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Cancer can have a big impact on the people close to you, including your partner, family members, friends, and colleagues.

Sometimes, the complex feelings and lifestyle changes that you experience as a result of cancer and its treatment are experienced just as intensely by your loved ones. This can have a big impact on the way that you interact with one another, sometimes leading to changes in your relationships.

By understanding what form these changes are likely to take, you can take steps to foster healthy and mutually supportive relationships while dealing with the challenges of cancer treatment and recovery. Below we provide you with information on how your cancer can influence relationships with your partner, family members, and children. We also offer some helpful tips on how you can keep the channels of communication open with those you care about.

Cancer has the greatest impact on marriages and other long term partnerships. It is not uncommon for partners of people with cancer to experience sadness, anxiety, anger, or even hopelessness when learning of the diagnosis. You might also find that your relationship with your partner functions changes following your diagnosis and treatment.

In particular, there may be changes in the roles that you and your partner typically enact (with things like household chores or family activities for example). It is important to remember that the effects of cancer vary from couple to couple. While some people find that the challenges of cancer place significant strain on their relationship with their partner, others find that facing these challenges together strengthens their relationship and commitment to one another.
Below we describe some of the changes that you might notice in your relationship with your partner while you go through your treatment and recovery.

Roles - Cancer can sometimes change you and your spouse's roles in quite unexpected ways. Your partner may want to try and take charge of what you are going through, in an effort to gain some control over the situation. For example, they may want to learn a lot about your cancer, organise and schedule your treatment appointments, and communicate with your healthcare team on your behalf. This can affect the flow of information between you and your medical team. In some cases, it can be very helpful for you, making it easier to cope with it all. However, in others you might want to take a more active role than your partner is allowing.

It is not uncommon for changes in roles to affect a person's self-esteem. You might feel frustrated if you are experiencing your partner to be over-protective, or isolated if they are not involving you in the decision-making process. It is important to talk with your partner about your feelings, and work together as best you can to make decisions about treatment, caregiving, and other issues. It may help you to think about it as teamwork and plan your strategy together. Be specific about the roles that you each would like to fill, negotiating who should take primary responsibility for different aspects of your care. The key is to remain flexible and openly discuss with your partner what is working best for you.

Responsibilities - In most relationships, each person is responsible for certain tasks. For example, one of you may be responsible for doing gardening and cooking while the other is responsible for cleaning and paying the bills. Head and neck cancer can limit your ability to keep up with these sorts of responsibilities, making it necessary for your partner to take them on instead. This is in addition to the added responsibility of caregiving that your partner must contend with. Your partner may even need to take on extra hours of paid work if you are required to stop working during your treatment. These added responsibilities can become overwhelming and lead to feelings of frustration and resentment. Meanwhile, you may feel guilty for burdening your partner and feel sad and frustrated by your limitations.

It is important to keep in mind that both you and your partner can benefit from taking on new responsibilities, particularly if this will best assist your recovery from head and neck cancer and its treatment. However, if you or your partner is finding that your responsibilities are becoming too much to cope with you can get help with managing these from friends, family members, or professionals.

Needs - Your physical and emotional needs (and those of your partner) will change as you cope with cancer. During and following your treatment you may find that you need help with basic activities of daily life, such as chewing and swallowing, speaking, or getting dressed. However, your partner may not always be aware of exactly what you need. Because of this, it is important to talk openly with your partner being sure to express your needs clearly. This can help to avoid any frustration or anger that may arise from misinterpreting your partner's behaviour and make it easier for your partner to support you in the best way that she or he possibly can.

Sexuality and Intimacy - Another important aspect of your relationship with your partner that can be affected by head and neck cancer or its treatment
is sexuality. Depression, fatigue, nausea, erectile dysfunction, vaginal dryness, and other physical or emotional problems may lower sex drive or make intercourse difficult or painful. This may cause the both of you to feel anxious about the issue. However, it is not always easy or comfortable to discuss, with every couple having varying levels of comfort when it comes to talking about sexuality and intimacy.

If you are finding that intimacy problems are negatively impacting you and your partner but are unsure about how to resolve them, speak with your cancer support person to find help on how to manage sexual side effects and maintain intimacy. She can also help to facilitate discussions about sexuality and intimacy between you and your partner.

Plans for the Future - Cancer can change the hopes and dreams that you and your partner have for the future. For example, your plans for retirement, travelling, or even parenthood may change, causing feelings of sadness, frustration, or anger. In order to counteract these feelings, it can help to focus on the present and the short-term goals that you share (such as getting through cancer treatment). While doing so, you can put your longer term goals on hold rather than abandoning them completely.

Communicating with your partner
Based on the above, it seems that the best way to manage any changes in your relationship with your partner is for the both of you to communicate openly and honestly about the way you are feeling. However, the complex emotions and lifestyle changes that follow a head and neck cancer diagnosis can make communication challenging. Even couples who previously communicated well may struggle to talk about cancer. Below we have some suggestions for ways to make communication between you and your partner easier during this difficult time. 

Try to be as open as possible with your partner about the details of your diagnosis and treatment. While you might think that you
are protecting your partner by withholding this information, it may cause the both of you to experience feelings of isolation and disconnectedness.
Talk about treatment options with your partner and work together to make treatment decisions. Think about what you most want out of your treatment; this might be surviving as long as possible regardless of the difficulty of treatment, or it might be maintaining a specific quality of life (even if this means stopping treatment at some point). If you are finding it difficult to talk with your partner about these things it can help to have a professional provide guidance. Your cancer support person will put you in contact with someone who can facilitate this.

Schedule a time to talk with your partner when you are both free from distractions and not rushed. Some couples find that scheduling a
daily time to sit down and talk works well. If you have something especially difficult that you would like to discuss with your partner it may help to practice what you want to say or even write notes for yourself beforehand. This can help to make sure that you get a chance to express what has been bothering you and not get side tracked by other topics.

Remember that you don't always have to talk about cancer. It can be helpful to talk about
other things that have been going on, such as what the children or grandchildren have been doing, interesting movies or books that you have come across, or the latest news and current events. These things can serve as a nice distraction from everything else that is going on. You may even agree that for one evening you won't talk about cancer.

You may find that you have a different way of coping with stressful events than your partner. For example, one of you may see cancer as a problem that needs to be solved, while the other views it as something that they need validation and emotional support to get through. This can result in you and your partner needing different things when you communicate. Talk with your partner about the differences in the way you cope and think about what you can do to accommodate these.

Be honest with your partner about your feelings, regardless of whether these are positive or negative. Emotions such as anger, fear, frustration, and resentment are very normal reactions to cancer but sometimes couples don't want to discuss these, for fear of upsetting one another or because they feel guilty about having negative thoughts. However, this can make it very difficult for your partner to know when you are in need of support and comfort. In contrast, sharing with your partner how you are feeling physically and emotionally helps them to understand the challenges you are facing and
gives them an opportunity to support you.

Recognise that you and your partner will not always feel the some way and that this is okay. Sometimes you may feel scared, while your partner is feeling hopeful. Talk about these differences and try your best to respect one another's feelings.

Let your partner know specific ways that they can provide you with the support and encouragement that you need. For example,
sometimes you may need some quiet time alone and other times you may need your partner to lend an ear or provide you with a shoulder to lean on.

Diana Ayling