How breast cancer can impact relationships
Pip Bell, a breast cancer nurse with the McGrath Foundation offers some tips which may help couples navigate through this difficult time.
A breast cancer diagnosis and ongoing treatment can have a significant impact on relationships. For some, it brings them closer together while if other relationships were already experiencing difficulties before the diagnosis, this added trauma and stress can drive them apart.
A woman with breast cancer may experience feelings of loss in many aspects of her life including confidence, control, well-being, financial, loss of a breast and lifestyle. Treatments can be lengthy and exhausting leaving side-effects and little energy for enjoying relationships to the full.
Being the partner of someone with breast cancer can also be very difficult and common feelings are shock, anger, fear, anxiety and acceptance and these emotions can affect partners both emotionally and physically. It can be a demanding time for partners who want to stay involved with the care to be the advocate and reliable strength.
1. Loss of confidence
Surgery and treatments for cancer can impact on a woman’s self-esteem and the way they feel about their body. As much as possible, it’s good to remain active. Physical activity helps creates energy and may help the person feel better during treatments. Physical and social activities can help the person escape the world of cancer and focus on something beneficial.
2. Loss of control
Accepting a cancer diagnosis and undergoing treatment may change a person’s life and it can take time to regain strength and vitality after surgery and treatment. Cognitive functions (decision making, memory and being able to multi-task) both on a personal level and also in the work place at the high level prior to the diagnosis may be delayed. Allow time to adjust.
We encourage people to acknowledge the trauma that they’ve been through (or are still going through) and to treat themselves with compassion and kindness and to focus on their strengths. We also encourage them to seek counselling if they need professional support.
A professional can help the person cope and understand worrying feelings and deal with physical changes but it’s mainly about people giving themselves time to go through the process and healing from a traumatic situation.
3. Loss of wellbeing
People often suffer side-effects from treatments and medications that may linger and make them feel generally unwell or easily fatigued. Depression and anxiety may also impact on well-being in addition to such things as disturbed sleep, family and employment problems or negative thoughts about the future. We encourage people to build a network of people who can offer support in different ways and help them feel hopeful.
Ask for help and accept help. Asking family and friends to assist helps free up time to concentrate on healing both emotionally and physically. Talking to other people who have been through a similar situation though a support group or one-on-one conversations can also help to provide empathy and hope.
4. Loss of finance
Breast cancer can create a lot of expenses including medical bills and loss of income through time off work. People may also have incurred additional expenses to employ people to help around the home or with family life in general to help them get through this disturbance. It is best for people to speak with their doctors, breast care nurse or social worker who can assess the situation and advise them about financial benefits that may be available to them.
Financial help to patients is available from a number of sources in the form of travel allowances, payments and assistance including rebates, legal information and financial counsellors. It is also helpful to speak with the local Medicare office about safety net levels.
5. Loss of a breast
The physical recovery after surgery is important however in addition, women may also require time to recover emotionally after the loss of a breast. Talking with a breast cancer nurse about thoughts and feelings is recommended.
Breast care nurses understand that women adjust differently to their bodies after surgery and the breast care nurse can offer reassurance, information and support to all women both face-to-face and by telephone to enhance feelings of well-being.
Breast care nurses can provide reassurance and support to women as well as information about bras, prosthesis, swimwear, exercise wear and breast reconstruction in addition to linking patients with other health care professionals.
6. Loss of lifestyle
Planning a holiday may be difficult when people aren’t sure of their treatment dates, durations, or how they may be feeling due to side-effects. People may also feel fearful of becoming reliant on others during their treatments.
A good approach is to try to remain flexible during treatment times and accept plans that can be changed. The medical team and breast care nurse are focused on preventing and controlling side effects and concerns. These days, side-effects are often anticipated and can be prevented prior to treatment starting or managed well with medication and they often resolve after treatment. Many treatments used today are less intense and quicker than previous treatments available.
7. Loss of intimacy and libido
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During a serious illness it’s important to acknowledge that sexuality may switch off, which is a natural physiological response. Reproduction is not necessary for survival and the body’s energy, not to be wasted, is directed to combating the disease. In addition to stress, pain and tenderness a woman may have an altered self-esteem and experience fatigue.
It’s important for partners to be understanding that this may not be a time for desire, and be sensitively aware of what their partner is going through. It is important for the partner to just be there solidly, emotionally, verbally, physically with love and tenderness, and to know that energy levels spontaneously return during the phase of well-being.
Some helpful interventions include vaginal lubricants, a change of position, massage and talking about ideas to increase sexual pleasure. Support groups often share advice that extends to the bedroom. Sex therapists, psychologists, psychiatrists, GPs and breast care nurses understand and can offer suggestions about intimacy and sex issues to people with breast cancer.
Friends, family and partners can have days when they feel positive and other days when they feel frightened and devastated. They may seem consumed with negative feelings about the future and their relationship. They may keep these feelings to themselves and put on a brave face to show the outside world they are strong, loyal and in control of the situation. Friends, family and partners need support with their own feelings.
Doctors, breast care nurses, social workers and psychologists and breast cancer are aware of this and can offer help. They may have knowledge of support groups or regular meetings for carers within the community.
At Bupa, we’ve teamed up with the McGrath Foundation to support breast cancer awareness and the work of McGrath Breast Care Nurses.