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After her diagnosis of stage 3 breast cancer, clinical sexologist Sueann Mark, PhD, began looking for information about cancer and its effects on sexuality. “I didn’t find much on the topic, and one of the nurses said that maybe that was what I was supposed to do.”
Mark developed STEPS (Sexual Transformation & Empowerment Program for Survivors) to help cancer patients and survivors open up to the possibility of sexuality after cancer and enhance the senses.
Cancer complicates sexuality because there is a new body that is completely different, Mark says, adding that the top three issues she addresses in the cancer population are body image, vaginal dryness, and lack of libido. For women there is also fear, which inhibits orgasm.
Mark, who was diagnosed at age 34 in 2006, says the challenges in discussing sexual issues among survivors are similar to those in the general population “because we are socialized not to talk about sex and to not know what feels good.”
“We also live in a pleasure-phobic society,” Mark says. “So, what I focus on is developing healthy sensuality.”
Mark has created the ABCs of healthy sex, which she encourages cancer patients to adopt.
“ 'A' stands for adapt,” she says, explaining that cancer means adapting to a new body, a new emotional state and perhaps a new relationship. “Physically and psychologically, it means adapting to where you are now.”
“B” stands for broadening your definition of sex to include sensuality—opening up to all the senses, whether it be enjoying chocolate cake, art, music, movies, walking or any other activity that involves the senses. “Give each other a massage, take a bath, hold hands,” Mark recommends.
“C” stands for communicate. “Work sex into everyday conversation,” Mark says. “Hollywood gives us ways to talk about sex with all the scandals. Start creating a vocabulary in your relationship, and once you have the words, you can talk about it. Don’t talk in bed, but start talking,” she emphasizes. “‘What do you want? What do you like?’ Talk about it—with the understanding that it may change.”
She compared it to preparing food for your spouse. “If I am going to make a meal for you, I need to know if you have allergies and what you like and don’t like and how you like it presented: Do you like fast food or a five-course meal? Do you like spicy food? It’s a sensual connection.”
For those in treatment, Mark recommends maintaining as much sexual activity as you are comfortable with. “It’s like a hot water heater,” Mark explains. “It has a pilot light and you need to keep it lit. If you don’t, the water gets cold and it takes a long time to warm it up. If it stays lit, you’ll be ready for that hot shower.”
In addition to working with cancer patients and survivors in her practice, Mark speaks to support groups and medical students. Mark is active in advocacy with a number of organizations, including the Young Survival Coalition (YSC), a nonprofit organization for young women affected by breast cancer. She represents YSC on the board of the California Association of Breast Cancer Organizations, a coalition of nine organizations, which later led to volunteering with the National Breast Cancer Coalition and lobbying for health care reform in Washington, D.C.^ TOP OF PAGE