Cancer doesn't affect just one person. Cancer affects couples, families, and friends. The complex feelings and lifestyle changes that follow a cancer diagnosis can be almost as overwhelming for family members and friends as they are for the person with cancer. Cancer changes the way you relate to your family and friends, and the way they relate to you.

The importance of communication

Communication becomes especially important for people with cancer and those who care about them. Lack of communication can lead to isolation, frustration, and unmet needs. People with cancer who don't talk about their illness often feel they are facing cancer alone. Talking about and sharing feelings and needs lets couples, families, and friends work together to solve problems and cope with difficult situations. When feelings and wishes are left unsaid, you may be left with inaccurate, even hurtful assumptions, about why the people who care about you are acting in a specific way. Sharing your feelings, such as sadness and fear, also lets others know how much you care for and love them. Talking about feelings and problems with honesty, sincerity, and openness can greatly reduce the stress that cancer places on relationships. If you are having a hard time talking with people, consider asking for help by joining a support group or talking with a counselor or social worker. Read how to find a counselor and how an oncology social worker can help.

Spouses and partners

Cancer has the greatest effect on marriages and other long-term partnerships. When cancer is diagnosed, both partners may have feelings of sadness, anxiety, anger, and hopelessness. For some couples, facing the challenges of cancer together strengthens their relationship. Fear of losing a partner can remind couples how much they love each other. Cancer can also cause couples to re-evaluate their priorities and reminds them of the importance of the relationship. For other couples, including those with significant problems before the diagnosis, the stress of cancer may create even more problems. Read more about talking with your spouse or partner about cancer and how to support your partner.

Although the effects of cancer vary from couple to couple, here are some common changes in relationships:

Changes in 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. A person with cancer may not be able to do some chores, which will need to be done by the other partner. If the partner with cancer has to stop working, the other partner may need to go back to work or work extra hours and, in many cases, take on the responsibility of caregiving. These added responsibilities can become overwhelming, and may lead to feelings of frustration, resentment, and guilt. The person with cancer may also feel guilty for burdening his or her partner and feel sad and frustrated by his or her own limitations.

Both partners may benefit from switching more active jobs, such as housework, for less strenuous tasks, such as paying bills. Although it may be difficult for both partners, accepting outside help from friends, family, or professionals can be invaluable. Most importantly, talking openly about limitations and brainstorming possible solutions may make the situation better.

Changes in roles. Cancer changes roles in relationships, often in unexpected ways. Some partners become overprotective or take on a parental role. Some partners take control and forget to include the other partner in decisions that affect the family. Adjusting to a shift in roles may cause problems for some. A person who in the past was always in charge may have trouble adjusting to a more dependent role, while the person who was the caregiver may have trouble being taken care of.

Changes in the roles may affect a partner’s self esteem. Either partner may be frustrated by the other's overprotectiveness, or feel isolated when decisions aren't talked about. Talk with your partner about your feelings and work together to make decisions about treatment, caregiving, and other issues.

Changes in needs. Since physical and emotional needs change frequently as couples cope with cancer, it is important for both partners to communicate their needs. Asking for help getting dressed or telling your partner you need some time off from caregiving can be difficult. But if you assume your partner knows what you need, your needs will likely go unmet, leading to frustration and anger. Both partners may also need extra reassurance that they are still needed and loved. You may think your partner knows how much you love him or her, but he or she may need to hear it more often.

Changes in sexuality and intimacy. The physical and emotional effects of cancer and cancer treatments often affect sexuality. Depression, fatigue, nausea, erectile dysfunction, vaginal dryness, and other problems can lower sex drive or make intercourse difficult or impossible. Both partners may feel anxious about their sexual relationship, but may be reluctant to talk about their feelings. Tell your partner how you are feeling and find ways to maintain intimacy through gentle touching, kissing, and physical closeness.

Changes in thinking about the future. Cancer can drastically change the dreams and hopes that couples share. You or your partner’s plans for retirement, traveling, or even parenthood may change, causing difficult feelings such as sadness and anger. The process of working together to meet new, short-term goals, such as finishing cancer treatment, can help couples feel more connected. For some, re-evaluating priorities may result in a better outlook on life. Things that seemed important before the cancer diagnosis may give way to new priorities, such as enjoying more time together. Putting some goals on hold rather than abandoning them completely can help.

Friends and family members

The effects of cancer on relationships with friends and adult family members vary widely. Siblings or close friends will be much more affected by the cancer than a friend or cousin you don't see often. Here are some suggestions to help you adjust to relationship changes.

Expect relationships to change. Many people have little experience with life-threatening illnesses and don't know what to say or how to act when someone has cancer. Your cancer may be frightening to some because it is a reminder that cancer 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 may not be able to offer you the support you expected. Although this is painful, try to remember that their reactions are not a reflection of how much they care about you. While some friends and family 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 just don't know what to say. Others may avoid talking about cancer for fear of upsetting you. If you feel like talking about your cancer, bring the subject up with your friends and family and let them know that it's okay for them to talk about it. Reassure them that you don't expect them to have answers; you just want someone who will listen and understand your feelings. It is also okay to tell people when you just don't want to talk about your cancer—sometimes you might just want to talk about normal things or just laugh with your friends.

Let people help you. Your friends and family will want to help you, but might not know what you need or how to ask you. Helping others makes people feel good and will benefit both you and your friends. Be specific about your needs. Prepare a list of tasks that people can do for you. For example, ask friends or family to do your laundry, walk the dog, or keep others updated on your progress.

Stay involved in social activities. As much as possible, try to continue doing social activities with your friends and family. Your friends might assume you don't want to be invited to social events, so make sure that you or someone else lets them know to keep inviting you. Let people know about your physical limitations—most friends and family will be happy to plan quiet activities, such as going to the movies or fixing lunch at your house. Don't be afraid to cancel a date if you are physically or emotionally tired.

Children and parenting

Being a parent with cancer presents unique challenges. The demands of cancer and treatment make it difficult to take care of young children. Adult children may act as a caregiver for a parent with cancer, but this role reversal can be difficult for both parents and children. Even for adult children, the fear of a parent dying can be huge.

For young children, the thought of losing a parent is frightening, and many parents try to hide the truth from their children. In reality, even very young children know something is wrong and need honest information to help them cope. Keep in mind your childrens' ages and give them truthful and accurate information they can understand, but won't overwhelm them. Focus on things that will affect them directly, such as changes to their schedule or changes to your appearance, such as hair or weight loss, which might be more frightening if the changes are unexpected. Learn more about how a child understands cancer and get more tips on talking with your children.

Expect changes in your children's behavior as they adjust to your cancer. Younger children may become overly clingy, impulsive, or want to stay home all the time. Older children or teenagers may be angry or distant and withdraw from family activities. Try to keep your child's daily schedule as normal as possible. Spend extra time with your children and encourage them to ask questions and talk about their feelings and fears. Reassure your children that they will always be taken care of and that you will always love them.

More Information

Coping

Relationships and Cancer

Additional Resources

National Cancer Institute: Taking Time: Support for People with Cancer and the People Who Care About Them

National Cancer Institute: When Someone in Your Family Has Cancer