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Talking to Your Spouse

102172269_8The emotions and lifestyle changes of cancer can make communicating with your spouse challenging. Even couples who communicate well can struggle as cancer creates intense emotions and uncomfortable or frightening thoughts about physical limitations, body-image issues, loss of intimacy and death. It will probably be excruciating to even tell your spouse about your diagnosis because you may hate to be the cause of your loved one’s fear and anxiety. However, you will have to tell your spouse about your cancer because he or she will likely be involved in every step of the process. You cannot protect your spouse from the effects it will have on both of you, your relationship, your family and your future. You will have to work together to seek the best possible outcome for your treatment. It will probably be the most difficult challenge you have ever gone through together.

Establishing and maintaining good communication habits

Good communication involves talking openly and honestly about your thoughts, feelings and fears with someone who listens and supports you, and also listening to their thoughts and feelings. Because cancer changes the lives of each person in a relationship, it’s important for both partners to talk honestly.

Ways to talk to your spouse about cancer can include:

  • Discuss treatment options and work together to make decisions. Attending doctor’s appointments together can help this process as both of you can ask questions.
  • Choose times to talk when you’re both free of distractions and not rushed. Scheduling a daily time to sit down and talk can be very helpful.
  • Write down what you want to say if you need to discuss something particularly important.
  • Talk openly and honestly about your feelings, both positive and negative, and do not interrupt when your partner says something you don’t like.
  • Let your partner know how you’re feeling physically and emotionally, and about specific types of support and encouragement you need.
  • Share coping strategies that are working or not working well and support each other’s efforts to actively and positively deal with emotions.
  • Say thank you for the things you do for each other. Though your spouse may take over your duties as well as his or her own, you can still contribute and support him or her. Your spouse may not notice your efforts when he or she is busy or distressed, so let him or her know you’re doing what you can.
  • Do not be afraid to laugh. For some people, humor can be very therapeutic.

Remember to talk about topics other than cancer, too. Sometimes it can feel like cancer has taken over everything in your life and relationship. Make an effort to just chat about subjects you have always enjoyed talking about together. Similarly, just spending some quiet time together reading, listening to music, watching a movie or doing hobbies can be a pleasant bonding time with your spouse.

Talking about distress

Both you and your spouse are virtually certain to experience emotional distress, such as fear, anxiety, depression, denial, anger, resentment and any number of other intense reactions, during your cancer journey.2 Galway K, Black A, Cantwell M, et al. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosedcancerpatients. Cochrane Database Syst Rev.2012 Nov 14;11:CD007064. Distress may become severe for one or both of you, and it is important to talk about your psychological symptoms with each other so that the affected partner can seek help if necessary. You both need the other to be strong and healthy. In one study of head and neck cancer patients and their partners, about 35 percent of cancer patients experienced serious psychological distress while 33-39 percent of their partners did.1 Manne S, Badr H. Intimacy processes and psychological distress among couples coping with head and neck or lung cancers. Psycho-Oncology.2010 September;19(9):941-954. In other words, the cancer can affect your spouse, who will likely also be your primary caregiver, just as much as it does you. Emotional support goes both ways, not just toward the person with cancer. In fact, cancer patients and their partners usually identify each other as their most important source of support.

You will also probably need to discuss the distress that comes from changes in your ability to be intimate with each other during your treatment and beyond. You may find that you or your spouse are too tired, that you are in pain, that you feel emotionally disconnected from each other, that your sex drive is diminished as a side effect of treatments or that physical changes make you feel unattractive or unable to show physical affection the way you want to. It can be uncomfortable and embarrassing, but talking openly about intimacy issues can really help you both to work through this part of your relationship. [link to 4.1.5: Guide to Intimacy and Relationships]

Talking about what you’ve learned

Research shows that if the cancer patient is well-informed about his or her type of cancer, treatments, recovery and follow-up, his or her spouse will also be better informed. When your spouse is well-informed, he or she will be able to support you more effectively and be a more active part of your care and medical decision-making.3 Chaitchik S, Kreitler S, Rapoport Y, Algor R. What do cancer patients' spouses know about the patients? Cancer Nurs. 1992 Oct;15(5):353-362. Therefore, it is a good idea for you and your spouse to work together to learn more about your head and neck cancer. Talk about what you learn and write down questions that both of you would like to ask your care team at your next appointment. This kind of proactive communication strengthens your relationship with your spouse and makes you both feel more in control.

If you are still having trouble talking to your spouse, you may wish to join a cancer support group together or seek help from a couples counselor.

Find out how you can help yourself live. Find out how you can help support your partner in supporting you.Michele C. (salivary gland cancer survivor)

References

1 Manne S, Badr H. Intimacy processes and psychological distress among couples coping with head and neck or lung cancers. Psycho-Oncology.2010 September;19(9):941-954.

2 Galway K, Black A, Cantwell M, et al. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosedcancerpatients. Cochrane Database Syst Rev.2012 Nov 14;11:CD007064.

3 Chaitchik S, Kreitler S, Rapoport Y, Algor R. What do cancer patients' spouses know about the patients? Cancer Nurs. 1992 Oct;15(5):353-362.