnosed with low-risk, low-volume prostate cancer 5 years ago. He was extremely distressed after learning of the diagnosis and made repeated phone calls and multiple visits in the...

I had never met the man but from a brief reading of the notes in his medical record, I knew that this was not going to be easy. Thirty years old with stage III kidney cancer, the notes showed a long history of missed appointments and late arrivals. I had been asked to...

Sheila* is a vibrant woman in her late 50s with stage II gastric cancer. She is slight but energetic; her chart states that she has lost a considerable amount of weight since her diagnosis and treatment. She’s had chemotherapy and surgery and is now on continuous...

The couples I see for counseling are not always perfect, not that any couples ever are. But when cancer enters the relationship, for some couples, things get ugly and get ugly fast. I believe that we like to think that cancer makes people “better”; that people rise to...

Jamie* and Alex* are a young couple starting out their married life. They came to see me shortly after Jamie completed his treatment for testicular cancer about 2 years ago. He had banked sperm at the local fertility clinic before starting treatment and asked to see...

One of the nurses knocked on my door on a quiet Monday morning. “Hey, can you see this patient? I guess it’s not urgent but he’s here now and I think what the doctor told him just threw him for a loop.” Of course I had time. In my role as clinical nurse specialist in...

Many of the couples that I see in my practice grow closer after the diagnosis and treatment of cancer. I describe it as being forged by the searing flames of this still dreaded disease. First comes the terror of the diagnosis and the fear of losing one’s love; I see...

My background in nursing has given me a perspective that many physicians don’t have. From the beginning of my career, I have valued the information that patients have provided me about the context of their lives, family, work, and beliefs. I have never cared for a...

Many men experience significant erectile problems after having a radical prostatectomy, and many of the men treated by the urologists I work with eventually land in my office. We talk frankly about the quality of their erections before the surgery, what they are like...

Not infrequently, I have to call a patient whom I don’t know. I receive referrals from all members of the oncology team at our institution and beyond and I usually make the call to the patient to book the initial appointment. I have just basic information about the...

Ten years ago, I first met this patient, newly diagnosed with intermediate-risk prostate cancer. As I walked into the examination room I was struck by the juxtaposition of his wife, crumpled in a chair and weeping silently, with the patient himself, pacing the...

The phone rang in my office one morning last week. Woman: “I received a notice of an appointment with you and it says to bring my partner or spouse with me. This problem has nothing to do with him.” (The opening statement could just as easily be from a man, and often...

I was sitting in a meeting, listening and participating, but at the same time keeping an eye on my email. I always do this, sometimes to my peril, as email is distracting and more than once I have been called on to say something and I have no clue where the discussion...

In my work at a busy prostate cancer clinic, I discuss all available treatment options with men who are experiencing erectile problems after surgery or radiation therapy. The discussion proceeds in an orderly fashion, with the oral agents described first, then the...

Every month or two I see a patient, usually a man with prostate cancer, who is concerned that if he has intercourse with his spouse, he will give her cancer. The question is asked with sincerity and I can see the worry in the man’s eyes. His spouse is often equally...

I run a dilator program for women with rectal or anal cancer where I educate patients about the need for and correct use of vaginal dilators to mitigate the effects of radiation on the vaginal wall. Many women don’t understand the need for dilators after radiation for...

When is an advocate not an advocate? When should a spouse step back and let the husband make a treatment decision? When should an adult child of a man with prostate cancer let their father decide what is best for him? These are questions that, fortunately, I don’t...

We have all seen patients whose distress is off the charts, or off the Distress Thermometer (NCCN). They sit in our offices, dazed and seemingly so depressed that we ask the mandatory question: “Are you thinking of hurting yourself?” Some patients just shake their...

I have written about the support that a partner/spouse provides to someone living with cancer—with prostate cancer and for young adults with cancer—and I always include the partner in discussions about treatment choice or sexual difficulties. But a number of my older...

My patient mix comes in waves—some months it is mostly women with breast cancer struggling with adjuvant endocrine therapy or men in the aftermath of surgery for prostate cancer. These past two months, it has been young adults, and my heart has taken a beating. There...

I see patients in three kinds of supportive scenarios. There are those who come to their visits with me by themselves. I understand why they come alone to address their sexual problems; they think that the problem is theirs to fix and often think it has nothing to do...

We all have our fair share of so-called “difficult” patients. And, I would suggest that how we define “difficult” is as diverse as we are as health care providers and as individuals. Some patients come to us with that reputation—perhaps, a vague descriptor in a...

The patient was a young looking 74-year-old woman, accompanied by her husband. She was not exactly sure why she was seeing me and nodded as I explained that I see all women with anal or rectal cancer who are being treated with radiation therapy. I explained that we...

I recently attended the David Stroud Adolescent and Young Adult [AYA] Symposium at Keck Medicine of University of Southern California. It was a very interesting symposium with experts in adolescent and young adult cancer presenting on many different topics important...

I received an email this week and this is all it said: “I’m 51 years old and I was diagnosed with breast cancer 8 years ago, I love my husband very much I have no sex drive I do not want to be touched by him I hate sex it hurts is not comfortable it's not enjoyable, I...

We’ve come a long way from the 1940s and 1950s when men didn’t cry—not when they stubbed a toe or came back from the war, and certainly not in front of strangers. In the last 20-plus years we have seen a loosening up of the "stiff upper lip" prescription and we now...

A friend of mine died after outliving her prognosis for more than a year. I was with her at almost all her appointments with various oncologists. She had asked me to be the notetaker for these appointments so that she could focus on the discussion as it happened and...

I have fertility on my mind—and it’s definitely not personal. And it’s really fertility preservation that has me thinking. I recently completed the manuscript of my 10th book—a text for oncology care providers about the provision of psychosocial care to young adults...

Hearing the words “you have cancer” changes everything. In my role as Clinical Nurse Specialist in a busy prostate clinic, I see the effects of these three words on men and their families every day. The shock and disbelief, the fear and confusion as most men feel...

It’s not often that I find myself speechless. I have heard all sorts of stories in my office—as a sexuality counselor, I am often humbled by the trust that people place in me and how much they disclose about their private lives. But one conversation I had with a...

As part of my role as a Clinical Nurse Specialist in a busy prostate clinic, I see men (with their partner) as part of their decision-making process for active treatment for prostate cancer. The purpose of the appointment is for me to explain the results of their...

A recent study published in the journal Supportive Care in Cancer suggest that yes, they do - so things are improving from just a few years ago when most weren't. But let me tell you more.. In this study, oncologists and nurses working with women with gynecologic...

I received official word late yesterday that my book for and about young adults with cancer has won a prestigious award from the American Journal of Nursing. The award is for the Consumer Health book of the year (2014) and I could not be more proud. This is an award...

While searching Amazon for a listing of my books recently it came to my attention that my book for the partners of men with prostate cancer will soon be available in paperback. It's available on pre-order for now. This is a good thing - mostly because it means that it...

So proud that two of my books have received awards this year- Prostate Cancer and the Man You Love (Rowman and Littlefield) will receive the SSTAR Consumer Book award in Boston in early 2015 This Should Not Be Happening: Young Adults with Cancer (Hygeia Media)...

My book for and about young adults with cancer is due out any day now... I just don't know which day! It's both frustrating and exciting - I really would like to know when to expect the hard copy and yet once I have it in my hands, the anticipation will be over....

I handed my latest book in on its due date - May 31, 2013. It was a really interesting book to write and has inspired me to be more involved clinically with fertility preservation counselling at work. But that's another story. For now, I wait anxiously to hear that...

My soon-to-be-newest book is almost done - just two or three chapters left to write and (hopefully) my co-author is done at the same time and - away she will go! this one is for and about young adults with cancer and it has been a most interesting and inspiring...

Having finished writing my last book (Prostate Cancer and the Man You Love) in May of 2012 I wondered how long it would be before another one got started. And here I sit on a cold morning in January, writing the first chapter of my next book. Well, really I should say...

I was recently interviewed for an article about the quality of life issues for women with breast cancer. The lengthy article published across Canada deals with the many issues facing women with breast cancer, including sexuality and body image. There are also...

Prostate cancer doesn’t just affect the patient, but also his spouse or partner, asserts Anne Katz, RN, PhD, in Prostate Cancer and the Man You Love. A clinical nurse specialist at Canada’s Manitoba Prostate Centre and editor of the Oncology Nursing Society’s...

How amazing - two of my books (Man Cancer Sex at left and Woman Cancer Sex) have been published in Chinese! Peking University Medical Press approached my publisher (the amazing Hygeia Media) and bought the rights to have the books translated and then published them....

My new book will be out at the end of July, 2012.... this weekend I will have the (dubious) pleasure of indexing it. This is no small feat, especially for someone who is not at all detail oriented. I have to read every single word and then create the index single...

Hang onto your hats, people - it's not quite here but at the end of the summer it will be. My latest book - PROSTATE CANCER AND THE MAN YOU LOVE: SUPPORTING AND CARING FOR YOUR PARTNER. Yes, it's a long title but it says it like it is - this book covers everything...

After 8 amazing years as editor of Nursing for Women's Health, my tenure is at an end. But bitter sweet endings leave room for new beginnings and I am happy and proud and generally overwhelmed to announce that I have been appointed as editor of Oncology Nursing Forum,...