A woman should learn to speak up when physicians or nurses asks how she's doing. "If she doesn't speak up and say, 'Everything is going OK, but I'm still dealing with sexual dysfunction issues that are really ruining my quality of life,' then it's a missed opportunity to get an open discussion and symptom relief," Shockney said.
Health professionals need to be trained to give the patient time to bring up sensitive sexual issues. "If we look like we're in a hurry, then that's just a disincentive for her to bring it up," she said.
Shockney, a two-time breast cancer survivor, has no hesitation in sharing stories about cancer and her sexuality if it will make others more comfortable sharing theirs. "I kind of function as the Dr. Ruth of the breast center," she said. "I don't have any problems bringing it up and when I bring it up, people don't have any trouble talking about it."
Sexuality is important, she tells women in her frequent lectures on the subject. "And it shouldn't be ignored because cancer came along and disrupted or interrupted it; derailed it in some cases."
Patients should be aware they have the right to address their sexuality with their health team, and shouldn't "assume that there's nothing we can do about these symptoms." she said.
Such an attitude helped her with a 51-year-old mastectomy patient who'd given up on romance until a former college boyfriend came back into her life during her chemotherapy, as she looked and felt her worst.
When the man asked her out for a long weekend, she called Shockney and revealed she hadn't been sexually active since they'd broken up 30 years earlier. She feared that vaginal changes caused by chemotherapy would stand in the way of sex and romance.
Shockney had to teach her that in the 30 years since she'd last had sex, chemical engineers had developed a space-age lubricant called Astroglide. The patient picked up four bottles, called Shockney from her hotel room for a pep talk, and hours later reported all went well. The two ended up marrying.
Shockney often shares "personal war stories, having traveled this breast-treatment road twice myself and been on hormonal therapies that certainly derailed what we were doing at home."
She admits that she married a gem of a man, a retired tractor-trailer driver with a deeply philosophical side who has long stood by her.
After her first mastectomy, he told her: "Women look at mastectomy surgery as losing an important part of your body. It's transformation surgery. The surgeon's mission is to transform you from a breast-cancer patient to a breast-cancer survivor. You're exchanging your breast for another chance at life and that's a fair trade."
After her second mastectomy operation, he picked her up for a surprise romantic getaway in the Pocono Mountains, saying. "I packed your toothbrush and hairbrush because we're not leaving the room. I read that when you lose one of your senses, like your sense of sight or sense of smell, your other senses become more intensified. Maybe the same thing happens to your erotic zones. My mission is to prove this hypothesis in the next 48 hours."
A nervous Shockney told him she wasn't sure she was prepared for the sexual intimacy so soon after surgery. "He said, 'Look at us. We've been married 14 years. We're just going to see where this takes us."
Those words were enough to allay her fears that losing her second breast might affect their sexual connection.
She often shares the Poconos story with patients, knowing they'll then go home "and tell their partner that story and that then opens up the conversation."
Because at day's end, she said, healthy sexuality depends on good communication.