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In Sickness and in Health

Facing Cancer Together as a Couple

by Susan Hedlund, MSW, LCSW

Wellness image

While a cancer diag­nosis is given to just one person, it can have a ripple effect on everyone who cares about that person. For many cou­ples, the challenges that accompany 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 relationship.

A number of factors play a role in how couples deal with cancer. We know that couples who have higher levels of satisfac­tion in their relationship prior to diagnosis tend to cope better with illness than do couples who have prior relationship difficul­ties. We also know that couples with other life stressors (such as financial difficulties or family dis- harmony) may have more difficulty facing cancer. In addition, each person in the partnership may have different – even conflicting – ways of coping with the diagnosis.

The person diagnosed with cancer may initially feel fear. They may worry about how well they’ll tolerate treat­ment, if they’ll survive, or how all this is going to change their life. They may feel guilty about the stress that their cancer has brought into the relationship.

Good communication involves both talking and listening.

Author of Article photo

Susan Hedlund

The well partner may feel helpless­ness, fear, sadness, and frustration. Partners may also feel guilty about their emotional reactions to the diag- nosis, and for having their own needs during this time. Partners may feel the pressure to be the primary helper and to give emotional support to their loved one who is facing cancer, all while trying to pick up the slack where the person with cancer can no longer provide. They may need support, but the person they would normally turn to may be overwhelmed with dealing with cancer and may not be able to give it. The well partner may be forced to put aside his or her own shock and trauma to support, help, and protect the person with cancer. All of this can change the dynamic of the relationship.

Gender differences must also be taken into consideration. While this may not apply to all men and women, in general, men are more concerned with the facts of the situation and want to take action. When a man is unable to protect the person he loves from cancer, he may feel helpless, frightened, and sad. The man may feel his job is to fix things for his partner, while his partner may simply long to be heard and supported.

When cancer enters the picture, many couples try to protect one another from unpleasant thoughts and feelings. Unfortunately, this often has the unintended consequence of pushing couples apart.

On the other hand, women are generally more focused on emo­tions and connection with others. When a woman’s partner is silent, or tries to fix what cannot be fixed, she may feel even more alone and misunderstood.

As is true with most challenges, communication is one of the most important tools couples can use when facing cancer together. Good commu­nication involves both talking and listening. Understanding your partner’s thoughts and feelings and making room for each other’s concerns is the heart of good communication.

When cancer enters the picture, many couples try to protect one another from unpleasant thoughts and feelings. Unfortunately, this often has the unin­tended consequence of pushing couples apart. In order to stay connected during this challenging time, couples need to find ways to talk about even the most difficult subjects.

Dr. Dan Shapiro, a professor at Penn State University and author of the book And in Health: A Guide for Couples Facing Cancer Together, writes about how cancer can cause people to lose their bearings and to push away those they love and most need to help them through the challenges of treatment. He offers the following advice for couples facing cancer:

Teamwork is essential. When couples see doctors as a team, it helps to have both people listening, taking notes, and asking questions.

Talk and touch. Love and support can be communicated through touch.

Allow for mistakes. Cancer requires a whole new set of skills at a time when people are depleted, distracted, and scared. Patience and tolerance are essential.

Nobody can read minds. It is important for spouses to check for understanding.

Prepare for the unknown. Talk with one another about the hard things, like end of life and advance directives.

Don’t hesitate to seek support if you need it. A counselor or other professional can help you improve communication and find ways to cope well with cancer together. Drawing on the support of family, friends, or other couples facing cancer may also be helpful.

When facing cancer together as a couple, it’s important to make room for one another’s reactions and styles of coping while also having open and honest dialogue with one another. And it doesn’t hurt to keep a sense of humor. Cancer isn’t funny, but life is, and laughter can help us regain some perspective through even the greatest difficulties.

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Susan Hedlund has been a healthcare social worker for 30 years and has extensive experience working with individuals and families facing life-threatening illness and loss. She is the manager of Patient and Family Support Services at the Knight Cancer Institute at Oregon Health & Science University in Portland, OR, and an assistant professor at the OHSU School of Medicine, as well as the Portland State University School of Social Work.

This article was published in Coping® with Cancer magazine, January/February 2017.