As you process your emotions, gather information, and come to terms with your treatment plan, remember one important thing: The diagnosis is not only a shock for you — it’s devastating for your spouse or partner too. “A diagnosis of prostate cancer is shocking to the patient, and it’s shared with that patient’s partner; it’s shocking to him or her as well,” says Michael J. Morris, MD, a medical oncologist who specializes in prostate cancer at Memorial Sloan Kettering Cancer Center in New York City. While you and your partner may be understandably fearful and anxious, it’s important that you support each other through whatever lies ahead in your prostate cancer treatment.
Advanced Prostate Cancer: Next Steps as a Couple
According to the American Cancer Society, nearly 250,000 new cases of prostate cancer will be diagnosed in the United States in 2021. In those with advanced prostate cancer, the tumor has usually spread to other parts of the body, such as the bones or lymph nodes. Doctors classify this type of cancer as stage IV, or advanced. For many men, advanced prostate cancer cannot be treated successfully. “Patients with advanced disease have the additional burden of being told they’re not curable,” says Dr. Morris. “Both the patient and his partner are forced to think about a finite life span and issues around mortality.” That’s when it’s most important that they accept the diagnosis and turn to each other for emotional support. Couples react in many different ways when given a diagnosis of advanced prostate cancer, and you and your partner must do what’s right for you. Some join as a team, pulling together to face the consequences of the diagnosis. Others may become angry or refuse to accept the diagnosis. If you and your partner are experiencing such a reaction, counseling might be of help so the two of you can find ways to communicate and work together. You should involve your partner in your care and treatment decisions and be open regarding symptoms related to sex and lifestyle problems. Sometimes, especially when a doctor is delivering bad news, it’s difficult to absorb everything that’s being said. Having a spouse or partner there with you can help you remember what you need to know about your choices, including those involving your treatment. At this most difficult time for you as a couple, “there’s a sense of robbery, that the illness has taken away intimacy, and specifically, sexual intimacy,” says Morris. “There’s a real struggle to recover the sense of a life together, and how to be intimate without having sex. Even if you find a way to regain erections, libido is still lower on hormone therapy than without hormone therapy.” Morris suggests that couples find other ways to express intimacy if, for example, intercourse is no longer possible. Physical contact — hugging and caressing — can help you and your partner feel close even in the absence of the sex life you may once have had. Working with a sex therapist or couples counselor can also help you and your partner find ways to address sexual or relationship problems you may be facing.
Advanced Prostate Cancer Can Affect Your Spouse’s Health Too
In a study presented at the 2018 meeting of the European Association of Urology, Danish researchers questioned 56 women about the effect their husbands’ advanced prostate cancer had on them. Just under half of them reported that their partners’ cancer had affected their own health. The researchers then conducted in-depth interviews with eight of the affected women. Some of them felt socially isolated because their husbands’ fatigue — a common side effect of treatment — made it difficult for them to socialize as a couple, which made the women feel cut off from family and friends. They also felt alone, because they thought they had to be strong for their husbands and therefore couldn’t share their anxieties and fears. They were concerned as well about the need to take over some tasks previously carried out by their husbands. “We have 22 windows, and my husband thinks that he can still polish them and also do all the gardening,” one wife said. “But nothing happens, and he doesn’t want me to arrange professional help.” The researchers said that “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 need.” Good communication between partners, of course, can help ease some of each partner’s concerns. You and your spouse should be open about your feelings and your fears. Sharing emotions and worries can help mitigate the fear and uncertainty you’re facing. And don’t be afraid to ask for help when you need it. Be specific about the ways your partner can help — whether it’s helping with chores around the house, driving you to doctor’s appointments, or assisting with treatment decisions. You and your partner may also find it helpful to talk to a therapist, who can help facilitate open communication, or join a support group to share what you’re going through with people who are undergoing similar experiences. “People shouldn’t feel that they don’t need help,” Morris said. “Help is okay.”
How Your Oncologist Can Help
Oncologists can do much more for couples than merely manage treatment, said Morris. “The oncologist has to align with the couple on the best way of treating that disease. Just like we have to sort out the medical problems that are important for the patients, we have to deal with the psychological needs too.” What does he tell couples who are struggling or even turning away from each other? “It depends on why the couple isn’t allied with each other,” Morris says. “Some couples feel very frightened by the prospect of what the future holds, and for those couples, additional information is very useful. In addition to the information that you can give to the couple, you can also recommend other resources they can explore. To some, more information can be reassuring — here’s what the future holds, and here are the factors that play into that. “For others, it seems overwhelming, and information isn’t helpful,” he adds. “There can be a pattern of Web searching until it becomes an all-consuming experience, which feeds the problem. There is a happy medium between too much information and not enough, although that set-point differs from person to person.” Decide with your partner what type of information you want to receive and tell your doctor how much or how little you want to know. Then you can all work as a team to manage your care and treatment.
