So you got the diagnosis no one ever volunteers for: metastatic breast cancer. Deep breath. It’s a challenging disease for anyone to face and to muddy the waters even more, it can put a strain on even the most solid relationship. Now, more than ever, it’s crucial to open the lines of communication with your partner. “With this diagnosis, it completely changes the life of not only the patient, but the whole family, says Geeta Nampiaparampil, M.D., a psychiatrist at the Miami Cancer Institute. “It’s especially important that partners learn good communication skills and are open and honest with each other about their concerns.” These tips will help you navigate the relationship stress that inevitably arises with an MBC diagnosis. More than just managing this rollercoaster ride with your partner, with a little luck, you may come out the other side even stronger than before.
Address Your Feelings
It’s a simple-sounding but difficult-to-execute piece of advice: Be honest about your emotions right now. “Both partners can be inclined to hide their fear or avoid talking about the situation,” says Sanam Hafeez, Psy.D., a neuropsychologist in New York City. “This only puts unnecessary stress on a couple already going through so much. Being honest about how you’re feeling during this time helps avoid isolation within a relationship.”
Right. So, how to have these convos? Start by remembering it’s not just a one-and-done event. The dialogue needs to be ongoing, so if you don’t say everything you want in your first go-around, there will be more opportunities down the pike. To make sure of this, pencil in a regular “check-in” time each week where you and your partner sit down and listen to each other’s feelings. During these sessions, make a rule that when one person talks, the other person can only listen or ask questions. (“How does that make you feel?” and “Is there anything I can do to help?” are good ones.) Questions indicate someone is paying attention and wants to know more, which creates a safe, supportive space for each person to share their feelings.
Specifically, ones that have nothing to do with chemo, checkups, or therapy. When you’ve got a calendar X-ed out with doc appointments, it’s super important to make time for a dinner out or a weekend away. Mark it on the calendar along with all the other medical jumbo, and make a pact that when the date starts, you leave the cancer talk at the door. “It’s important to do things and plan things that are not related to cancer and devote time to returning to the roots of your relationship,” says Dr. Nampiaparampil.
Look, the two of you got together because your strengths and weaknesses balanced each other out, right? Cancer has an effed-up way of turning that sense of equal-ness in a relationship upside-down. And when one partner takes on more of a caregiver role, it can easily leave the other person feeling dependent, even powerless. While necessary at times, it’s also important that the sense of give-and-take in your relationship stays as normal as possible. “Keep relying on each other as partners,” advises Hafeez. “Make sure the caregiver isn’t taking on too much. This includes chores, decision-making, medical care, and emotional support.”
Because the natural inclination of your partner may be to do as much for you as possible (hey, they don’t call it love for nothing!), you might want to create a weekly chores chart (yes, like the kind you had as a kid). Each of you can initial certain tasks, eliminating any awkward sense of “Should I do this for her or not?”
Shift the Focus
Clearly, you've landed the starring role in this metastatic breast cancer saga (we know, you didn’t ask to play it). But your partner needs attention, too. “In healthcare, I think we do a good job of asking the patient how they’re feeling, how they’re sleeping, and how they’re doing overall,” says Dr. Nampiaparampil. “Caregivers, though—we don’t often ask them how they’re doing. They may be suffering with anxiety and depression but feel they can’t say anything. And that can come out in all kinds of behaviors that are not good for your relationship.”
Take a minute to find ways to make your partner feel appreciated. That might mean asking your friend to take over driving duties for one of your treatment appointments. Or maybe you’ll surprise your partner with takeout from a favorite restaurant so no one has to cook dinner. Little gestures can go a long way toward balancing the relationship during these times.
It’s not only well-meaning friends and acquaintances who suffer from foot-in-mouth syndrome: Your soulmate can step in it, too, during these times when emotions are running high. “With metastatic breast cancer, a lot of times people don’t look as though they have what people think of as stage 4 cancer,” says Dr. Nampiaparampil. “Your partner may say ‘Oh, you don’t look that sick or tired,’” and mean it as a compliment, even though you truly feel like crap. Instead of bristling at an offhand comment, use it to further communication. Tell your partner how it makes you feel—and how you really do feel (and have a sense of humor about it, too—who knows, it could become your new inside joke!).
Talk About Sex
If sex is the last thing you feel like having right now, you’re not alone. It’s common to temporarily want to hit the intimacy pause button during cancer treatment. But with MBC, that feeling can conflict with another one, namely, if not now…? As always, honesty is everything. Also, be open to creative solutions. “Make it a point to keep the romance active,” says Hafeez. Think outside the bedroom box: Massages, cuddling, and even small romantic gestures like holding hands on a walk can go a long way toward keeping the connection alive.
You spent your life being tough and independent, so shifting into patient mode isn’t always an easy thing to do. But right now, let’s face it, it’s OK to let down your guard. “Sometimes patients feel they have to be stronger than they feel,” says Hafeez. “It can be hard to feel like you’re the cause of people worrying, especially if you’re someone who has always been the backbone of the family.”
As President Roosevelt famously said, the only thing you have to fear is fear itself. Acknowledging your uncertainty during this time can be surprisingly cathartic. “It’s important to accept that you’re scared and you need your loved one,” says Hafeez. Remember, feeling afraid doesn’t make you weak, it just makes you honest. Cut through the bull and tell your partner the truth—it will give you both a better starting point as you take this journey together.