August 29, 2005
When Your Spouse Has Cancer
Andrew W, Kneier, PhD
What to do for your spouse when he or she has cancer depends on your spouse's personal needs and the individual situation. For example, a lot depends on whether your spouse is newly diagnosed, dealing with metastatic cancer, or living in a kind of limbo, not knowing whether the cancer is gone or not. Nonetheless, there are some general guidelines that could help you provide the kind of support your spouse needs.
Facing cancer together.
Although your spouse has cancer, the illness is really happening to both of you. Your life is being disrupted in many of the same ways. You are sharing many of same emotions and concerns. You are both challenged to find constructive ways of dealing with the disruptions and threats posed by cancer and with the side effects of medical treatments. It can be tremendously reassuring and comforting to your spouse to know that the two of you are facing the illness together and that your support and involvement will be steadfast and unwavering regardless of what happens.
Here are some of the specific issues that you should try to face together: How serious is the cancer? What is the best treatment, and what are the pros and cons of different options? Are there clinical trials to consider, or perhaps complementary or holistic approaches? What roles or division of labor should we take in learning about these matters? What should we tell our children, and how can we best help them in dealing with this? What changes do we need to make in our daily routine to accommodate the need for treatments and to deal with side effects? What does our family need in the way of support and practical help from relatives, friends, and (if applicable) our religious community? How can we best reach out for the support we need?
Discussion is better than assumption.
Do not assume that you know what your spouse is thinking or feeling about the cancer, or that you know what he or she needs from you. You might think your spouse is mostly scared, when actually he or she feels more sad or perhaps guilty about the consequences of the cancer for you. You might think that your spouse is strong and resilient, when actually he or she feels vulnerable and dependent on you, but may not want to show that. You might think that your spouse wants you to offer encouragement and hope, when actually he or she just wants you to say ``I'm with you in what you are feeling, and we'll face this together no matter what happens.''
The point of this is to talk with your spouse about his or her emotional reactions and concerns....and to ask what your spouse needs from you. Some of these needs may be concrete or practical: going together to doctor's appointments, becoming educated about his or her cancer and the treatment options, handling all the phone calls from friends and relatives, taking over more household chores. Other needs may be more emotional: being attuned and responsive to what your spouse is feeling, encouraging your spouse to confide in you, offering empathy and support during difficult times.
Support your spouse's true feelings.
Most cancer patients feel pressure to maintain a positive mental attitude, and too often this pressure prevents them from expressing their true feelings. Your spouse might hold back in sharing legitimate fears because he or she does not want to disappoint or burden you, or because he or she thinks that negative emotions might jeopardize healing. Actually, it is the suppression of fears, sorrow, or anger that could jeopardize your spouse's psychological adjustment and immune response.
Your spouse probably has good reasons to be worried and upset, but also good reasons to feel hopeful and optimistic. You should try to support and validate both sets of emotions (not only the positive ones).
Confronting sexual issues.
Your spouse's cancer or the treatments have probably affected his or her sexual interest or functioning or feelings of attractiveness. Some common examples are the loss of libido caused by chemotherapy and hormonal therapy, the impotence caused by prostate cancer treatments, and the body image effects of mastectomy and reconstructive surgery. Even without such specific problems, the depression that cancer can cause can reduce libido and sexual functioning. The bodily or mood changes in your spouse can also cause you to lose interest.
The key to dealing with these issues is open communication. Because your spouse might be reluctant to broach these topics, you could take the lead by acknowledging these issues and conveying your desire to face them together. You might also go out of your way to reassure your spouse of your love and devotion (because of who he or she is as a person, not because of physical attractiveness or sexual performance), that your main priority is his or her survival, and that you continue to desire an intimate physical relationship.
I know of hundreds of couples who have followed these principles. They have told me that the bond between them has actually been deepened and strengthen in this process. "It's ironic," one husband told me, "but somehow having to face death, and having to say good-bye to each other if that happens, has made us hold on tighter and cherish what we have."
Reprinted with permission from CancerSupportiveCare.com and Coping Magazine