Cancer and its impact on relationships

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How you manage this difficult situation depends on your coping style before cervical cancer. If you have always struggled with or found it challenging to deal with your emotions or those of others, you are unlikely to develop these emotional skills immediately. This can be hard as you are both feeling your way through unfamiliar territory and the mix of emotions you may be feeling can lead to misunderstandings between you and your partner.

Your partner may need support from other people, she may find it easier to talk about some issues with relatives or close friends, or she may be trying to reassure and protect you by maintaining the image that she is coping [1].

This section covers the following topics: 

• Communicating how you are feeling
• Talking about changes to your relationship
• Sex and intimacy
• Loss of fertility
• Getting things back on track

Communicating how you are feeling

Partners with experience of supporting a woman with cervical cancer have told us how helpful mutual support in a relationship can be. Mutual support means that you emotionally support your partner and she supports you. 

Despite the difficulty of your current situation, you may feel that you want to be the stronger one and take on the whole burden. If this is how you are feeling, please remember that you can still look to your partner for support when you are feeling low or worried. By allowing your partner to sometimes feel that they are supporting you, you may help them to feel ok about accepting support from you and others. This means that ‘being strong’ and not showing emotion may not necessarily be very helpful. If you are normally a couple who share problems, why would this situation be any different? If you don’t show your emotions, your partner may feel unable to freely show how she is feeling either. If you are someone that does not show their emotions easily, that is ok and you could suggest your partner look to other close family members or friends if she needs support that you cannot give at this time.

"I had my bad days, like everyone else, but on the majority of days I was positive and I think that attitude helps others around you so that they’re able to cope as well" 

– Kester, partner

Crying reflects the grief people are feeling; it doesn’t cause it. So do let your partner express her feelings in whatever way works for her, just as you should express your feelings in your own way. You will almost certainly feel more connected as a result. Try to avoid second guessing how each of you is feeling. Accept that this is difficult for both of you and that you are negotiating your way through a whole new set of experiences.

Talking about changes to your relationship

You may both wonder if you will ever feel normal again. However, even if you were happy with the way your relationship was, don’t see change as a disaster. All relationships evolve; so, rather than focusing on how different things are, see your ability to adapt as a positive thing. Nothing stays the same and, though you may be aware of what you seem to have lost, be aware of gains as well. Some couples feel they are actually sharing more in this situation [2].

However, if you feel less close, try to consider why this is. If it feels as though the cancer is coming between you, try to think of it as a separate entity that you are fighting together, rather than seeing your partner as a cancer patient.

Finding a calm time to talk is better than blurting things out when you are feeling angry, frightened or frustrated. Use “I” statements rather than “you” comments, which tend to sound blaming. For instance, “I am concerned you are overdoing it” is less blaming than “You are doing too much”.

Most of all, don’t make assumptions. Talk about what you both want and need, and accept that this may change from day to day, for both of you.

"It’s about sitting down and discussing your differences and then it makes it better to work thorough together. Then instead of having an enemy you are developing a closer friendship" 

– Jessica, Cervical Cancer Stories participant 

Sex and intimacy

Your intimate relationship with your partner may have altered significantly since her diagnosis. In our recent sex and relationship survey, 90% of the women who took part told us that they had experienced changes in their intimate relationships as a result of cervical cancer. Some felt it had improved, but over half were not satisfied with how things are now. Perhaps you also feel that things have changed and you may not feel happy about this.

Changes in your sex life may happen for several reasons, some of which are due to physical and emotional changes in both your partner and yourself. Both of you may feel anxious about resuming sexual activity and some of this anxiety is a normal part of going through the diagnosis and subsequent treatment for cervical cancer. You may feel worried about hurting your partner or concerned about damaging the area in which she has received treatment. You are not alone in having these concerns and your partner’s medical team should be able to talk to you about these issues.

"I felt a bit nervous at first. It was a mutual thing, we talked about it. I wanted to give it six months’ recovery time. I felt comfortable talking to her, but I did also tend to shut conversations down."

– Partner, Cervical Cancer Stories Report

We have information on sex and intimacy written for women affected by cervical cancer that you may also find helpful. You can read more about the following areas:

• Sex and relationships
• Loss of desire
• Not able to feel aroused
• Sexual pain
• Orgasm less satisfactory/more difficult to achieve.

After treatment some women feel that the area where they have had treatment is no longer special or private, and this can make it hard to reconnect with their sexual life. Sometimes psychosexual counselling can help to reconnect sexuality after a cancer diagnosis. You can also receive this type of counselling together as a couple.

Some people feel concerned about human papillomavirus (HPV). Some of these worries include, where the HPV came from and the issue of re-infection. This can be a very difficult subject to talk about, but also to find answers to. It is important to remember that HPV is extremely common and 80% of people will have it at some point in their lives. It can also be transmitted through any skin to skin contact of the genital region and stay in the body with no symptoms or effects for many years. You can find more information on HPV, its link to cervical cancer and frequently asked questions about it in our information section. All the issues raised in this section are important and it is good to try and talk to, as well as listen to, your partner so you both know how you are feeling.

Sex can be a very important part of a relationship and it may take time to bring things back to how they were before a cancer diagnosis. They may always be different, but keeping communication open between you and your partner can help to get things back on track.

There is more information about this in our sex and intimacy after cervical cancer section.

Loss of fertility

Even if you already have children, it can be hard to accept that you no longer have a choice about whether to have more. If you haven’t yet started a family, you may be facing a very different future to the one you had imagined. You may both need time to grieve in your own ways and to be aware that you may each react differently.

"It matters more to 'A' than me about fertility. I was not as worried about that. I felt fully involved, but it was not an issue to me. All the issues were about my wife." 

- Partner, Cervical Cancer Stories Report

Where the possibility of having children remains uncertain, there may be additional stress and confusion [3]. It is worth keeping yourself well informed and trying not to make judgements. For instance, even treatments like large loop excision of the transformation zone (LLETZ) or cone biopsy, which can preserve fertility, may still worry your partner because of their small risk of causing premature labour.

Treatment for more advanced cervical cancer, such as a hysterectomy, chemotherapy or radiotherapy, can bring on short- and long-term changes within a woman’s body. For example, going through the menopause may affect her feelings about her sense of femininity or sexuality. Reassure her, but don’t dismiss what she is going through. She may be facing some physical side effects, such as hot flushes, changes in mood and sleep disturbances. This may emphasise the difference she feels from other women of her age who are not yet experiencing menopausal symptoms. However, information and planning before treatment can help to minimise symptoms and improve emotional adjustment [4]. Be careful not to assume you know what is best for her. Be ready to listen when she is ready and avoid jumping in with solutions; she may just want to feel heard.

Getting things back on track

Don’t expect things to go back to exactly the way they were. Many of the everyday rules you may have had can be thrown away. Having cancer is the permission some people need to make the most of every day without always having to worry about the future or being productive. It’s not uncommon for people affected by cancer to look back at their experience of cancer and feel that they have gained both positive and negative experiences as a result of their diagnosis and treatment.

Consequently, don’t feel you can’t laugh and enjoy your life together. Ensure you talk about things other than cancer and treatment. Make some plans; whether it is for a break away or just a quiet night in together, planning can give you a sense of togetherness and healthy anticipation.

Most of all, be flexible and don’t be thrown off course if you have to be adaptable. Although you may be looking for the reassurance of certainty, be aware of the resources you have that allow you to deal with issues as they arise. It is these same skills that will also allow you to make the most of any opportunities for relaxation and fun.

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References

1. Macmillan Cancer Support website page - Communication with your partner: www.macmillan.org.uk/Cancerinformation/Livingwithandaftercancer/Relationshipscommunication/Youyourpartner/Communication.aspx. Accessed: 11.04.2017.
2. Canada, A.L. and Shover, L.R. 2012. The psychosocial impact of interrupted childbearing in long-term female cancer survivors. Psycho-Oncology, 21, 134-143.
3. Penrose, R. 2013. The psychosocial impact of cancer-related infertility on women: A review and comparison. Clinical Journal of Oncology Nursing, 17;2, 188-193.
4. Knobf, M. T. 2008. ‘Coming to grips’ with chemotherapy-induced premature menopause. Health Care for Women International, 29, 384-399.

 

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