Breast cancer is a disease that affects the whole family. So, what can a woman do to cope with the emotions of her spouse, especially when her treatment could involve a mastectomy? Dr. Mary Jane Massie, Attending Psychiatrist at Memorial Sloan-Kettering Cancer Center, offers some excellent advice for couples facing a breast cancer diagnosis and its treatment.
I'm Lisa Birnbach. Breast cancer is a disease that affects a whole family. So what can a woman do to deal with the emotions of her spouse, especially when her treatment could involve mastectomy?
Joining us is Dr. Mary Jane Massie, a psychiatrist at Memorial Sloan-Kettering Hospital in New York. Dr. Massie, thank you for joining us today. Is it important for a patient to encourage her spouse or partner to talk about his or her feelings?
I think couples have different communication patterns. But I think that what we don't want to be set up when there's cancer in the family is the conspiracy of silence. I'm ill. I'm guessing what you're thinking. Of course, I may be guessing wrong. I can't talk about this because this may upset you.
But when we have those attitudes, our partner often thinks that then certain topics are off the table or can't be talked about. So the more we can talk with each other about our shared fears-- because of course they're shared feared-- the more we can talk with each other about how we're going to manage life disruptions, although cancer treatment is required right now, the better off a family's going to be.
I would think that mortality is the primary fear.
It is. And I think that really should be addressed and is addressed by most cancer doctors, cancer specialists. That everybody realizes that whether those words are being spoken, that those are the fears that's in everybody's head.
I suppose this wouldn't be a bad time to say and remind everybody watching that early detection usually means long-term survival.
Should a partner share all of his or her feelings? What if I'm very-- what if a partner is very upset, thinks that his partner will be very unattractive with one breast, or with fake breasts, or is terrified of seeing his partner bald? Should he or she let the patient know or keep that to himself or herself?
Increasingly, husbands, partners, are asking for consultation with the oncologist or with a mental health professional to talk over, how do I best communicate? Should I be brutally honest? What will be helpful in my communications right now? What might be hurtful?
Because I think it's well known at this point that the couples who will do the best through cancer treatment and at the end of cancer treatment are couples who are effective communicators. And yes, some coaching. So a partner gets some coaching about what is most useful. That can be very helpful.
Dr. Massie, I would think that sexually, this is a very difficult time. A woman still wants to feel sexual. Or a partner still feels that kind of affection for her. And yet, maybe she feels damaged.
You said such a key word. Affection. When we have just been told that we have cancer or after our first chemotherapy treatment, we may not be feeling very sexy. But we certainly have a need for affection.
And I think we can communicate our love and our concern by touching, and caressing, and hugging, and kissing when someone doesn't feel like having an intimate relationship that evening.
I think that when we're particularly worried, or when we are in pain, or when we have some trouble, some side effects from chemotherapy, sex may really not be in the front of any woman's brain. But I think that can be talked about with a partner.
What if a patient's spouse or partner really doesn't want to talk about it?
Many of my patients have recommended that their partner or their spouse read the book Breast Cancer Husband. That book was written by a man whose wife was treated for breast cancer. And that particular book, the written word, has been very useful in letting men or partners understand what the partner goes through.
And how can a patient allay her partner's fears when she herself is fearful?
I think that maybe it's best for the couple to acknowledge that they have the same fears.
Thank you, Dr. Massie.
For more information, please go to Susan G. Komen for the Cure at www.komen.org, or call the Komen for the Cure helpline at 1-800-IM AWARE. I'm Lisa Birnbach.
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