A Couple’s Guide to Facing Breast Cancer Together
by Susan Hedlund, MSW, LCSW, OSW-C
The diagnosis of cancer is a life crisis for anyone who hears those words: “you’ve got cancer.” The impact, however, extends beyond the person receiving the news. Cancer affects the whole family. For couples, there is a profound impact. The challenges that come with a cancer diagnosis, treatment, and recovery can be difficult and long lasting. The words “in sickness and in health” take on an entirely new meaning when cancer enters the picture. Still, most couples can and do get through the experience, and some report a renewed sense of closeness afterward.
Most couples establish ways of being together and communicating under optimal circumstances. Life crises, such as a cancer diagnosis, can disrupt and change everything, even for the healthiest of couples. Understanding one another’s perspective and learning new ways to communicate can help a couple through the cancer experience and strengthen the relationship for the future.
For the person who has cancer, and specifically for the woman with breast cancer, life changes immediately and dramatically. Initially, she may fear for her survival: Will I survive? Can I tolerate treatment? How will this change me? For her partner, feelings of helplessness, fear, sadness, and frustration may exist. The partner may also feel guilty for having their own needs and reactions to the situation.
Understanding one another’s perspective and learning new ways to communicate can help a couple through the cancer experience.
The basic differences between men and women may also prove challenging as couples navigate the cancer experience. In general (and this may not be typical of all men and women), men are more connected to the facts and want to “do” something to take care of the people they love, especially their wives and families. When a man is unable to protect the woman he loves from cancer, he often feels helpless, frightened, and sad. He may feel his job is to “fix” or cheer up his partner, while his partner may long simply to be heard and supported.
On the other hand, most women are focused on connection with others and the experience of emotion. When her partner is silent, or attempts to “fix” what cannot be fixed, she may feel even more alone and misunderstood. Again, cancer can strain even the healthiest of relationships. It’s important to maintain faith in your relationship and in each other, and to allow yourselves time to adjust. As is true with most challenges for couples, communication is the key.
Having cancer is like being on a roller coaster, often forcing confrontation with mortality and a lack of control over some domains. For couples dealing with other stressors, such as strained finances, cancer may magnify previous problems while adding additional stress.
The onset of cancer can also challenge the physical boundaries of a couple’s relationship. During active treatment, the idea of sexual contact may be secondary to the stresses of managing side effects of treatment and recovery from surgery.
One way to deal with this is to use the COPE model. The COPE model, originally developed by Dr. Peter Houts and published in the book Home Care Guide for Cancer by the American College of Physicians, is a problem-solving model applied to all domains of the cancer experience. “COPE” represents four key steps to solving a problem: C for Creativity, O for Optimism, P for Planning, and E for Expert Information. Applying the COPE model to sexual intimacy, couples might consider first identifying the problem. For example, the question “How can we reconnect sexually?” may be a starting point.
Gathering information from your healthcare team or opening up the conversation with one another may also be helpful. Make a plan considering possibilities that are both optimistic and creative. While your intimate connection may need to change somewhat, it may open up a range of options that enhance your sense of closeness.
Many resources are available to help couples navigating cancer together. Couples may consider seeking the assistance of a counselor or other cancer professional to improve communication and find ways to cope effectively. Drawing on the support of family, friends, or other couples facing cancer may also be helpful. Don’t hesitate to seek support if you need it.
As always, communication is the central component in helping couples effectively overcome the numerous challenges that the cancer experience brings. It’s important to make room for one another’s reactions and styles of coping while also having open and honest dialogue with each other.
Try to maintain a sense of humor as well. Cancer isn’t funny, but life is, and laughter can help us regain some perspective through the greatest difficulties.
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Susan Hedlund has been a social worker in the healthcare field for 30 years and has extensive experience working with individuals and families facing life-threatening illness and loss. She is currently the manager of Patient and Family Support Services at the Knight Cancer Institute at Oregon Health & Science University in Portland, OR, and is on the faculty of the School of Medicine at OHSU, as well as the Graduate School of Social Work at Portland State University.
This article was published in Coping® with Cancer magazine, September/October 2012.