Cancer Realities

By Heather Millar

This may be stating the obvious: Cancer is not an aphrodisiac. For most of us, thoughts of romance fly out the window the moment we’re diagnosed. Then, we wake up six months, or 18 months, or 24 months later to survey the wreckage that was once our libido.

It’s tough on patients. It’s tough on partners. It’s tough on marriages, and that makes it tough on families.

But it’s far from insoluble, says Dr. Sueann Mark a 5-year, young adult survivor of breast cancer and a sex educator specializing in the unique needs of cancer survivors.

“Some people make sex a priority during treatment because it makes them feel alive,” Mark says. “But most people shut down. I encourage people to think of their sex life as a water heater. Every water heater has a pilot light. If you shut off the pilot light on your water heater, how long is it going to take to heat up that tank again so that you can take a shower? If you can maintain that pilot light, you’re starting from a better place.”

Since I became part of the cancer community, Mark has given a couple of sexuality seminars for “Bay Area Young Survivors” here in San Francisco. They usually take place around Valentine’s Day. I’ve meant to go each time, but conflicts have always come up, alas. So a few days ago, I called up Mark and picked her brain about sex and cancer.

Mark has a Ph.D. from the Institute for Advanced Study of Human Sexuality, the only graduate school in the United States, and one of the few in the world, dedicated to training “sexologists.”

Though Mark has had a thriving sex therapy practice, she’s currently preparing to begin the nursing oncology program at University of California, San Francisco, one of the preeminent nursing programs in the country.

Mark has big plans: She hopes to develop a sex education and sex therapy program for cancer patients. She hopes that some day these services will be a standard part of cancer treatment.

Until that dream becomes a reality, Mark has lots of advice. She has so many good tips that I’m going to break them into two posts. Today, we’ll focus on how to maintain that “pilot light” during the harrowing months of active treatment. In my next post, we’ll tackle some of the romantic challenges for cancer survivors.

First of all, Mark makes the point that having bedroom challenges is not at all unusual. “We have the same problems that everyone else does,” she says of cancer patients. “It’s just that we have cancer in addition. If you had existing problems before cancer, it’s probably just going to get worse after cancer.”

So what to do?

Here are some of Mark’s suggestions:

• Broaden your idea of what “sex” is. If you’re feeling miserable with muscle aches or mouth sores, or your skin is burned from radiation therapy, don’t pressure yourself to re-enact “Behind the Green Door.” Cuddling, a massage, or just holding hands are all good ways to maintain physical closeness, Mark says.

• Try to keep communication open. “We’re not given a good vocabulary to talk about sex,” Mark explains. “We don’t have any practice. I encourage people to work sex into everyday conversation. I don’t mean serious talks about needs and desires, though there’s a place for that. I mean just talking to create a common vocabulary.

“It’s easier than you think. There’s always a sex scandal in Hollywood or Washington. If you go to a museum, you’re going to see naked figures. If you just look around the room you’re in right now, I guarantee you that you can find sexual symbols.”

In other words, chill out and relax when you’re talking about sex. It’s supposed to be fun, right? If you can relax talking about it, it’ll be easier to relax doing it.

• Allow yourself as much pleasure as possible when you’re going through treatment. “That can be going to hear your favorite band or having that piece of chocolate cake or growing lavender,” Mark explains. “You don’t get that during treatment and it’s so important.”

If you try to remain open to pleasure in general, it will be easier to remain open to sexual pleasure.

If you feel you and your partner need help taking these steps, consider finding a sex therapist to help you. The American Association of Sex Educators, Counselors and Therapists can help locate professionals in North America, South Africa, Australia, China, India, and several other countries.

Before hiring someone, be sure to ask if they have experience working with cancer patients, Mark says.