- A cancer diagnosis can be as overwhelming for your family members and friends as it is for you, possibly changing your relationships in unexpected ways.
- Expect that the roles, responsibilities, and priorities you are familiar with in a marriage or long-term partnership may shift after a cancer diagnosis and continue to change throughout treatment and recovery.
- Talking about your diagnosis with partners, children, and friends and family and expressing your needs to those close to you can help avoid misunderstandings that stress your relationships.
As any person with cancer knows, a cancer diagnosis affects family members and friends. Sometimes, the complex feelings and lifestyle changes caused by cancer and its treatment become as overwhelming for others in your life as they are for you. Understanding the potential changes in the way you relate to specific family members and friends may help you take steps to foster healthy, mutually supportive relationships during this challenging time.
Spouses and partners
Cancer has the greatest effect on marriages and other long-term partnerships. After a diagnosis of cancer, both individuals may experience sadness, anxiety, anger, or even hopelessness. For some couples, facing the challenges of cancer together strengthens their relationship and commitment. For others, especially those who struggled in their relationship before the diagnosis, the stress of cancer may create new problems and worsen existing problems.
Although the effects of cancer vary from couple to couple, here are some changes that frequently occur in relationships.
Roles. Cancer often changes roles, which may be a challenging adjustment. A person who has always been in charge or served as the caregiver may have trouble accepting a more dependent role, while a person who has not served in those roles may struggle to take charge and provide care.
Your partner may try to gain some control by becoming an “expert” in some area of the disease or by managing the schedule of treatment and communicating with the medical team. If this is comfortable for both individuals, it may help you cope with the illness, but it is important to listen to each other's needs and desires and remain flexible. Sometimes, a partner may become overly protective or controlling. This tendency may affect the exchange of information, both at home and with the medical team. Although it may seem normal, or even generous, to spare your partner some details of the diagnosis or treatment, keeping secrets usually results in feelings of isolation for both people. It is important to talk with your partner about your feelings and work together as much as possible to make decisions about treatment, caregiving, and other issues. Learn more about how to talk with your spouse or partner about cancer.
Responsibilities. In most relationships, each partner is responsible for specific chores. One partner may do yard work and cook, while the other cleans and pays bills. If cancer and its treatment leaves you feeling exhausted or unable to perform your usual tasks, those responsibilities may fall on your partner’s shoulders. If you must stop working, your partner may need to go back to work or work extra hours while—in many cases—taking on caregiving responsibilities. These added responsibilities may become overwhelming and lead to feelings of frustration and resentment. Meanwhile, you may feel guilty for burdening your partner and feel saddened and frustrated by your limitations. Talking openly about limitations and brainstorming possible solutions will help you both feel more comfortable with changes in responsibilities. In addition, although it may be difficult for both partners, it is important to accept outside help from friends, family members, or professionals.
Needs. Because physical and emotional needs change frequently as couples cope with cancer, it is important for both partners to communicate their needs. Asking for help with basic activities of daily life, such as getting dressed or washing your hair, may be difficult. However, your partner may not know that you need help or may not want to offend you by offering it. As a result, it is important to talk openly and clearly express your needs to avoid the frustration and anger that could result from misinterpreting your spouse's behavior.
In addition to addressing physical needs, couples need to be sensitive to the shifting emotional needs. Sometimes, both partners need extra reassurance that they are still loved.
Sexuality and intimacy. Cancer and its treatment often affect sexuality. Depression, fatigue, nausea, erectile dysfunction, vaginal dryness, and other physical or emotional problems may lower sex drive or make intercourse difficult or painful. Both partners may feel anxious about this issue, but they may be reluctant to talk about it. Every couple has varying levels of comfort in discussing sexuality and intimacy. If sharing your concerns and challenges is especially uncomfortable for you, consider getting help from a counselor, therapist, your doctor, or a social worker. If your doctor does not initiate discussion of sexual side effects, feel free to express your concerns and ask questions. Often, your doctor or another member of the health care team can provide suggestions for managing sexual side effects and suggest ways to maintain intimacy.
Future plans. Cancer often changes the hopes and dreams that couples share. Your plans for retirement, traveling, or parenthood may change, causing feelings of sadness or even anger. It helps to reevaluate priorities and work together to establish new, short-term goals—such as finishing cancer treatment. This process can help you feel more connected to each other. Things that seemed important before the cancer diagnosis may give way to new priorities, such as enjoying more time together. However, putting some goals on hold, rather than abandoning them completely, may help your outlook on the future.
Friends and adult family members
The effects of cancer on your relationships with friends and family members vary widely, largely dependent on the closeness of each relationship. We all know that different families have different communication and coping styles. Consider how your family reacts in a crisis and how family members have dealt with other difficult situations. This will help you plan your strategy for communicating news and asking for support. Here are some suggestions to help you adjust to relationship changes with friends and family, based on strategies that have worked well for others in similar situations.
Put one person in charge of giving medical updates. It is exhausting to call or email every family member or friend after every test result or doctor's appointment. Designate a family member to be the point person for medical information, and have that person make the necessary phone calls, post the updates online if you are comfortable with that mode of communication, and field questions. That person may also be able to assign tasks to family members who offer to help.
Expect relationships to change. Many people have little experience with life-threatening illnesses and don't know what to say to you or how to act. For some, it may be frightening to learn that you have cancer because it is a reminder that it can happen to anyone. Others may have lost a loved one to cancer, and your diagnosis may bring up painful memories. For these reasons, some of your friends or family members may not be able to offer you the support that you expect. Although this is painful, try to remember that their reactions may reflect their past experiences and losses and not their feelings for you. Although some friends and family members may distance themselves from you, others will surprise you with emotional and physical support throughout your illness.
Take the lead in talking. Some friends and family members may avoid talking with you because they don't know what to say. Others may avoid talking about cancer, fearing that they will upset you. If you feel like talking about your cancer, bring up the subject with your friends and family members and let them know that it's okay for them to talk about it. Reassure them that you don't expect answers; you only want them to listen and try to understand your feelings. It’s also okay to tell people when you don't want to talk about your cancer. At times, you might prefer to talk about other things or just laugh with your friends.
Let people help you. Your friends and family members will likely want to help you, but they might not know what you need or how to ask you. Be direct and explicit about your needs, and try to avoid making assumptions about who will help and who will not. Prepare a list of tasks that people can do for you. For example, ask friends or family members to do your laundry, walk the dog, or keep others updated on your progress. However, if you find that you have a well-meaning but overbearing family member who is complicating your efforts, you or a close family member will need to set boundaries with that person. This may be difficult, but it is best to be direct and let them know exactly what is helpful and what is not. One way to approach this is to say, “I appreciate your involvement, but I get tired when you are here every day. The best way you can help me is by visiting on [name a specific day or time].”
Stay involved in social activities. As much as possible, try to maintain social contact with friends and family. Your friends might assume that you don't want to be invited to social events, so let them know to keep inviting you, if that is your preference. Meanwhile, let people know about your physical limitations; most friends and family members will be happy to plan quiet activities, such as going to the movies or fixing lunch at your house. And don't be afraid to cancel a date if you are physically or emotionally tired.
Being a parent with cancer presents unique challenges, including the following.
Communication. Although you may want to protect your children from fear and other difficult feelings, it is important to talk openly with them about your diagnosis and treatment. Even very young children can sense that something is wrong, and avoiding the topic may lead them to believe that the situation is worse than it is, creating feelings of confusion and fear. Remember that children may overhear conversations between adults and worry more if they feel that important news is being withheld from them. Honest communication will help your children cope with your cancer diagnosis. However, it is important to provide information that is appropriate for your children’s ages and temperaments, aiming to help them understand the situation without overwhelming them. Focus on things that will affect them directly, such as changes to their schedules or changes in your appearance, which might be more frightening if they are unexpected. Get more tips for talking with your children and learn how children understand cancer at different ages.
Changes in children’s behavior. Expect shifts in your children's behavior as they adjust to the changes resulting from your cancer diagnosis and treatment. Younger children may become overly clingy or impulsive. Meanwhile, older children or teenagers may become angry or distant and withdraw from family activities. Try to keep your children's daily schedules as normal as possible, and be patient. Encourage children to ask questions and let them know it is okay to talk about their feelings and fears. Reassure your children that they will always receive care and that you will always love them.
Role reversal. Adult children may act as caregivers for a parent with cancer—a change that is often difficult for both parents and children. Learn more about caring for a parent with cancer.
Balancing your needs and your children’s needs. Being a parent while living with cancer is often physically and emotionally exhausting. You may wonder how you can continue to care for your family while caring for yourself and coping with a cancer diagnosis. This is the time to reconsider your schedule and to-do list and accept help from others. Knowing that you do not have the time or energy for everything and reevaluating your priorities will help you create realistic goals and expectations. And asking for help when you need it will allow you to spend less time worrying and more time enjoying your loved ones. Learn more about how to get support for parenting while living with cancer.
The importance of communication
As demonstrated above, good communication is especially important in relationships between people with cancer and those who care about them. A lack of communication often leads to isolation, frustration, and misunderstandings. Talking about feelings and personal needs with honesty, sincerity, and openness greatly reduces the stress that cancer places on relationships. If you are having a hard time talking with people, or if others don't seem to want to communicate with you, consider asking for help by joining a support group or talking with a counselor or social worker.