Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The unhappy couples after a cancer diagnosis

Anne Katz, RN, PhD
Conditions
May 26, 2017
88 Shares
Share
Tweet
Share

asco-logoThe couples I see for counseling are not always perfect, not that any couples ever are. But when cancer enters the relationship, for some couples, things get ugly and get ugly fast. I believe that we like to think that cancer makes people “better”; that people rise to the challenge and become the best they can be. I think that we like to believe that all our patients and their partner/family experience personal growth and end up as better human beings after cancer than they were before. Perhaps it is human nature to hope that every cloud has a silver lining.

This does happen, of course. Couples grow closer, family grievances and feuds are put aside, and people learn that life is precious and fleeting and relationships are important. But there are also people for whom cancer makes things worse, and old grievances and feuds rise to the surface, and the parties refuse to let them go. I have had a number of such couples in my office recently. Couples who sit in their chairs facing me, arms crossed, not making eye contact with each other even when emotions are shared and tears flow. These are not couples who reach out to each other over the small table between them to offer comfort or empathy. They each sit there in their solitude, and one glares at me while the other beseeches me with their eyes to close the chasm that divides them. I try my best to get them to connect, to just look at the pain in the other’s eyes, just for a moment. There have been times when I have had to say, “Look at your spouse! Look into their eyes and tell them what you see!” Some can’t do that, despite my exhortations to try. Others glance across briefly, then look away. Do they find the pain unbearable or do they not care?

Mary* and Jim* are one such couple. She was diagnosed with breast cancer a year ago, and they sleep in separate bedrooms. She says it’s because he snores and she sleeps more soundly without him. Jim wants them to sleep in the same bed, but Mary prefers the solitude of her own room. She literally shuddered when he said that he wants to touch her. What else is going on that is not being said? Is his snoring the excuse she needs to keep him further than arm’s length? Their body language told a story: she sat with her arms crossed, seemingly trying to make herself smaller in the chair. Her posture suggested someone who was trying to protect herself, but from what? He is a large man who spilled over the sides of the chair, his one arm on the table almost invading the space that surrounded his wife. He wanted them to come back to see me, to learn strategies to get closer again, to move her back into his bed; she said nothing and her silence told a different story. I asked them to talk privately about what we could achieve in our work together; 3 months later they have not called for another appointment.

Another patient, Doug*, is convinced that his wife of 45 years is having an affair. He described a series of events to me that “prove” to him that she is cheating on him with someone from work. He has waited outside her office building to monitor her coming and going and once or twice he thinks he has seen the other man’s car leave at the same time that hers did. These thoughts consume his every waking moment. Since starting androgen deprivation therapy five years ago he has not been able to “satisfy” her, he says, and therefore he is convinced that she has found a replacement for him. When I met with them as a couple three months ago, she presented herself as a caring spouse who is confused by his possessiveness and mercurial moods. She has either refused to accompany him to our subsequent appointments, or he has not told her that he continues to meet with me.

And then there was the older man who has been seeing someone (or multiple some ones) other than his wife throughout the many years of his marriage. His wife may not know about this, or she may be happy to not be “bothered” for sex, but his long history of going outside his marriage challenged my core values.

Being part of a couple is not always easy. I have encountered women who, after 20, 30 or 40 years of marriage, walk away from their spouse after a cancer diagnosis. The cancer was a wake-up call, and they realize that they cannot stay in a relationship that is not affirming or loving, or is outright bad, any longer now that their time is more limited than they thought. I have seen men made vulnerable by their inability to perform sexually question their role in their relationship and challenge their partner to find someone else to satisfy them. Some are deliberately cruel in their misguided attempt to make their partner happy, as if they can be replaced so easily and just for sex.

For some reason, these unhappy couples stand out in my mind more than those who are happy and strong and trying so hard to connect with each other in the aftermath of cancer. We often remember our “failures” as clinicians more than our successes. And often those who are successful don’t need my care once they have resolved their problems or learned to live with their altered bodies. I understand why my oncologist colleagues like to see their patients for many years after treatment is over; it is so good to see those who are doing well rather than those who still struggle.

* Names and identifying details changed for privacy.

Anne Katz is a certified sexual counselor and a clinical nurse specialist at a large, regional cancer center in Canada who blogs at ASCO Connection, where this post originally appeared. She can be reached at her self-titled site, Dr. Anne Katz.

Image credit: Shutterstock.com

Prev

How to give constructive criticism as a physician

May 26, 2017 Kevin 1
…
Next

MKSAP: 57-year-old woman is evaluated after a recent screening colonoscopy

May 27, 2017 Kevin 0
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
How to give constructive criticism as a physician
Next Post >
MKSAP: 57-year-old woman is evaluated after a recent screening colonoscopy

More by Anne Katz, RN, PhD

  • Breast cancer’s silver lining

    Anne Katz, RN, PhD
  • Genital shrinkage is real. And so is the distress it causes.

    Anne Katz, RN, PhD
  • Do COVID restrictions in the office negatively affect patients?

    Anne Katz, RN, PhD

Related Posts

  • Hormone replacement therapy is still linked to cancer

    Martha Rosenberg
  • We have a shot at preventing cervical cancer

    Lisa N. Abaid, MD, MPH
  • Obstruction of medical justice: How health care fails patients with cancer

    Miriam A. Knoll, MD
  • Despite progress in cancer care, cost and equity challenges still must be addressed

    David M. Aboulafia, MD
  • Using the Avengers to explain how cancer treatments work

    Jennifer Lycette, MD
  • Is social media a friend or foe of science?

    Michael Joyce, MD

More in Conditions

  • The power of coaching for physicians: transforming thoughts, changing lives

    Kim Downey, PT
  • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

    Althea Halchuck, EJD
  • An obstetrician-gynecologist reveals the truth about reproductive planning and how to navigate society’s expectations

    Yuliya Malayev, DO, MPH
  • Nose-brain connection: The surprising link between allergies and mental health revealed

    Kara Wada, MD
  • Is the rise in mental illness due to greater awareness or a true increase in incidence?

    Zahid Awan, MD
  • A patient’s perspective on the diminishing relationship between doctors and patients

    Michele Luckenbaugh
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Raw humanity on night float: inspiring patient encounters and overcoming challenges

      Johnathan Yao, MD, MPH | Physician
    • Is AI the solution for the shortage of nephrologists? ChatGPT weighs in.

      Amol Shrikhande, MD | Tech
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why HIPAA is failing and what you need to know to protect your data [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • What Drug Did FDA Just Approve for COVID?
  • PET Scan for Alzheimer's Dx; Predicting Colon Cancer Survival
  • What Happens When We Classify Kids' Weight as a 'Disease'?
  • Sotagliflozin Gets FDA's Blessing for Heart Failure
  • Cardiorespiratory Monitoring Can Be Telling of Outcomes in Extremely Preterm Infants

Meeting Coverage

  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Trial Results Spark Talk of Curing More Metastatic Cervical Cancers
  • Cross-Border Collaboration Improves Survival in Pediatric Leukemia Patients
  • Monoclonal Antibody Reduced Need For Transfusions in Low-Risk MDS
  • Less-Invasive Surgery for Pancreatic Cancer Proves Safe, Effective
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Raw humanity on night float: inspiring patient encounters and overcoming challenges

      Johnathan Yao, MD, MPH | Physician
    • Is AI the solution for the shortage of nephrologists? ChatGPT weighs in.

      Amol Shrikhande, MD | Tech
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why HIPAA is failing and what you need to know to protect your data [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...