The Impact on a Couple

The shock of a cancer diagnosis will be shared with those close to a patient. For some, it will bring a couple closer together but for others the relationship will be painfully challenged in many different ways, emotionally and physically. Here are some of the things that might happen.

It may be that the patient, the one who has always looked after everyone else’s needs, has become the person who needs to be looked after. This change is hard for the patient and for those who have depended on them. There can be feelings of resentment or anger which can be hard to own up to and resolve.

The diagnosis may bring up difficult feelings about experiences from the past – experiences of loss, experiences of physical attack or invasion or feelings of shame.

Couples may find it difficult to share what they are feeling as they want to protect each other from the painful thoughts about the future. They find their communication skills are not good enough for such uncertain times.

It may be that the treatmentis over but that the patient or the partner cannot ‘move on’.

A partner may be so frightened at the thought of being alone after many years together that they withdraw and cannot support the patient, even though they love them. This is incredibly painful for both individuals at a time of crisis.

Treatment may have included surgery which has altered his or her body. This may lead to fears of rejection or actual rejection. While the patient is trying to come to termswith the change, the partner may be struggling too. Both can find it almost impossible to talk about what they are feeling and how they imagine it might be for the other.

Finally, all this may be experienced as an attack on their sexual identity.

Psychosexual Health

When someone is given a diagnosis of cancer, it is often very traumatic. Sex and sexuality are overshadowed by fear of pain and treatment and possible death.  “Will I survive?” becomes the overriding focus of the patient’s thoughts. The couple’s intimate relationship may completely take a back seat. This is deeply upsetting for both as this contact can be a very important support, allowing them to feel loved and connected however much the treatment impacts physically. In addition, the patient may be challenged by changes in their body which make the sex they are used to difficult or impossible.  They need to find a ‘new normal’ so that they can continue to make love in one way or another.

During treatment, most people focus on getting well.  Sometimes the treatment feels like kill rather than cure and sex is not top of the agenda. In counselling, you will have the opportunity to address the question of intimacy and how you, the patient or couple, might approach any difficulties that have arisen so that you do not lose this important source of connection at a very difficult time.

Post-treatment is known to be one of the really challenging stages of the cancer trajectory. There will be all the feelings addressed in the section AFTER THE TREATMENT and there may be more. For example, you may think “I feel so unattractive following surgery. I feel mutilated and invaded. I have lost my confidence and my self-esteem and I worry whether my partner still finds me attractive.” Onformation commonly given about the post-treatment stage often does not address the sexual aspect of life after cancer. There may be some reference to the difficulties posed by an altered body and body image but there is often little thought as to what to do about it.

At Cancer Counselling London we understand that this may be one of the most difficult issues to face and we can offer specific psychosexual counselling to help you find your own solutions.

Here are some of the issues you might want to address with your partner and a therapist:

IDENTITY

• Attack on identity and sexual being
• Impact on desires, attractiveness, possibility of sex

RELATIONSHIP

• Fear of rejection/actual ejection
• Partner’s fear of hurting the patient
• Fear of contagion
• Sexual relationship at risk
• Fear of death overshadows sexual feelings of both individuals
• Fear of disclosing illness and impact on body in new relationships

PHYSICAL

• Lack of desire affected by both diagnosis and treatment
• Difficulty in arousal due to fear and treatment
• Impotence
• Penetration painful or impossible
• Orgasm difficulties
• Loss of identity
• Loss of fertility
• Loss of sexual health, trust in body

All these are common possible side effects and there are ways to address them all. In a confidential setting with an experienced counsellor it will be easier to identify the problem and then find practical solutions, ones that will help you to continue to have a healthy and satisfying sexual life.