Examine Yourself: Impact of a cancer diagnosis on a couple's relationship
A diagnosis can be devastating for relationships. talks to experts about how strong partnerships need to be in their darkest hour
FOLLOWING a cancer diagnosis, the journey to recovery is not just about striving to be physically clear of the disease; it can also lead to a whole spectrum of emotions including fear, anger and grief.
How a person reacts can depend on the type of cancer, their personality and other circumstances, but if they are in a relationship, then their partner’s response adds another layer to the experience of travelling down a road that nobody wanted to be on in the first place.
“There is the shock and trauma for the person diagnosed because they are considering the fragility of life, their own mortality — but the partner, who doesn’t have the cancer, can feel quite helpless and scared because they can’t make it go away,” says counselling psychologist, Damian Davy.
“And then there’s the restriction of their normal life in what they can do and because it’s a long process; life as they knew it can be suspended.”
Understandably, cancer patients can get anxious and depressed; they may have to stop work and that impacts on their confidence, or it can put the couple under extra financial pressure, he says.
Having professionally counselled individual cancer patients or concerned partners for decades, Davy himself was diagnosed unexpectedly with colon cancer in February 2016 and in his own case he feels the “treatment and awful journey that couples have to go through together” drew himself and his wife closer.
“What I say is that on this cancer journey your partner can be your best support, but it depends on where the relationship was prior to diagnosis,” says relationship and psychosexual therapist, Anne Mathews. “It takes a level of maturity in the relationship. If the relationship is not in a good place to start with, then at the survivorship stage, that plays out.”
While cancer support services such as ARC and the Irish Cancer Society offer counselling to survivors and their partners, the medical model falls short on that inclusiveness — such as in adding therapists who can offer emotional support, to their multidisciplinary teams, she points out.
And although patients are told to be optimistic and positive post-treatment, Mathews says it’s important to acknowledge the loss: “It’s the loss of your body as you knew it; your potency as you knew it –— it’s a grief journey.
“And the person who hasn’t had cancer is also grieving for the partner they thought they had and depending on where the cancer is, they might be grieving their sexual life as they knew it,” she adds.
Body image problems are one of the most common issues that arise post treatment for cancer survivors, says psychosexual and relationship psychotherapist, Linsey Blair. “So if a breast is removed your body isn’t going to look the same. And even if you have had a replacement breast it might not feel the same. There might be scars on your body that weren’t there before.
“For men there might be lack of a testicle, or penis shortening – so their body is going to look and feel differently.”
A lot of what people have to do at the start, is re-engage with their own bodies — to reclaim it back in a compassionate way — and that needs to happen before they can re-engage sexually with their partner, she says (see panel).
“When it comes to physiological changes, there might be shortening of the vagina if you’ve had a radical hysterectomy which means your partner’s penis won’t go all the way in. If ovaries have been removed for any reason, you have what we call a ‘vicious menopause’ which is menopause which comes very fast and the symptoms are a lot worse than natural menopause — so a lot of vaginal dryness, vaginal atrophy, thinning of the vaginal walls, the libido might go down because of lack of hormones.
“And with the men of course, if there’s prostatectomy there’s probably damage to the nerves so there might be erectile dysfunction; there might be differences in the penis if some has to be taken off — so there are a lot of physiological reasons also, why sex is going to feel very different,” she says.
“And equally if the woman has changes to her body the man might feel less aroused and may not be able to get an erection - even if she feels OK.”
What can happen then is that the couple feels as if sex is a failure and it will get more and more avoided, she adds.
“With a lot of medical procedures it also means you have lost ownership of your body. There are no boundaries any more; things are in you, and up you, and getting removed, and you lose a sense of self or protection over your body. So you have to rebuild that - this trust in your body; you can say no to things.”
Communication regarding intimacy — as it is in all aspects of the relationship — is essential.
A couple who bring emotional flexibility to their relationship has a good foundation to work from, to adjust to change, says Blair.
“But for every couple — no matter how strong a base they have — it can be a shock to the system for both of them. There’s often a lot of anger, resentment, fear and grief and all those things need to be emotionally worked out.”
With a cancer diagnosis, the couple’s needs change and it’s important that they stop and think how they communicate those needs, says Siobhan McSweeney, manager at Recovery Haven Cancer Support House in Tralee, Co Kerry.
“When there’s a lot going on it’s very hard, but sometimes we think that people are mind readers, that they will know you want help with this or that, and it’s to stop and look at how we communicate, especially when there is something big going on in our life.”
The centre, which is supported by the Irish Cancer Society, sees many patients and partners arrive at the recovery stage, after the all-clear has been given medically “because they feel all is not well for them”, says Mc Sweeney.
Nationally, in 2018, for instance, the Irish Cancer Society provided 7,000 free counselling sessions.
Two thirds of those who use the service in Tralee are women and although men are still slow to come forward, there is an increase in attendance, she says, especially as they have a very good men’s cancer support group.
“Women have had experiences of varying physical wellness and some men might never have been at a doctor and it can make it harder for them to adjust to being ill. For them to have to come in and explain they are struggling with feeling tired, or bowel habits or a sexual relationship - they are things they don’t find so easy to talk about.”
Then within relationships, there are the different personality types, says Mc Sweeney. “Some people are positive, some less so; some want lots of information, others don’t do well with that – and it’s balancing all that within your relationship and in the shadow of an illness and treatments and appointments - and the stresses and strains that go with it.
“It’s certainly a challenge. I suppose it’s sometimes no harm for people to access professional support services to help them as they go through the journey. And of course, we are more than our physical beings — we are emotional, we’re spiritual, we’re sexual - and we have to look after all those aspects of who we are as an individual as well as in relationship.”
CONNECT WITH US TODAY
Be the first to know the latest news and updates
