Approach cancer as a “we disease.”

Both parties should learn to recognize the signs that you or your partner is feeling stressed. Explore the different ways you may experience stress, and help each other to relax by reading to each other, getting a massage together, taking a bath together, or listening to music together.

Make a list of questions, and attend medical appointments together to develop a shared understanding of what to expect. Write down how medical decisions will affect both of you, and make treatment decisions together.

Strategize together about how best to balance work, family, and self-care. Write down all the tasks that need to be done to keep things running (e.g., meal preparation, paying bills) and who is currently responsible for each task. Then, be honest and realistic about what each of you can and cannot do, and accept help. Helping makes others feel good and will benefit both you and your partner. Ask friends or family to do your laundry, walk the dog, or keep others updated on your condition. You and your partner can then use that extra time to spend together.

Talk about cancer together.

Your partner may avoid talking about cancer for fear of upsetting you. This advice goes for both the person with cancer and the caregiver.  If you feel like talking about cancer, bring the subject up and let your partner know that it’s okay to talk about it. Reassure your partner that you don’t expect him or her to have answers; you just want someone who will listen.

Make a list of questions and develop a shared understanding of what to expect.

Do not anticipate that you know what your partner is thinking or feeling about cancer, or that you know what he or she needs from you.  Encourage your partner to share emotions and concerns, and always ask what he or she also needs.

For example, my husband Brian and I were both struggling to communicate effectively with each other about my illness.  Probably because I am a clinician, I assumed Brian knew information that he didn’t have or that would have been helpful to give him a better grasp of my diagnosis.  In the stress of my disease, I basically forgot that Brian didn’t go to medical school and wasn’t an oncologist.  As a result, he didn’t have—and I didn’t provide for him—many things that would have helped to relieve the stress he was feeling.  Similarly, it seemed to me as if Brian was always in an unusually good mood and we rarely talked about cancer at all.  His inexplicably cheery disposition made me feel as if he didn’t care about what I was going through, or even that he was making light of my diagnosis.  Out of frustration I asked him to join me in several of my psychotherapy sessions.  As it turns out, Brian was deliberately not talking about cancer and acting upbeat because he thought that would help me not dwell on a terrible situation.  What I also learned was that Brian was holding his anxiety inside and not discussing it with me, which was very difficult for him.

Essentially, what we gleaned from those therapy sessions was that we both had the best intentions, but we were really making big mistakes in helping each other deal with this stressful situation.  It may sound trite, but it all basically comes down to keeping open and clear lines of communication; in a nutshell, miscommunication can make a situation that already is fraught with stress much worse, even if both parties are well-intentioned.

Sometimes people coping with cancer feel pressure to maintain a positive outlook for the sake of their partner. Just as your partner may have good reasons to be hopeful, he or she may also have good reasons to be worried or upset.  Try to support and acknowledge both sets of emotions (not just the positive ones).

Focus attention on your relationship

After diagnosis, couples often concentrate their resources and energy on coping with cancer.  While this shift in focus is natural, couples need to continue to relate as spouses and not let cancer completely dominate their lives.  Cancer can affect a relationship by altering roles and responsibilities, expectations, and communication patterns.  Instead of looking back, look ahead.  The way you handle cancer together could chart a new course for your relationship.

When discussing things that need to change in the relationship, pick a time and place that foster relaxation and privacy.  Focus on one or two specific issues, and ask for changes in a positive way.  Avoid criticism, sarcasm, yelling, interrupting, name-calling, and the rehashing of old wounds.  Restating what your partner says to you shows you were listening and allows for correcting misunderstandings.

Assure your partner of your commitment to him or her and to the relationship.  Knowing your support will be steadfast and unwavering regardless of the outcome can be extremely reassuring and comforting for your partner.  Express physical affection even if sexual activity has stopped.  Maintain your loving feelings by kissing, hugging, cuddling and caressing.  Physical touch is often very therapeutic and lets your loved one know he or she is dear to you and is not going through this alone.

Talking to each other about the quality of your relationship (e.g. how good it is, how much you appreciate your partner, etc.), about fond relationship memories and hopes for the future can help you to reconnect and reestablish emotional intimacy.  Spend quality time together by engaging in leisure activities and staying socially active, but do let others know your physical limitations.

The good news is that with thoughtful attention and honest communication, couples can not only maintain their relationships, but also develop a bond that is even stronger and more fulfilling than the bond they had before cancer.