Cancer and communication: Tips and advice for couples

Research shows that good communication between you and your partner may be vital to not only your mental health but also to your relationship.

A cancer diagnosis may upend many aspects of your life. It may impact your job and your daily routine and affect your finances. A diagnosis may also put stress on your relationship with your partner or spouse. Even couples who typically communicate well may have trouble talking about a cancer diagnosis and how it’s affecting their lives. Yet research shows that good communication between you and your partner may be vital to not only your mental health but also to your relationship.

“Communication is the most important piece in seeing that your relationship survives cancer,” says John Kenny, MD, a Psychiatrist at Cancer Treatment Centers of America® (CTCA), Phoenix. “Being able to talk about what you’re going through, and how it’s impacting you both, is essential. Couples who shut down and don’t talk about their fear, frustration, guilt, anger, sadness, or grief don’t do well. These are normal emotions that most people experience at one time or another in dealing with cancer.”

A study of prostate cancer patients and their partners concluded that mutual constructive communication decreased psychological distress and improved relationship satisfaction while avoiding communication had the opposite effect. Another communications study of breast cancer patients reported similar findings: “During cancer-issue discussions, patients reported less distress when partners responded to disclosures with reciprocal self-disclosure and humor and when partners were less likely to propose solutions.”

Breaking through barriers

Common obstacles that may get in the way of talking about your emotions with your partner or spouse include:

  • Feeling guilty about burdening the other person
  • Feeling like you need to be positive all the time for your partner
  • Feeling pressured to act in a certain way because of real or perceived expectations
  • Feeling irritable, which can be caused by physical or emotional pain or distress

Effective communication isn’t easy, and it doesn’t come naturally to some people. “If you found it difficult to talk about your emotions before your diagnosis or treatment, that may not change. Becoming a cancer patient or caregiver doesn’t change your personality,” says Diane Schaab, MS, LPC, Behavioral Health Therapist at CTCA® Atlanta.

However, Schaab offers these tips to cancer patients and caregivers who struggle to communicate their needs and wants in positive ways:  

  • Use “I” instead of “you” statements. For example, say “I would appreciate you picking up these items at the grocery store,” instead of “You should pick up these items at the grocery store.”
  • Avoid using global words like “always” and “never”.
  • Be aware of your tone of voice.
  • Watch your nonverbal communications. You may be saying one thing, but your facial expression communicates something else.
  • Plan the best time for your conversations, when you both have time to talk, and you’re relaxed and not fatigued.
  • Avoid immediately offering solutions to “fix” the situation. Your partner may just need you to listen at that moment.
  • Don’t assume you know what your partner is thinking or feeling or what your partner will say next. Ask questions if something is unclear.

Asking for help

Behavioral health therapists often work with couples undergoing cancer treatment to help them overcome communication challenges. A few of the strategies used by Schaab in her counseling work with patients and caregivers include:  

Communication modeling: Meeting your partner where he or she is at in the moment by first listening and acknowledging his or her emotions. “Either the patient or the caregiver can take the lead in the discussion. It really depends on who is more comfortable talking about their emotions,” Schaab says.

Active listening: Concentrating on understanding what your partner is saying, rather than thinking about what to say next. This is done by “reflecting back” or rephrasing the statement or question in your own words to be sure you understand your partner’s point of view.

Written communication: If you don’t feel comfortable talking, share your thoughts in writing. Communicating what you find helpful or not helpful during the cancer journey is critical for patients and caregivers and writing those out can be helpful for couples.

Responding to inappropriate comments or questions: First, it’s important that you and your partner agree on what to communicate with others and what you prefer to keep private. Next, write out or verbally practice an agreed upon response to well-meaning friends or family members. It could be something like: “Thank you for your concern, but I’d or we’d prefer to focus our conversation on (work, family, church, etc.) right now.”

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“This gives people permission not to talk about your cancer, which can be very cathartic. It can be a relief to those around you who want to be empathic but who may not be savvy communicators,” Schaab says.

 “Some couples’ relationships don’t survive a serious illness because one or both shut down or run away, Dr. Kenny says. “It takes real effort on both people’s parts to preserve the relationship.”

If you feel the relationship is falling apart for any reason, Kenny recommends couples counseling. “Getting a neutral outsider to look at the situation with you often helps couples figure out how to fix it. We all have times in life where we lose perspective, and serious illness can definitely be one of those times.”

Additionally, the American Society of Clinical Oncology (ASCO), offers several suggestions for talking with your partner or spouse about cancer on its website.

10 tips for talking to a loved one with cancer.