In Sickness and In Health: The Breast Cancer Husband

Patient Expert

Author Marc Silver explains the do's and don'ts for husbands of breast cancer patients.

When writer Marc Silver's wife Marsha was diagnosed with breast cancer in 2001, he realized he needed help getting his wife through her health crisis. Unfortunately, there were no books aimed at guiding husbands of breast cancer patients. So he wrote Breast Cancer Husband: How to Help Your Wife (and Yourself) Through Diagnosis, Treatment and Beyond. The book covers a range of topics -- from what to do in the early, frantic days of diagnosis to defusing family tension to explaining various treatment options. Silver also includes a chapter on an often taboo subject: everything you want to know about sex and breast cancer.

Silver found that most men are unaccustomed to being the family caretaker, and their instincts are often dead wrong. He spoke to Beth Brophy about what he has learned about being a good breast cancer husband:

You write in your book that you didn't get off to a good start as the husband of a breast cancer patient. What did you do wrong?

Just about everything for the first three or four days. When Marsha, deeply distraught, called me after her mammogram to say that the doctor thought it looked like she had cancer, my reaction was, "Eww, that doesn't sound good." Then, instead of rushing home to be with her, I stayed in my office all day, in denial. As bad as I was, I've heard worse. One guy told me his response to his wife was, "You're kidding." And another guy told me that on the way home from hearing the diagnosis, he asked his wife if she wanted to go car shopping.

Why are men, in general, bad at being caretakers?

Lack of experience. Even in 2005, most of the family caretaking tasks fall to women. Guys have the urge to fight and to fix. Still, there are lots of things you can do for your wife that are tremendously helpful, even if you can't fix her cancer. For example, you can go with her to her doctor's appointments and be another set of ears for her. You can hold her hand in the waiting room. Don't try to be a cheerleader. If my wife was cheerful all the time it would be easier for me. But she gets depressed and mad sometimes, and I've had to learn to let her be. Also, when treatment ends, guys want to close the box. But it's not over for your wife. Symptoms and side effects and fears linger on for a lifetime.

Typically, what do husbands get wrong the most?

Often, guys don't listen. They play the denial game. They don't want to admit how serious it is. They deal with their fears by working harder, staying at the office late, holing up in the den at home. They don't want to deal with their wife. They want her to work as much as she used to. But you can't pretend nothing has happened. You're not going to have the year you wanted to have. You're facing surgery, chemotherapy, radiation.

You based a great deal of your book on interviews. What was the most surprising thing you learned from interviewing couples?

That every couple copes differently with breast cancer. There are no set steps you can follow. For instance, on a practical level, for many couples, the husband's job is to gather information online. But some husbands don't want that job, so their wife or other family member becomes the information gatherer. Everyone wants a different level of information, and that's fine.

Every couple works it out differently. There may be certain times when it is kinder to not burden your wife with your feelings. The husband can admit that he's scared, but also emphasize that "we'll get through it together." The patient needs to think that her advocate is solid and there for her, not having a meltdown.

I cried in the car one day. I thought I was going out of my mind. A song on the radio made me cry. I never told anyone. Then, while I was doing the book, I found out lots of guys cried in the car. Your emotions are stored up inside and they have to come out.

It's hard for men because lots of guys only confide in their wife. They have no network of close friends. They feel dread: What if she dies? How am I going to raise the kids? It helps to understand that these feelings are normal. I think women are more used to playing out these scenarios in their head than men.

You say the motto of a breast cancer husband should be "Shut up and listen." Can you elaborate?

We're programmed to fix things, to protect our family. Lots of guys want to take charge of the cancer experience. But your wife won't always follow your advice. That's part of the process. But it's still valuable to tell her what you think. And to be there.

The simplest way to find out what your wife needs is to ask her. A back rub? A list of questions to bring to the doctor? Of course, it's hard for women to ask because they are used to being the caregiver.

Does a good husband have to be totally selfless and devoted to his wife every moment of her illness?

Of course not. Everyone needs down time. It's important to play golf, or go out with your friends for a couple of hours to relax. But you will be busier picking up the slack at home on tasks your wife used to handle. If you have kids at home, Dad should become the go-to guy because Mom may feel wretched. Because our kids were older, 12 and 15, I assumed more of the transportation functions. I ran around more, doing groceries and laundry while my wife was in treatment.

What did you learn in your research about the impact of breast cancer on a marriage?

It's impossible to predict how breast cancer will affect a relationship. Some couples are able to pull together to fight the cancer as a team. Sometimes your marriage can be on the rocks and you come back together. Or a seemingly OK marriage can unravel. Breast cancer is a big stress, not a little stress.

And I heard lots of horror stories, about men cheating on their wives during chemo, about one woman who thought her marriage was perfectly fine before, but her husband went into denial and wasn't there for her when she wanted some understanding and attention. He couldn't rise to the occasion. Their marriage broke up. I even heard about one husband who left his wife, telling her it was because he couldn't stand to see her suffer.

But most men don't leave their wives.

What happened in your own marriage?

Our marriage is stronger. My wife knows I'm there for her, except for those first few days when I did everything wrong. And that's a powerful piece of knowledge. We say, "I love you," to each other more than we ever did. We make a point of saying it and meaning it. We're still a normal couple. We squabble. I'm sloppy. She's neat. We have our ups and downs. But we have a deepness of feeling that wasn't there before.

In your book, you talk about the concept of a "new normal" after a woman's treatment ends. Explain what you mean by a "new normal."

You and your wife are entering a new phase of life. You can never go back to life the way it was. Breast cancer is now a member of your family. As time goes by, the disease may fade from your mind, like a distant relative you don't really care for. But you cannot rush the process. It's only natural that the process is faster for the husband than for the wife. Your wife has more fatigue, and her body may continually remind her of breast cancer. So she still needs your patience and understanding.