For women in the U.S., breast cancer death rates are higher than those for any other cancer, besides lung cancer. [source]
Among men too, it’s a rare but increasing trend, like male breast cancer and gynecomastia.
If your wife or partner has been diagnosed with breast cancer, it’s important that you become an integral part of her healing. Of course, your partner must make the final decisions regarding her treatment with her doctor. However, it is important that you listen to her feelings and fears, learn about treatment options, and become involved in her care.
You may feel a lot of conflicting emotions right now. The traditional male role — solving problems and acting knowledgeable, protective and in charge — may be causing you turmoil. You may even be experiencing guilt over worrying about your own emotional pain.
These feelings are normal, as you and your partner try to come to terms with the diagnosis of breast cancer. This article will guide you through the stages of breast cancer, from initial doctor’s appointments and diagnosis to treatment and your future together.
For each stage, we will discusses potential trouble spots and provides some helpful suggestions. You’ll learn more about your partner’s feelings, your own feelings, how your relationship may be affected, and ways to improve your communication, physical closeness and sexual intimacy.
Throughout this booklet, terms such as “partner” and “wife” will be used interchangeably, but we understand the range of possible relationships in which you may be involved. The term “wife” is not meant to disparage any relationship. We hope that this information can help you better discover, understand and communicate what is important to you and your loved one as the first step in the healing process.
INITIAL DOCTOR’S VISIT/DIAGNOSIS
What she may be feeling
When first confronted with a breast cancer diagnosis, your wife may experience fear, denial, frustration, isolation, confusion, guilt, anxiety and a sense of betrayal. Many women understandably change their everyday priorities, putting themselves first.
This new attitude may be confusing or disturbing to you.
Your partner may distance herself from you, physically and emotionally, to protect you from potential loss.
Her feelings of helplessness, hopelessness or despair may be compounded by her need to change from being the family caretaker to becoming the one who needs care. She may be afraid of becoming a burden on you and your children. She will also fear change sin appearance and sexuality.
What you may be feeling
You may also be feeling fear, anger, denial and a sense of betrayal. you may feel that you have to adopt the strong role which has stereo-typically been associated with men. And as a man, you may not be oriented toward your deepest feelings. Critical issues for you are likely to be anxiety over the future and the possible loss of your wife. Such thoughts may trigger fears regarding your own mortality.
Many men feel guilty over this, it’s important to recognize that your fears and feelings of guilt are normal and common.
It’s also normal for you to worry. Studies conducted with husbands of breast cancer patients found that the husbands went through a variety of emotional and psychosomatic problems — including eating and sleeping disorders. They also had a significant amount of anxiety before and after their wife’s surgery.
You may feel overwhelmed — that the news comes so quickly that you have no time to prepare. You may be in great pain and not want your loved ones to see you this way; you may even want to seek counseling without you wife.
Support groups for men are available. You may also have strong needs at this point — for information as well as for choice and control. State openly what you need, and give yourself permission to experience these feelings fully. Sometimes a journal may help to give you a sense of control. This may be especially useful during treatment and subsequent doctor’s visits. You can write down every doctor’s visit, the date and time, anything else that needs to be checked later, and every procedure suggested or performed. Write down what you’re feeling as well.
At this point, you may also want to tape record consultations, request photographs of mastectomies (to help prepare you and your wife), prepare questions, and request printed information regarding treatment options (see the section on “Treatment Options”). During treatment, you can be supportive in a number of important roles: coordinator of social support, monitor of normal functioning, patient advocate, and even physician’s assistant.
How this could affect your relationship
Whenever one partner gets sick, a couple’s usual pattern of give and take, dependence and independence, is altered. Serious illness can bring a couple closer together. However, like any crisis, it can also disclose shortcomings in your relationship.
Once your partner is diagnosed with cancer, your relationship will very likely change. With open, trusting communication, that change can be positive. Tell your wife what you’re feeling. Establish clear and open communication: avoid mind reading and don’t make assumptions. Talk in specifics, and attempt to feel comfortable with a free exchange of ideas. Express your feelings and “own” them; that is , use “I” messages. When your wife tells you something, listen to what is expresses without becoming defensive. Make sure you understand her message. Give feedback so that your wife knows how you feel about what was said — express your viewpoint during the conversation, not three days later.
Communication can also be physical — as simple as holding your wife’s hand. Comforting your partner in this manner may make you feel better.
Build on the strong, positive areas of your relationship to help feel closer and enjoy each other. Strive for cooperation coupled with independence, and place a high value on flexibility:
- demonstrate mutual love, respect and understanding
- maintain independent identities and accept each other as separate individuals
- give each other privacy
- trust each other
- make a commitment to tough it out together
Direct, open communication should also be extended to the family, so that you and your wife have as large a support system as possible. Family and friends cannot offer help if they don’t know you’re in crisis. if children are not told, they will sense that something is wrong, and confusion will be added to their concern.
Physical closeness and sexual intimacy Cancer is not contagious, and sexual activity will not make cancer worse. You cannot “catch” cancer by kissing, hugging or having intercourse; a cancer cell from one person’s body cannot take root and grow in someone else.
What she may be feeling
After mastectomy or lumpectomy, your wife may have feelings of embarrassment or low self-esteem, as well as physical discomfort.
Though your wife needs emotional support at this point, she may find it tiring to deal with too many well-meaning friends. She may have to conserve her energy and screen out those individuals whose interaction is not helpful. You may have to mediate between your wife and her friends and relatives: when she’s tired, explain to them that your wife appreciates their concern but is not up to seeing them that day.
Try to be at the hospital as much as possible. be optimistic, but don’t promise miracles. Reinforce genuine hopes and promise her what you can guarantee: for example, let her know that you won’t abandon her. Acknowledge her anger, confusion, and frustration. And because a positive attitude may help your wife fight cancer, help her keep an optimistic frame of mind.
What you may be feeling
Many men have trouble acting as a support system for their partner while coping with their own emotions. While you need to be strong for your wife, you may be feeling guilty, lonely or abandoned. You may be afraid of what would happen if you were to become ill now, since everyone depends on you.
You may have feelings of fear and even repulsion — these are natural. Generally, however, it is not your partner’s superficial change in appearance that affects you so strongly, but rather its psychological significance to you. The fear of losing your wife may cause you to withdraw affection and sexual intimacy as part of a larger, more harmful process of withdrawal. In other words, if you cannot look at your wife’s scar, you may be expressing deeper feelings — perhaps anger over suddenly being responsible for the children and other household chores, or fear at being reminded of your own vulnerability.
Many men also feel a real sense of loss. It is unrealistic to expect a man to have no reaction whatsoever when his lover loses her breast. For these reasons, you may have to make as many adjustments as your wife.
Couples should go through the entire process — diagnosis, treatment and recovery — as partners. Communication is important: silence may be misinterpreted as a lack of interest. During recovery, men may feel cut off from the information flow, leaving them isolated and angry. However, just as you helped your partner gather information before treatment, you can continue to take a proactive role during treatment, especially with physicians. This can be very valuable, as your wife may forget to bring up an important point. For example, one man whose wife has kidney disease questioned the doctor about the use of chemotherapy drugs, which are metabolized through the kidneys. he worked to get her oncologist and kidney specialist to talk to one another, and a modified chemotherapy program was used.
Communication and information is also very important for sexual health after cancer treatment. When you know what to expect, it is easier to have a meaningful discussion about potential challenges to this aspect of your relationship.
Physical closeness and sexual intimacy
Perhaps nothing can prepare your wife (and you) for the shock of what her chest may look like. Acknowledging that the loss of a breast is very sad for both of you begins the grieving and promotes the healing process.
Looking at the scar together with your wife will help you both adjust to the physical changes. The sooner a couple can look at the scar — preferably before leaving the hospital — the sooner they can deal with the fact that the breast is gone. (OR in the case of a lumpectomy, that a scar is present.) Remember that most scars are at first red and raw, but with time they fade and are much less frightening.
Sexual issues can arise after surgery, because the loss of a breast can damage a woman’s sense of attractiveness and self-esteem. She may be embarrassed in certain sexual positions, such as the woman on top, since the scar is more noticeable in that position. Or she may have pain or stiffness in her arms and shoulders, especially after axillary dissection (surgery involving her armpit area). You may want to avoid positions which put weight on her shoulders or arm. It can be helpful to support these areas with pillows during intercourse.
Sexual activity is usually safe during and after cancer treatment. Check with your doctor if you have questions.
FOLLOW-UP TREATMENT (CHEMOTHERAPY/HORMONE THERAPY AND RADIATION)
What she may be feeling
Chemotherapy is given in cycles; a recipe repeated every few weeks. Each chemotherapy agent has its own side effects, most of which are temporary — lasting hours to days. Some women will have none, others many. This does not reflect the severity of the disease, only the individual’s tolerance to these drugs. There are medications that can relieve some of these side effects, but some doctors do not routinely prescribe them. if your partner’s side effects seem particularly severe, ask the doctor whether intervention is available to relieve the symptoms.
Many women feel fatigue. Encourage your wife to be active, to see friends, to work if possible, but allow her extra time to rest. Let her know you understand how she feels by volunteering to do tasks she normally does without making her feel guilty. Nausea can make her even less active. Medications can help. Changing diets often helps.
Not all chemotherapy causes hair loss, and some women experience only partial baldness. Ask the doctor what you can expect on her particular drug regimen. Hair loss, when it occurs, is devastating to most women. With breast cancer, personal body image concerns are already present — but baldness lets the world know. Remind your wife that her hair will grow back, that she is beautiful to you, and that she is still very much loved. participate in wig shopping with her. If your wife develops menopausal symptoms, loss of menses, hot flashes or vaginal dryness, she is dealing with one more issue — loss of femininity. Hot flashes come unexpectedly and can disturb sleep and normal activities.
Radiation therapy can be fatiguing — it is given every day for five to seven weeks after lumpectomy. Every treatment is a reminder to your wife of her diagnosis and her mortality, making this a stressful time.
Often, radiation therapy is easier than chemotherapy, because the immediate side effects are milder. Most women have a skin reaction, which is sometimes like a bad burn which constantly aches. The breast can swell and may hurt and feel heavy. Sexual breast play can be very uncomfortable at this time. Radiation therapy or surgery can also cause lymphedema, which is a swelling around the breast, or under and down the arm, caused by a buildup of lymphatic fluid. Lymphedema may occur suddenly after radiation, or it may be brought on by physical exertion following treatment.
For some women, especially those with severe cases, lymphedema can be devastating: their arms may not fit into their clothes, and they may have to wear a special elastic sleeve. To keep swelling to a minimum, encourage your wife to perform appropriate exercises and to avoid heavy lifting and working long hours near a hot oven.
Severe lymphedema should be discussed with the doctor, because there are certain procedures that can help relieve symptoms.
Physical closeness and sexual intimacy
Chemotherapy may leave your lover tired, nauseated, anxious or depressed for periods of time. Radiation therapy can cause irritation or swelling in her breast or arm. As a result, she may not be interested in intercourse. During this time, you can be physically intimate in other ways — through kissing, touching, stroking, cuddling, hugging, massage, or loving words.
Chemotherapy can also bring about changes that directly affect your partner’s interest in sex. It can directly or indirectly induce the development of menopause, even if she is quite young. Your wife may experience hot flashes, vaginal dryness and thinning of the vaginal walls — which can result in painful intercourse and postcoital bleeding.
Some of these changes can be addressed directly. For example, vaginal dryness can be reduced with the use of a vaginal lubricating jelly, which can be purchased over the counter. A gynecologist may recommend other products to help. Remember that sexual activity does not expose you to the effects of chemotherapy or radiation.
Many who have not only survived breast cancer but have turned it into a positive, even enriching experience have done so because they had an ally in their partner. In fact, most couples are drawn closer together by the experience. We encourage you to continue learning about the medical and psychological effects of breast cancer. If you and your wife make a commitment to go through diagnosis, treatment and recovery as partners, her recovery may occur more quickly.
Now is the time to learn more about the disease, so that you can do all you can to support your wife or partner’s recovery.
- I still buy green bananas: Living with hope, living with advanced breast cancer