Family Life | Cancer.Net

Cancer doesn't happen to just one person. Cancer happens to couples, families, and friends. The complex emotions 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 can change the way you relate to your family and friends, and the way they relate to you.

The importance of communication

Cancer affects all aspects of relationships and communication becomes especially important. Lack of communication can lead to isolation, frustration, and unmet needs. People with cancer who don't discuss their illness often feel they are facing cancer alone. Talking about and sharing emotions and needs allows couples, families, and friends to work together to resolve problems and face difficult situations. When feelings and wishes are left unsaid, it is easy to be left with inaccurate, even hurtful assumptions, about why the people who care about you are behaving in a particular way. Sharing your sadness and fears also lets others know how much you care for and love them. Discussing feelings and problems with honesty, sincerity, and openness can greatly reduce the stress that cancer places on relationships. If you are experiencing communication difficulties, consider asking for help by joining a support group or talking with a counselor or social worker.

Spouses and partners

Due to the relationship's intensity and closeness, cancer has the greatest impact on marriages and other long-term partnerships. When cancer is diagnosed, both partners may experience sadness, anxiety, anger, and hopelessness. For some couples, facing the challenges of cancer together can strengthen 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 reinforces the importance of their relationship. For others who may have been experiencing significant problems before the diagnosis, the stress of cancer may create even more problems. While the effects of cancer vary from couple to couple, the following relationship changes are common.

Responsibilities change. In most marriages, each partner is responsible for certain jobs. 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 certain jobs, which will need to be done by the person who is well. 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, also take on the responsibility of caregiving, providing nursing care and emotional and physical support. These added responsibilities can become overwhelming, and may lead to frustration, resentment, and guilt. The person with cancer may also feel guilty for burdening his or her partner, as well as 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 frankly about one's limitations and brainstorming about possible solutions may make the situation more bearable.

Roles change. As with responsibilities, couples may assume different roles within their relationship following a cancer diagnosis. One partner may become the problem solver who deals with practical issues, or the caregiver who looks after everyone. Cancer changes roles in relationships, often in unexpected ways. Some spouses become overprotective or assume a parental role. Some partners take control and forget to include the other partner in decisions that impact the family. Adjusting to a shift in roles may cause a problem for some. A person who was previously always in charge may have trouble adjusting to a more dependent role, while the caregiver may have trouble being taken care of.

Because self-esteem is tied to fulfilling our roles in relationships, the inability to do so can cause sadness and feelings of worthlessness. Either partner may be frustrated by the other's overprotectiveness, or feel isolated when decisions aren't discussed. Talk to your partner about your feelings and work together to make decisions about treatment, caregiving needs, and other issues.

Needs change. Since physical and emotional needs change frequently as couples cope with cancer, it is important for both partners to communicate their needs. It can be very difficult to ask for help getting dressed or to tell your partner when you need some time off from caregiving. 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 you to say it more often.

Sexuality and intimacy change. The physical and emotional impact of cancer and cancer treatments often affect sexuality. Depression, insecurity about one's changed body, fatigue, nausea, erectile dysfunction, vaginal dryness, and other problems can lower sex drive or make intercourse difficult or impossible. Both partners may experience anxiety about their sexual relationship, but be reluctant to discuss their feelings. Tell your partner how you are feeling and find ways to maintain intimacy through gentle touching, kissing, and physical closeness.

Hopes for the future change. Cancer can drastically change the dreams and hopes that couples share. You or your spouse's plans for early retirement, traveling, or even parenthood may need to be temporarily put on hold, causing immense sadness, as well as 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 an enhanced outlook on life. Things that seemed important before may give way to new priorities, such as enjoying more time together. It may also help to avoid an all-or-nothing approach by putting goals on hold rather than abandoning them completely.

Friends and family members

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

Expect relationships to change. Many people have little experience with life-threatening illness and don't know how to act when someone has cancer. Your cancer may be frightening to some, as 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 devoted 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 to you 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 have a conversation about another topic or 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 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. 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 including 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 exhausted.

Children and parenting

Being a parent with cancer presents unique challenges. The demands of cancer and treatment can make it difficult to take care of young children. Adult children may be available to 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 enormous.

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 they are unexpected.

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.

Additional resources

Lance Armstrong Foundation: Communicating with Your Partner

American Cancer Society: Coping with Cancer in Everyday Life

American Cancer Society: Talking About Cancer

CancerCare for Kids

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