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Survivorship: Relationships

Having cancer may change the way that a patient relates with family, friends, and colleagues.  Patients may find that the stress going through a cancer diagnosis and treatment strengthens their relationships with loved ones.  While some relationships provide much needed support, other relationships may unexpectedly lead to frustration.  In many cases, stress in the relationship is caused by misunderstandings and confusion of how to offer support to a cancer survivor.  Many want to offer support, but they just do not know how.  With open communication, these issues may be resolved.

After treatment ends, some friends, family, or coworkers may appear to show less support due to their belief that the cancer is gone.  They may seem unsupportive due to anxiety and other emotions; speaking with that friend, family member, or coworker can help to mend and strengthen relationships.  As survivors work through relationships to figure out what matters most in their life, some may choose to let some casual friendships go as they focus more on those that are more valuable and meaningful.


Family and Friends

In addition to dealing with their own feelings, a cancer survivor may also have to cope with their friends’ and families’ feelings of sadness and uncertainty.  Everyone needs recovery time, both the cancer survivor and those close to them. 

Family members and friends of different ages face different challenges.  For example, young children may convince themselves that they were somehow to blame for the cancer.  Teenagers, on the other hand, may find it difficult to cope because they may feel they have been forced back into the family just as they were beginning to break free and gain their independence.  Remember that silence can block communication and that open communication is critical to maintain healthy relationships.

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Intimacy
Changes that affect a survivor's sex life can be an important issue for many couples. Survivors may experience physical changes such as hair loss, changes in weight, surgical scarring, or alteration of body parts. Any of these can affect a person's body image and sex drive. If a survivor's appearance has been altered, he or she may fear their partner's reaction to the changes; open discussion is the best way to address this. Sexuality can be important to a person's identity and intimacy with a partner can be an important way to communicate, alleviate suffering, and to retain a sense of normalcy.

Some cancer survivors lose interest in sex. Even though few talk about it, this is quite common and is a normal response to extreme stress. When people are diagnosed with a life-threatening disease like cancer, survival is paramount and other activities, including sexual intimacy may be pushed aside. Some common issues that cancer survivors face include: worrying about intimacy after treatment, not being able to have sex as they once did, having menopausal symptoms, losing the ability to have children, and that the cancer may cause changes in the sex organs. Additionally, it takes time to adjust to fatigue and altered sensations that may come with surgery and other cancer treatments. Many of the problems are quite common and decrease as time passes.

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Impotence Not all of the sexual side-effects of cancer treatment are temporary. Nearly half of women who have been treated for breast and reproductive organ cancers, and over half of men treated for prostate cancer have reported long-term sexual problems. The problems often are the result of physical changes caused by treatment (i.e. surgery, radiation, chemotherapy, and certain medications), these issues are fairly common and it is important to discuss them with your doctor.

Many doctors trained in traditional Western medical schools learn ways to handle the functional aspects of patient sexuality such as fertility,  erectile dysfunction, or menopause. Often times however, their training does not prepare them to provide guidance about sensuality and intimacy issues. Some health care professionals avoid the topic of intimacy because it is not a 'life or death' issue, because they do not have experience in the area, or because they are embarrassed by the topic. For this reason, if a survivor experiences intimacy issues, it is important that they bring the topic up with their doctor. It may also be beneficial to talk with a counselor, psychologist or sex therapist. Approaching all of these issues openly will benefit everyone involved.

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Social Support Network
The people in a survivor's social support network include partners, family members, children, and friends.  It is important that these caregivers listen to the unique needs and concerns of their loved ones.  A survivor's social support network should be sensitive to their desire to share and gain information about their cancer, treatment options, and their prognosis.  Information about cancer can make a survivor feel more empowered and give them a sense of control.  A support network can greatly reduce the stress of dealing with cancer, so survivors should not be afraid to ask for help from loved ones and friends.  The people in a survivor's support network can help ensure that they get to appointments on time, help to pick up children, or just be there to listen.  Studies show that when survivors are able to freely communicate information with the members of their support network (family, friends, etc.), they experience lower levels of anxiety. 

For many cancer survivors, formal support groups are also helpful.  Support groups provide the opportunity for survivors to openly discuss survivor issues, get useful suggestions and even learn from the mistakes of others.  Most survivors who attend support groups feel more emotionally fulfilled, are able to get help managing side effects, and therefore experience less pain and anxiety.  The lack of an adequate support system is associated with higher levels of anxiety and consequently, a lower quality of life.

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