As any person with cancer knows, a cancer diagnosis also 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 grow healthy, mutually supportive relationships during this challenging time.
Spouses and partners
Cancer has a major effect on marriages and other long-term partnerships. After a cancer diagnosis, both individuals may experience sadness, anxiety, anger, or even hopelessness.
The effects of cancer vary from couple to couple. For some couples, facing the challenges of cancer together strengthens their relationship. For others, the stress of cancer may create new problems and worsen existing problems.
Here are some changes that often occur in relationships:
Roles. Cancer often changes roles. A person who has always been in charge or served as the caregiver may have trouble accepting a more dependent role. Or a person who has not served in those roles may struggle to take charge and provide care.
A partner may try to gain some control by becoming an “expert” in some area of the disease. He or she may try to manage your treatment schedule or communication with the health care team. If this is comfortable for both of you, it may help you cope with the illness. But it is important to listen to each other's needs and desires and remain flexible.
A partner may become overly protective or controlling. This may affect the exchange of information, both at home and with the health care team. Although it may seem normal, or even generous, to not tell your partner all the details of the diagnosis or treatment, keeping secrets usually results in feelings of isolation for both people. 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 handles 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 tired or unable to perform your usual tasks, your partner may have to pick up those duties. If you must stop working, your partner may need to go back to work or work extra hours while perhaps also taking on caregiving duties.
These added responsibilities may become overwhelming and lead to feelings of frustration and resentment. Meanwhile, you may feel guilty, saddened, or frustrated. Talking openly about limitations and possible solutions will help you both feel more comfortable with these changes. In addition, although it may be difficult for both partners, it is important to accept outside help from friends, family members, or professionals.
Physical needs. The physical needs that come with cancer may change throughout the course of the disease. It is important that both partners talk about their needs. Asking for help with basic activities of daily life, such as getting dressed or washing your hair, may be difficult. But your partner may not know that you need help or may not want to offend you by offering it. So it is important to talk openly and to clearly express your needs. This will help avoid the frustration and anger that could result from misinterpreting your spouse's behavior.
Emotional needs. Each partner may have different emotional needs that change frequently. But both partners may need extra reassurance that they are still loved. Couples need to be sensitive to the changing emotional needs that come with a cancer diagnosis. Spouses or partners may want to consider talking with a professional, such as a therapist or counselor, on their own. Spouses or partners caring for their loved one may find it difficult to express certain feelings for fear of hurting or overwhelming their partner. And it is important that the spouse or partner with cancer is able to express their feelings to someone who can handle the intensity of those feelings without being overwhelmed.
Sexual health and intimacy. Cancer and its treatment often affect sexual health. 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 be reluctant to talk about it. Every couple has different levels of comfort in talking about sexual health 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. They can provide suggestions for managing sexual side effects and suggest ways to maintain intimacy.
Future plans. Cancer often changes a couple’s hopes and dreams. 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. Things that seemed important before the cancer diagnosis may give way to new priorities, such as enjoying more time together. But putting some goals on hold, rather than changing 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, based on the closeness of each relationship. 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:
Put 1 person in charge of giving medical updates. Having to repeat medical information and answer the same questions over and over again can be tiring and time-consuming. It can also be stressful, especially when it is about your own health. Ask a trusted family member to share medical information with other family and friends. Have that person make necessary phone calls, send emails, answer questions, and post updates online if you are comfortable with that. That person can also assign tasks to family members who offer to help.
Expect relationships to change. Many people have little experience with life-threatening illnesses. They may not know what to say to you or how to act. For some, it may be frightening to learn that you have cancer. 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. Some friends and family members may distance themselves from you, but 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 do not 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. Let them know that it is okay to talk about it. Reassure them that you do not expect answers and that you only want them to listen and to try to understand your feelings. It is also okay to tell people when you do not 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 detailed about your needs. 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 update others on your progress.
You may find that you have a well-meaning but overbearing family member who is complicating your efforts. In this case, 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 him or her 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 do not 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 do not be afraid to cancel if you are physically or emotionally tired.
Being a parent with cancer presents unique challenges, including the following:
Communication. You may want to protect your children from fear and other difficult feelings. But it is important to talk openly with them about your diagnosis and treatment. Even very young children can sense that something is wrong. Avoiding the topic may lead them to believe that the situation is worse than it is. This may create feelings of confusion and fear. Remember that children may overhear conversations between adults and worry more if they feel that important news is being kept from them.
Communication will help your children cope with your cancer diagnosis. But it is important to provide information that is appropriate for your children’s ages. This will 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.
Learn more about talking with your children and how children understand cancer at different ages. You can also ask a social worker or counselor about how to have these conversations.
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. Older children or teenagers may become angry or distant and withdraw from family activities. Try to keep your children's daily schedule 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. This is 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, to-do list, goals, and expectations. Take help from others and ask for help when you need it. This will allow you to spend less time worrying and more time enjoying with 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 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 lowers the stress on relationships. If you are having a hard time talking with people, or if others do not seem to want to communicate with you, consider joining a support group or talking with a counselor or social worker.