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Husband, partner, father... and caregiver

Author: Bridget McCrea

News of a cancer diagnosis is never easy to process. For many men, hearing that a spouse or a partner has been diagnosed can result in emotions ranging from anger and sadness to fear and guilt. Throughout the treatment and recovery process that follows, the emotional roller coaster will likely continue. It’s a completely natural response to the life-changing experience of a cancer journey. But although emotional challenges are inevitable, male caregivers can take steps to manage these responses, avoiding additional difficulties for themselves and their families.

Confronting difficult emotions

“The fact that men are taught from a young age to suppress their emotions means they aren’t always comfortable confronting emotions like sadness and fear,” says Linda Sullivan, LCS W, mind-body therapist at Cancer Treatment Centers of America® (CTCA) in Philadelphia, Pennsylvania. As a result, these emotions often segue into anger when feelings are charged and stress levels are high.

“Experiencing true emotions like fear, sadness, and anxiety can make a man feel vulnerable,” says Sullivan, who often works with families who are coping with the cancer diagnosis of a loved one. “Those feelings aren’t easy for a man to experience, so it’s not unusual for the emotions to manifest themselves into anger, which in turn is displaced on the person who is ill.”

Sullivan sees the result of this displaced anger in her work with female cancer patients, who often say things like, “My husband is so irritable and angry all the time.” Many times those patients then turn that anger inward, where it can result in depression, as the patient takes on the caregiver’s emotional burden in addition to their own pain and suffering.

Problem solvers

“Feelings of helplessness and frustration over their inability to ‘fix’ the situation are especially challenging for male caregivers,” says Sullivan. “Men want to know what they could have done differently to prevent the illness,” she says, and “there’s a lot of Why us? and Why me? going through their minds during this time.”

Faced with a problem they can’t solve, men are often also thrust into a more domestic role that provides added challenges. “Accustomed to their role of breadwinner, they must now step out of that box and take on child rearing, domestic responsibilities, household chores, and the care of elderly parents,” Sullivan says, all of which can be overwhelming. “The additional workload and responsibilities can take their toll, not only on the individual but on the entire family.”

The already-difficult situation can be intensified when men won’t reach out for support or professional help during this time. “There is this outer façade that men are strong and that they have to be all that they can be for everyone around them,” says Sullivan. This tendency can be unhealthy, she says, for men who then cope with the situation by withdrawing socially, overindulging in food and alcohol, or living in a state of denial.

Expanding roles

The good news is that there are some simple strategies men can use to not only cope with a loved one’s illness but also manage their added responsibilities during this time. Here are six ways Sullivan says men can manage the situation in a positive way:

Establish a spiritual connection. If you haven’t visited your house of worship in years, now is a good time to get reconnected. “I worked with one man who invited the bishop over to his home to bless it,” says Sullivan. “He was convinced that doing so would bring about a miracle and make his wife well. While the strategy may sound idealistic,” she says, “it can be extremely healing and cleansing to turn to spirituality during this difficult time. People cope in the ways that they know how.”

Let go of the Why me? attitude. Viewing cancer as a curse and wondering what could have been done to prevent it is a common reaction to the illness. The problem is this attitude doesn’t help make things any better. In fact, it can result in even more depression and anxiety. “Sometimes, you just have to realize that things happen in life that you can’t prevent,” says Sullivan.

Turn to the healing arts. You may have never considered attending a meditation or yoga class, but as you work through the issues associated with cancer, these relaxation and exercise techniques can help instill a sense of calm. Simple, meditative breathing and visualization methods, for example, can help you better cope with the perfectly normal feelings of anxiety, anger, sadness, and guilt.

Pay attention to harmful behaviors. If you’re using alcohol as a crutch, it’s time to look elsewhere for comfort during this difficult time. Other behaviors to be aware of include excessive exercise, overindulgence in food, and withdrawal from your regular work and social routines. “This is a time when your own self-care is important,” says Sullivan, “so be mindful of any behaviors that are affecting your own health and emotions.” Accept the fact that there will be good days and bad days. “Be hopeful and optimistic,” Sullivan advises, “knowing that it’s also okay to feel sadness and fear about the illness and its impact on your life.” By balancing those natural emotions with a positive outlook, says Sullivan, you can help create a more harmonious family life during this difficult time. “Instead of ruminating on negative thoughts, take in the beauty of every day through small gestures like your children’s smiles or a walk in the park with your wife,” Sullivan advises.

Get professional support when needed. Your friends, family, and colleagues will serve as a vital support network during your spouse’s illness, but sometimes it’s not enough to turn to a buddy for help. “Women are quick to reach out for professional help when needed, but men are not,” says Sullivan. “It’s important to realize that counseling is for everyone and that it can serve as a valuable coping mechanism during seemingly unbearable situations.”

Each individual will process the diagnosis of a loved one differently, but these tips can provide guidance in managing some of the emotional challenges that can result. “Remember that all of the negative emotions associated with a spouse’s illness are completely normal,” says Sullivan. “How you manage and channel these feelings is what makes the real difference.”

SIDEBAR: The clueless caregiver

One father’s take on “what it takes” to give proper care to a wife and mother with cancer.

First, you should know this: I’m writing anonymously as much to protect my own reputation (that of allegedly wonderful husband and father) as to protect the privacy of a woman I’ve long cared for deeply but not always so well.

We met in college at 18 and married at 24. At 28 we had the first of our three sons—now 12, 14, and 16. At age 40 cancer barged into our lives. Five years later it remains a grudgingly accepted “permanent” member of the family.

The diagnosis came during my wife’s first-ever mammogram. We had recently begun entertaining the idea of having another child. The mammogram was to be a mere formality, something to check off our list on the way to receiving a clean bill of health to conceive. Instead of a baby, what my wife got was an aggressive strain of stage IV breast cancer called HER 2/neu. It started in her milk duct and, before any lump could form, bounced pinball-like to her armpit and then to her liver, where it left three sizable lesions.

For the first three years after the diagnosis, my wife spent most of her energy simply figuring out “how not to die,” as many with her type of cancer quickly do. Likewise my initial caregiving focus centered on calmly her through do-or-die treatment decisions as the fog of “chemo brain” rolled in. The past two years saw that focus shift to How do the boys and I help mom live, as long as possible, in the fullest way possible.

This meant first making my sons gradually aware of Mom’s fragile mortality. I soon realized that caregivers with school-age kids must exercise a measured honesty. Getting the real dope on Santa or sex from a parent is mind-boggling enough. The truth that Grandma may outlive Mom can’t be sugarcoated, but it shouldn’t come unvarnished either. “We all die eventually, and none of us gets to know exactly when” is how I plainly but abstractly put things early on. “How well we accept that truth and use it to drive us to live better in the time we have together—that’s what counts.”

Fortunately, most of the news we’ve had to share with our boys about my wife has been good. An ever-evolving combination of newer treatments eventually beat back the cancer to where there is no evidence of it today. But the various chemical, biological, and surgical remedies have taken a heavy toll. Even now she must continue a monthly regimen of hormonal therapy that starves her body of cancer-feeding estrogen. Though effective, during the 10 days following each shot she experiences crushing fatigue, drenching hot flashes, Jekyll and Hyde mood swings, and searing joint pain.

Looking back, I see I had the brains and the physical strength to meet my wife’s frontline caregiving challenges. And in what’s always been a marriage of equals, I could be counted on to take up more cooking, cleaning, and chauffeuring of kids. But being the Sensitive Family Man? Being innately attuned to the emotional traumas besetting the mother of my children? Well, let’s just say I’ve always been more Mr. Spock than Dr. Spock. And our boys, being boys, weren’t much better, even if our hearts were in the right place.

We’ve improved with time. A good bit of the credit goes to CTCA pros like therapist Linda Sullivan, who led us through difficult family discussions. Various CTCA® mind-body services and treatments also made my wife’s hormonal and pain issues more tolerable. But, ultimately, great resources only get you so far. In the end patient and caregiver must learn to live more richly, never an easy task, in sickness or in health.

Every caregiver’s challenge is as different as the loved one he or she is helping. Still, I have it on good authority (a wife/mom who’s faced about the worst cancer can dish) that there are four things even a clueless husband/dad like me can do to drastically improve the quality of emotional care he’s giving:

  • Give what the patient truly needs, not what you think she needs. There’s only one way to know the difference with certainty. Ask and listen hard. The listening may well matter more than the doing. In fact, it may be all she really wants from you. For men like me (and there are still a lot of us), if it’s a problem we can’t personally solve—like, say, end-stage cancer—what’s the point in discussing it in painful detail? But if your life mate can’t feel free to share her darkest fears with you—her caregiver— who else is there?
  • Protect her from herself so she won’t overdo. There’s a fine line between living a full life and an overloaded one. Women tend to put a lot of pressure on themselves to be the good wife and mother (not to mention employee, if they also work outside the home). The self-inflicted stress and guilt of trying to measure up to unrealistic perceived societal expectations when cancer has laid them low can be immense. Guarding my wife’s sleep and mediating petty boyhood squabbles without involving her when I can is a big part of my caregiving. So is constantly reminding her there’s no such thing as a perfect parent or spouse. Luckily, she has me around to constantly make her look great in comparison.
  • Make sure she knows she’s not a burden. A person debilitated by cancer has trouble enough accepting that she can’t do everything for others that she used to love to do. Don’t let her add to that the feeling she’s somehow a burden to others. When fatigue straps her to a sofa, generously bring your world to her bedside. Let her know that being able to do for her gives you as much joy as it does her. A warm cup of tea, a soft smile, and a soothing touch can help her see just how truly glad you are to have the opportunity to do a kindness.
  • Conserve her time and energy to be present for the special moments in her children’s lives. Whether her fight with cancer is a temporary or never-ending one, the time spent dealing with it is time you don’t get back as a family. That’s why you need to help her make the most of it, as much for you and the kids as for her. How are you going to help her pace herself to minimize the pain and the fatigue? What nonessential activities are you going to strip away? What precious moments are you going to try to ensure she has the strength to engage in 100 percent? These are questions that must be constantly asked and re-asked.

My wife and I are blessed to know what few in our youth-obsessed society discover until too late: that growing older is better than the alternative. We’re slowly teaching our kids how to live with cancer—the unruly fiveyear- old in our midst. The disease is a wild stepchild that, for now, won’t leave without taking my wife too. So we take care to make room for the both of them—and to strive to be more nurturing to a woman who for so long was the one to nurture us.

The author is a business writer who works from his home in suburban New Jersey.

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