A metastatic cancer diagnosis can radically change what matters. For some people, limited time means traveling, spending more time with family, putting work aside, or seeking spiritual peace. For Molly Kochan, it meant something much more personal: exploring sexuality, intimacy, autonomy, and parts of herself she felt she had never fully understood. Her story later became attached to an irresistible headline: the woman who had nearly 200 sexual partners after being diagnosed with terminal breast cancer. But the number is only the most sensational part of a much more complicated story.
Kochan’s own writing and the conversations that later became the podcast Dying for Sex reveal a woman living with metastatic breast cancer who was grappling not only with mortality, but also with body image, relationships, past trauma, desire, and the question of what it means to live authentically when the future suddenly becomes uncertain.
Who Was Molly Kochan?
Molly Kochan was a Los Angeles-based writer whose experience with metastatic breast cancer became the basis of the acclaimed Wondery podcast Dying for Sex. She recorded intimate conversations about cancer, relationships, sexuality, and mortality with her best friend Nikki Boyer. Kochan died on March 8, 2019, at age 45, from metastatic breast cancer. Her obituary noted that her parents and Boyer were with her when she died. The podcast was released by Wondery in 2020, after her death. Her memoir, Screw Cancer: Becoming Whole, was also published posthumously that year.
Her story reached an even larger audience in 2025 when FX adapted it into the television miniseries Dying for Sex, starring Michelle Williams as Molly and Jenny Slate as Nikki Boyer. FX describes the series as inspired by Kochan’s true story and her journey of sexual self-discovery following a Stage IV breast cancer diagnosis.
From Breast Cancer to Stage IV Disease
Kochan had already experienced extensive breast cancer treatment before her metastatic diagnosis. By 2015, she had undergone chemotherapy, breast surgery including bilateral mastectomy, radiation therapy, reconstruction, and hormone treatment. In her own writing, Kochan described her earlier breast cancer as involving her breast and lymph nodes and wrote about receiving chemotherapy, surgery, radiation, further surgery, and hormone therapy. Then, in August 2015, everything changed. Kochan wrote on her blog:
“Yesterday I was diagnosed with Stage IV breast cancer. I’m 42.”
She initially described disease in her hip bones with possible liver involvement. In later writing, she said the cancer had returned in her bones, liver, and brain. Stage IV breast cancer means the disease has spread beyond the breast and nearby lymph nodes to distant parts of the body. It is generally considered treatable but not curable, although treatment can sometimes control the disease for extended periods.
Unlike early-stage breast cancer, treatment of metastatic disease is primarily aimed at controlling cancer, prolonging survival, relieving symptoms, and preserving quality of life. Systemic therapies form the foundation of treatment, while surgery and radiation may be used for particular symptoms or metastatic sites.
The Decision to Leave Her Marriage
After her metastatic diagnosis, Kochan began re-evaluating her life. Her relationship was one of the areas she reconsidered. She ultimately left her long-term marriage and began dating. In an April 2016 blog post titled “Single with stage IV,” Kochan described entering the dating world while living with metastatic cancer. She wrote about a strong desire to live intensely and experience things she might otherwise have postponed because she no longer knew how much time remained. The decision was not simply about having sex.
It became part of a broader effort to understand her desires, regain a sense of ownership over her body, and reconsider relationships that had previously left her dissatisfied. The official description of the Dying for Sex podcast frames the journey similarly: after her Stage IV diagnosis, Molly leaves an unhappy marriage and begins a series of sexual adventures that help her feel alive, while conversations with Boyer gradually reveal deeper themes involving trauma, healing, forgiveness, friendship, and mortality.
Did Molly Kochan Really Have Nearly 200 Sexual Partners?
This is the part of Kochan’s story that has generated the most headlines. Contemporary profiles have described her podcast and sexual exploration as encompassing nearly 200 encounters. Biography.com’s account of her life, for example, describes the podcast as documenting and examining nearly 200 of Kochan’s sexual experiences. Other retellings have cited specific totals in the high 180s. The precise number is therefore less certain than the headline often implies. More importantly, reducing Kochan’s final years to a partner count misses much of what she and Boyer were trying to document.
The podcast was not simply a catalog of encounters. Episodes moved through dating, changing body image, unconventional desires, cancer treatment, disclosure of illness, childhood trauma, friendship, and the increasing physical realities of advanced cancer. The “nearly 200” figure may attract attention. It is not the whole story.
Cancer, Body Image, and Sexual Identity
Breast cancer can profoundly alter someone’s relationship with their body. Kochan experienced mastectomy, reconstruction, systemic therapy, and metastatic disease. Yet some of her own writing describes an unexpected shift in how she experienced her reconstructed breasts and her sexuality. In a 2016 essay, she wrote about developing a stronger sense of ownership over her body after surgery and described sexual exploration as part of reconnecting with her femininity and physical identity.
That experience illustrates something oncology sometimes struggles to discuss openly: surviving or living with cancer does not eliminate sexuality. People with cancer can continue to desire closeness, sexual activity, experimentation, or romantic relationships even while undergoing intensive treatment or approaching the end of life. For some, sexuality becomes less important. For others, it becomes more important. There is no universal response.
Does Cancer Treatment Increase Sexual Desire?
One element of Kochan’s story requires particular caution. Popular coverage has sometimes linked her heightened sexual interest directly to cancer treatment or hormonal changes. That should not be generalized as a typical effect of breast cancer therapy. Cancer and its treatments more commonly create challenges to sexual health. The National Cancer Institute notes that chemotherapy can reduce estrogen production and contribute to ovarian insufficiency, hot flashes, vaginal dryness, and painful intercourse. Other medications, including opioids and some antidepressants, may reduce sexual interest.
Cancer can also affect sexual desire through fatigue, pain, anxiety, depression, changes in appearance, altered body image, relationship stress, and fear surrounding illness. At the same time, sexuality is influenced by far more than hormones. A life-limiting diagnosis may change someone’s perception of time, priorities, identity, and inhibition. Kochan’s increased focus on sexuality should therefore be understood primarily as her individual psychological and personal response to illness, rather than a predictable biological consequence of metastatic breast cancer or its treatment.
Sexual Health Is Part of Cancer Care
The broader medical lesson from Kochan’s story is not about how many partners she had. It is that sexuality remains relevant during cancer treatment and advanced illness. The American Society of Clinical Oncology has specifically recommended that healthcare professionals initiate conversations with people with cancer about sexual health and sexual dysfunction related to cancer or treatment.
ASCO recommends raising sexual health at diagnosis and revisiting it throughout follow-up rather than waiting for patients to bring it up themselves. Patients should have access to appropriate information, counseling, and specialist referral when concerns arise. These concerns can extend well beyond intercourse and may include changes in sexual desire, vaginal dryness or pain, treatment-induced menopause, erectile or orgasmic difficulties, body-image changes after surgery, loss of breasts or other body parts, fear of rejection, relationship changes, questions about dating after diagnosis, fertility and contraception, intimacy without sexual activity, and concerns about sexually transmitted infections. When needed, ASCO also recommends psychosocial or psychosexual counseling to address sexual response, body image, intimacy, relationships, and overall sexual satisfaction.
What About Sexual Safety During Cancer Treatment?
Cancer does not automatically mean sexual activity must stop. The NCI notes that most women can remain sexually active during cancer treatment, although individual circumstances matter. There may be periods when low blood counts, infection risk, bleeding risk, surgery, pain, or other treatment complications make some forms of sexual activity inadvisable. For patients with new or multiple partners, conversations about barrier protection, sexually transmitted infection prevention, contraception when relevant, and treatment-specific precautions remain important.
The correct advice depends on the patient’s treatment, immune status, blood counts, symptoms, reproductive potential, and type of sexual activity. The principle is straightforward: sexual health should be treated as a legitimate component of medical care rather than something patients are expected to navigate alone.
Why Autonomy Became So Important
For Kochan, metastatic cancer meant living with circumstances she could not control: scans, treatments, pain, medical appointments, physical limitations, and the knowledge that the disease might shorten her life. Against that background, deciding whom to date, what experiences to pursue, and how to relate to her body became areas where she could still exercise choice. Her own writing repeatedly returned to themes of control and self-definition. After her metastatic diagnosis, she described losing the life she had imagined and struggling with changes to her body and identity, while also searching for meaning and deciding what she wanted from the time she had. That is why the sexual dimension of her story cannot be separated from the broader question of agency.
The Friendship Behind Dying for Sex
The other central relationship in Kochan’s story was not romantic at all. It was her friendship with Nikki Boyer. The two friends could talk openly and often humorously about subjects that are normally surrounded by discomfort: cancer, death, sex, bodies, fear, regret, and desire. Wondery’s description of the podcast emphasizes this relationship as much as Molly’s dating life. The series ultimately became a story about what people do with the time they have left and how friendship can remain present through serious illness.
That friendship became central to the FX adaptation as well. The television series stars Jenny Slate as Nikki alongside Michelle Williams as Molly, and FX describes Nikki as the friend who supports Molly throughout both her sexual exploration and the final stage of her illness.
From Podcast to Television
Kochan did not live to see Dying for Sex become a cultural phenomenon. She died in March 2019. Wondery released the podcast in 2020, using conversations she had recorded with Boyer before her death. It subsequently received widespread recognition and eventually became the basis for the FX miniseries released in 2025. Michelle Williams portrayed Molly, while Jenny Slate played Nikki. The adaptation brought Kochan’s story to millions of viewers who had never heard the original podcast and restarted public discussion about sexuality, terminal illness, friendship, caregiving, and patient autonomy.
It also brought the “nearly 200 partners” headline back into circulation.
What Oncology Professionals Can Take From Molly Kochan’s Story
Kochan’s choices were uniquely her own. They should neither be romanticized as the “right” way to face metastatic cancer nor dismissed because they fall outside conventional expectations of how a seriously ill patient should behave. The more useful lesson for oncology is that patients continue to be whole people after diagnosis.
- They may still care deeply about sex.
- They may want to date.
- They may leave relationships.
- They may seek intimacy with a long-term partner—or with someone new.
- They may lose all interest in sexual activity.
- They may grieve changes to their bodies.
And those priorities can change as the disease and treatment change. For clinicians, that means sexual health deserves the same respectful, nonjudgmental approach as other quality-of-life issues. A simple question such as “Has your cancer or treatment changed intimacy or sexual health in a way you would like help with?” may uncover concerns a patient would otherwise never mention.
Beyond the Headline
Nearly 200 sexual partners makes an irresistible headline. But Molly Kochan’s story was ultimately about much more than sex. It was about a woman confronting metastatic breast cancer while trying to understand her body, her history, her relationships, and herself. Cancer removed many of the assumptions she had made about the future. Her response was to examine what she wanted from the present.
That choice was deeply personal, sometimes unconventional, and impossible to separate from the larger questions that Dying for Sex eventually explored: What makes a life meaningful? What do we postpone because we assume we have time? And how much freedom should someone have to define what living well means when cure is no longer possible? The answer will look different for every patient. That, perhaps, is the part of Molly Kochan’s story most worth remembering.
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Written by Aharon Tsaturyan, MD, Editor at OncoDaily Intelligence Unit
FAQ
Who was Molly Kochan?
Molly Kochan was a Los Angeles-based writer whose experience with metastatic breast cancer, sexuality, relationships, and mortality became the basis of the podcast Dying for Sex. Her story was later adapted into an FX television series starring Michelle Williams.
What type of cancer did Molly Kochan have?
Molly Kochan had breast cancer that later progressed to Stage IV metastatic breast cancer, meaning the disease had spread beyond the breast and nearby lymph nodes to distant parts of the body.
Did Molly Kochan really have nearly 200 sexual partners?
Media reports and later profiles describe Kochan as having had nearly 200 sexual encounters or partners during the period after her metastatic diagnosis. Exact figures vary, so “nearly 200” is more accurate than presenting one specific number as definitive.
Why did Molly Kochan have so many sexual partners after her cancer diagnosis?
Kochan described sexual exploration as a way to understand her own desires, reconnect with her body, experience intimacy, and reclaim a sense of autonomy after being diagnosed with incurable cancer.
What is Dying for Sex about?
Dying for Sex began as a podcast created from conversations between Molly Kochan and her best friend Nikki Boyer. It explores Kochan’s metastatic cancer diagnosis, sexuality, relationships, trauma, friendship, and the choices she made while facing a life-limiting illness.
What does Stage IV metastatic breast cancer mean?
Stage IV breast cancer means cancer has spread from the breast to distant organs or tissues. It is generally considered treatable but not curable, with treatment focused on controlling disease, extending survival, relieving symptoms, and maintaining quality of life.
Can people with metastatic cancer still have sex?
Yes. Many people with metastatic cancer can remain sexually active, although treatment effects, pain, fatigue, infection risk, low blood counts, surgery, or other complications may require individualized precautions. Sexual health should be discussed with the oncology team when concerns arise.
How can breast cancer affect sexuality and intimacy?
Breast cancer and its treatment can affect sexual desire, vaginal dryness, pain, menopause symptoms, body image, fertility, relationships, and emotional intimacy. Some people experience reduced sexual interest, while others may place greater importance on intimacy or sexual expression after diagnosis.
Why is sexual health important in cancer care?
Sexual health is an important part of quality of life. Cancer can affect body image, relationships, fertility, desire, and physical sexual function, yet many patients are reluctant to raise these concerns. Oncology guidelines encourage clinicians to discuss sexual health rather than waiting for patients to initiate the conversation.
How did Molly Kochan die?
Molly Kochan died in 2019 at age 45 after living with metastatic breast cancer. Her story continued after her death through the Dying for Sex podcast, her memoir, and the later television adaptation.