Weekly Blog: Navigating relationships after a diagnosis

22 June 2022

By Tim Baker

Prostate cancer is often spoken of as a couple’s disease because it can affect the partner of the person living with the diagnosis so acutely (if they have a partner).

Statistically, men with prostate cancer in long term relationships tend to do better over time than single men. It’s not hard to understand why. Another set of ears at medical appointments to help recall and process the overwhelming tide of information. A gentle reminder when tests, oncologist’s appointments or treatments might be due. The companionship. Emotional support.

But for those partners of men with prostate cancer, the news isn’t so great. One Danish study in 2018 found the wives of men with advanced prostate cancer often felt their own lives were being undermined by their partner’s illness and feared falling ill themselves.

“Many feel isolated and fearful, and worry about the role change in their lives as their husband’s cancer advances,” the report authors note. “Many felt increasingly socially isolated. Their husbands were fatigued both by the illness and by the treatment, which meant that they couldn’t socialize as a couple, which made the women feel cut off from social support”.

Professor Hein van Poppel (Leuven, Belgium), EAU Adjunct Secretary General for Education, said: “Many prostate cancer patients have a hard time, both physically and emotionally, and this work shows that this stress can spill over and affect wives and partners. This is good for neither of them. Good mental and emotional health needs to be part of how we judge a treatment, and we need to try to ensure that both patients and their partners get the support they both need”.

Another British study in 2007 reported nearly 40% of men with prostate cancer felt their marriage quality had declined since their diagnosis. The impact was greater for men whose economic position was worsened by their diagnosis, those suffering erectile dysfunction, urinary leakage and depression, as well as for younger men.

Again, none of that should come as a surprise. A prostate cancer diagnosis can profoundly impact the dynamics of a relationship. The side effects of hormone therapy, the decline in libido and sexual function, moodiness, the stress of managing a cancer diagnosis, can all eat away at even the strongest relationship.

Of course, these are only statistics, and many couples manage to defy these odds and live long and fulfilling lives together. Any many single men find the emotional support they need in friends, extended family and community, as well as mental health professionals. But the challenge is not to be underestimated. In the early days post-diagnosis, as you process your abruptly altered circumstances, it’s easy to be oblivious to the impact your health might be having on the people around you. It’s entirely understandable to be somewhat self-focussed and to go within while trying to process your diagnosis.

Getting on the front foot early and doing whatever you can to tend to your relationships and family is important to help everyone within your inner circle adjust to your changed circumstances. Emotional support, a mental health care plan for both the cancer patient and their partner, relationship counselling if necessary, and frank and sensitive communication can all help a couple adapt and manage their stress and anxiety. A shared sense of mission and purpose can help forge a bond and commitment that you’ll weather this storm together.

A few things I have learnt along the way that might help:

• Choose your times to discuss your health. Don’t let cancer conversations leak into every part of your daily lives. It’s difficult for your partner to be going about their day and suddenly find themselves in the midst of a grim conversation about your test results, treatment options, fears and distress. Agree on a time for a weekly catch up, or ask if it’s okay before launching into such topics.
• Don’t let cancer dominate your worlds. Still do the things you’ve always enjoyed together as much as possible, whether that’s swing dancing, eating out, bush walking, travel. The fatigue of hormone therapy can sabotage a lot of good intentions, but it can be worth pushing through tiredness to open yourself up to new experiences or maintain your favourite pastimes.
• Even when libido and sexual function are impacted, physical closeness and intimacy matter. Become a good hugger. Be affectionate. Addressing erectile dysfunction is a whole topic of its own we’ll re-visit in a future blog post, but it is worth consulting a men’s sexual health specialist early on to see what can be done to maintain sexual function.
• Learn your partner’s “love language” – that is, how do they like you to show your love for them. Verbal expressions of love, physical touch, small acts of service like doing chores, gifts? We all have our own love language and learning your partner’s can help ensure they feel loved and appreciated.
• Don’t lean exclusively on your partner, no matter how well they seem to be holding up. Spread the load. Call on close friends and extended family and a psychologist, if necessary.

Even so, and despite both parties’ best efforts, many relationships come apart under the strain of a cancer diagnosis and this shouldn’t be seen as a failure or an abandonment or betrayal. A prostate cancer diagnosis changes us and is likely to change your relationship in ways that are difficult to foresee. Many men struggle with a sense of loss, of not being the stoic protector or provider we’ve been raised to see as a man’s role. Sharing these fears and insecurities can help build a new closeness and a new kind of relationship.

Friendship, companionship, a bond forged through adversity can compensate for some of the loss in other aspects of your relationship. Many men struggle to discuss these kinds of issues and finding a good counsellor or psychologist early on, whether individually or as a couple, can help you recalibrate your relationship.

References

^{European Association of Urology. (2018, March 19). Wives of many prostate cancer sufferers made ill or feel undermined by the disease. ScienceDaily. Retrieved June 12, 2022 from www.sciencedaily.com/releases/2018/03/180319091027.htm}

^{Sunny, L., Hopfgarten, T., Adolfsson, J., & Steineck, G. (2007). Economic conditions and marriage quality of men with prostate cancer. BJU international, 99(6), 1391-1397. http://www.acfw.com.br/crio1/Prostata/British%20Journal%20of%20Urology/2007/Junho/7.pdf}

This August, Tim will launch his latest book, Patting the Shark. This candid story documents his journey learning to live well with prostate cancer. To launch Patting the Shark, Tim will join Professor Suzanne Chambers at Brisbane Library on August 21, 2022 from 11am to 12pm to talk about his journey. To attend, click here.

---

About the Author