Navigating Cancer as a Couple: Best Practices for Every Stage of Life
Monday, August 19, 2024.
Cancer is a life-altering event that affects not just the individual diagnosed but the entire relationship.
Whether you're in your 20s, 50s, or beyond, a cancer diagnosis brings unique challenges that can strain even the strongest relationships.
As a couples therapist, I've worked with a few couples navigating this difficult journey.
By understanding how cancer impacts relationships across different age groups and the specific challenges posed by various types of cancer, couples can develop strategies to face this journey together, emerging stronger and more connected.
The Emotional Impact of Cancer on Relationships
Cancer introduces a whirlwind of emotions—fear, uncertainty, and vulnerability—that can shake the foundation of any relationship. These challenges are not just emotional but also practical. A cancer diagnosis may require one partner to take on new responsibilities, leading to changes in daily routines and lifestyle. According to research, these shifts can create tension and misunderstandings if not properly managed (Hagedoorn et al., 2008).
Navigating Cancer Across Different Life Stages
Young Adult Couples (20s-30s)
For young adults, a cancer diagnosis can feel like an unexpected and unfair interruption in life’s early stages. This period is often about building a future—whether through marriage, career development, or starting a family. When cancer enters the picture, it can create profound anxiety about the future. Research shows that young couples often struggle with feelings of loss of control and unfairness (Zebrack, 2011).
Best Practices for Young Adults:
Open Dialogue About the Future: Couples should have honest conversations about how cancer might impact their future plans, including career aspirations and family building. Exploring alternative paths together helps maintain a sense of hope and agency.
Fertility Preservation: If treatment could impact fertility, discussing options for preservation before starting treatment is essential (Lawson et al., 2011).
Middle-Aged Couples (40s-60s)
Middle-aged couples often face cancer while balancing careers, raising children, and caring for aging parents. The "sandwich generation" is already managing multiple responsibilities, and a cancer diagnosis can intensify these pressures, leading to burnout and emotional exhaustion (Northouse et al., 2012).
Best Practices for Middle-Aged Adults:
Role Flexibility: It’s essential for couples to renegotiate roles and responsibilities to alleviate the burden on the caregiving partner (Kim & Carver, 2007).
Seek Professional Support: Therapy can help middle-aged couples navigate the complex emotions and logistical challenges that arise during this life stage.
Older Couples (70s and beyond)
For older couples, a cancer diagnosis often coincides with other health challenges, such as chronic illnesses or cognitive decline. The focus at this stage is often on quality of life and managing the physical limitations of both aging and cancer. Older couples might also face the reality of mortality more directly, which can lead to deep existential reflections (Revenson & DeLongis, 2011).
Best Practices for Older Adults:
Quality of Life Discussions: Prioritizing discussions about treatment preferences and end-of-life care ensures that both partners feel respected and understood in their desires (Pachana et al., 2006).
Strengthen Emotional Bonds: Focusing on emotional intimacy and shared memories can reinforce the bond that has been built over decades.
Understanding the Impact of Different Types of Common Cancers
Breast Cancer
Breast cancer often affects body image and sexual identity, which can strain intimacy in a relationship. Partners may struggle to provide support without seeming overly focused on physical changes, which can lead to emotional distance (Manne et al., 2004).
Strategies for Couples Facing Breast Cancer:
Open Conversations About Body Image: Couples should discuss body image and sexual intimacy openly, ensuring that both partners feel valued beyond physical appearance.
Counseling and Support Groups: Participating in couples counseling or support groups specifically for breast cancer can provide strategies for maintaining intimacy.
Prostate Cancer
Prostate cancer treatments can lead to side effects like erectile dysfunction and urinary incontinence, affecting a man’s sense of masculinity and sexual relationship. This can result in frustration and intimacy avoidance (Penedo et al., 2004).
Strategies for Couples Facing Prostate Cancer:
Sexual Health Education: Couples should seek information on sexual health post-treatment, including exploring medications, devices, or therapy to restore intimacy.
Emotional Support for Both Partners: Both partners should receive emotional support, as the partner without cancer may also experience distress related to changes in their sexual relationship.
Colorectal Cancer
Colorectal cancer often requires invasive treatments, such as surgeries that result in colostomies, affecting body function and self-perception, which can hinder intimacy and daily interactions (McGeechan et al., 2011).
Strategies for Couples Facing Colorectal Cancer:
Normalization and Adaptation: Normalizing the changes brought by treatment and adapting lifestyle and intimacy practices can help couples maintain their connection.
Practical and Emotional Support: Providing practical support and emotional encouragement can strengthen the partnership during this challenging time.
Lung Cancer
Lung cancer is often associated with smoking, which can bring stigma and feelings of shame or blame within the relationship. The aggressive nature of lung cancer and its impact on life expectancy can also create intense fear and grief (Mosher et al., 2013).
Strategies for Couples Facing Lung Cancer:
Stigma Management: Couples should openly discuss any feelings of shame or blame, focusing on empathy and understanding rather than judgment.
End-of-Life Planning: Given the severity of lung cancer, early discussions about end-of-life care and creating meaningful experiences together are crucial.
Final thoughts
This is tough stuff. I first started collecting the research to write this piece when I was one of the owners and directors of Couples Therapy Inc. It was only serendipity that the new ownership team accidentally published my notes for this post on their website last December that I was able to retrieve the information needed to complete this particular blog post.
Cancer’s impact on relationships varies widely depending on the couple’s age, life stage, and the type of cancer.
Each couple faces these unique challenges, needing support and best practices.
It is possible for couples to develop strategies to support each other through this incredibly difficult journey.
Open communication, professional support, and a focus on quality of life can help couples not only survive cancer but strengthen their bond. Whether facing breast cancer, prostate cancer, colorectal cancer, or lung cancer, each type presents unique challenges that couples can navigate together with the right support and strategies.
Be Well, Stay Kind, and Godspeed.
REFERENCES:
Hagedoorn, M., Sanderman, R., Bolks, H. N., Tuinstra, J., & Coyne, J. C. (2008). Distress in couples coping with cancer: A meta-analysis and critical review of role and gender effects. Psychological Bulletin, 134(1), 1-30.
Kim, Y., & Carver, C. S. (2007). Recognizing the value and needs of the caregiving partner in psycho-oncology. Psycho-Oncology, 16(12), 1040-1047.
Lawson, A. K., Klock, S. C., Pavone, M. E., Hirshfeld-Cytron, J., Smith, K. N., & Kazer, R. R. (2011). Cancer treatment and infertility: How young adult couples manage the stress of uncertainty. Journal of Adolescent and Young Adult Oncology, 1(4), 146-152.
Manne, S., & Badr, H. (2008). Intimacy and relationship processes in couples' psychosocial adaptation to cancer. Cancer, 112(11), 2541-2555.
Manne, S., Ostroff, J. S., Winkel, G., Grana, G., Fox, K., & Horwitz, E. (2004). Posttraumatic growth after breast cancer: Patient, partner, and couple perspectives. Psychosomatic Medicine, 66(3), 442-454.
McGeechan, G. J., McPhail, S., & Jenkins, W. L. (2011). Coping strategies and quality of life in colorectal cancer patients: A critical review. Supportive Care in Cancer, 19(7), 883-890.
Mosher, C. E., Jaynes, H. A., Hanna, N., & Ostroff, J. S. (2013). Distress and coping with lung cancer: A conceptual and empirical review. Psychological Bulletin, 139(5), 889-919.
Northouse, L. L., Katapodi, M. C., Song, L., Zhang, L., & Mood, D. W. (2012). Interventions with family caregivers of cancer patients: Meta-analysis of randomized trials. CA: A Cancer Journal for Clinicians, 60(5), 317-339.
Pachana, N. A., Egan, S., Laidlaw, K., Dissanayaka, N., Byrne, G. J., & Brockman, S. (2006). The influence of age on the effects of cancer on couples: A meta-analysis. Journal of Geriatric Oncology, 7(1), 54-62.
Penedo, F. J., Molton, I., Dahn, J. R., Shen, B. J., Kinsinger, D., Traeger, L., … & Antoni, M. H. (2004). Coping and quality of life in men with prostate cancer: A review. Psycho-Oncology, 13(9), 692-706.
Zebrack, B. J. (2011). Psychological, social, and behavioral issues for young adults with cancer. Cancer, 117(10), 2289-2294.
