For Rob Anderson,* that day in May 2009 was one of the darkest of his life. At the Toronto home the 42-year-old shares with his wife, Sandra,* she told him she would have to return to Princess Margaret Hospital (PMH) in Toronto for more cancer tests. Two years earlier, she had been diagnosed with Stage 3 breast cancer. Over the next year, she’d had a double mastectomy, chemotherapy and 35 rounds of radiation, and doctors were cautiously optimistic they had gotten it all. ‘But our worst fears seemed to be coming true. The doctors thought the cancer had spread,’ says Rob, adding, ‘I nearly lost it. It seemed that ever since we’d been married we had been dealt one bad hand after another.’
Standing in their sunny kitchen in their middle-class neighbourhood, Rob’s first impulse would normally have been to do what he had done since the moment cancer came into his marriage: lament their woes with his wife, and then go downstairs and drown out the realities of the world by working. Rob, who runs his own computer consulting company, was frustrated. He and his wife shared little intimacy anymore, and communication had waned dramatically. They had been partners and good friends for nearly 15 years, but now moved through periods of argument to withdrawal from one another, in which they slept at different times and led separate lives. Along with doctors’ appointments, Sandra took care of the couple’s home and four-year-old son, and Rob worked.
‘In my view,’ says Sandra, ‘Rob was always saying the wrong things. I’d be hurting or scared, and he’d express his own fears and frustrations. So when he’d say things like ‘we’ve been dealt a bad hand,’ I felt guilty. I felt I had ruined his life.’
But on that May day, when his pretty and petite dark-haired wife told him the hospital wanted her to return, Rob didn’t express feelings of despair, nor did he retreat. He had been seeing a psychiatrist at PMH’the psychiatrist overseeing the hospital’s new Helping Her Heal program. This program, the first of its kind in Canada, involves counsellors providing communication tools to men whose partners have cancer. Rob was able to implement some of the strategies he had been learning. He asked Sandra: ‘How does this make you feel? What can I do for you?’
‘I was quite surprised,’ says Sandra. ‘That day I felt close to him for the first time in a long time. I felt I could turn to him.’
Every year, some 23,000 women (and 180 men) are diagnosed with breast cancer in Canada. More than 85 percent of these women will live for at least five years. In fact, advances in breast cancer treatment have enabled many to live longer lives than ever before. Yet the stress and anxiety of battling cancer still wears on many marriages. Studies show that most relationships stay intact, but anxiety about the illness can cause depression not just in women (which is well documented), but also in their partners. This anxiety can lead to one or both individuals distancing themselves from the other at a time when they most need their partner’s support. The cancer sufferer often turns, as Sandra did, to friends and relatives for that emotional guidance. And the man? He generally holds things inside, as Rob did, or explodes at his wife.
A man’s anxiety is usually the fear that his wife will die, even when she is diagnosed with a cancer that is treatable, says Frances Marcus Lewis, a professor of family and child nursing at the University of Washington and one of North America’s leading researchers on the impact of cancer on relationships. The man will often forgo his own social activities and self-care, including personal time and sleep, in order to take on tasks, such as grocery shopping and child-rearing, that might have previously been shared. He does it so his wife can concentrate on her healing. And he does it between accompanying his wife to doctors’ appointments and working at his job. Financially, he may feel the crunch: If his wife is taking sick leave from work, she may not be earning a salary. Or there could be pressure on him to earn more to pay for medical and other costs not covered by health insurance plans.
Despite popular opinion to the contrary, says Lewis, most men do not lose attraction to their wives due to body changes including mastectomies or weight loss or gain; it’s poor communication that often causes increased tension and problems in the relationship.
This is why Lewis originally designed Helping Her Heal in Seattle in 2002, and why researchers and clinicians at PMH recently collaborated with Lewis and her team to adapt it and pilot-test it here in Canada. (Best Health would love to see the program introduced across the country.)
The program involves five group sessions in which male partners meet with a facilitator and discuss ways they can improve communication and intimacy plus put in place healthier approaches to their own mental and physical well-being. Here is a summary of each of the five sessions:
‘ Anchoring to be strong for her invites the spouse to describe his experience with his wife’s cancer and how he is coping with it, including what is working and what is not. The session helps him learn and practise stress-reducing strategies, including taking time for himself and finding an activity he can do every day for at least 10 to 15 minutes that is just for him.
‘ Listening and not fixing: letting go of Superman aims to get the partner to abandon his need to act, react, move and find solutions. The goal is for him to relax and learn to listen to what his wife needs and wants from him, rather than assume he has the answers.
‘ Gaining a deeper understanding of her assists partners whose wives may not be talkative or forthcoming about their needs and wants, and/or where communication may have already broken down. This session helps men respond to their partner, and to draw her out if she has withdrawn.
‘ Connecting with her includes creating space for special times’activities that may not involve talking’that the couple once shared and loved doing together. The goal is to get the attention away from the cancer.
‘ Putting the pieces together is implementing long-term strategies to keep the communication open and to keep the special times going.
Fortunately for Sandra and Rob, that cancer scare last May turned out to be false. But in the long run, it was a blessing. ‘This time, we turned to each other to get through it,’ says Sandra. Rob adds: ‘You hear stories about how relationships can become stronger when couples survive an ordeal together. It’s been two years since Sandra was diagnosed with cancer. We’re only now getting to a place where we can communicate properly. We feel like we’re going to get through this with each other.’
This article was originally titled "Saving lives’and relationships" in the October 2010 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!’and make sure to check out what’s new in the latest issue of Best Health.