Dana Kababik speaks in the first-person plural when talking about her husband’s prostate cancer. ” We opted for a radical prostatectomy.” ” We thought it was his best chance for a cure.” “If he had a recurrence, we would have other options,” says the 54-year-old medical copywriter in Whitehouse, New Jersey.
Kababik’s parlance is common among partners of men with prostate cancer, says Dr. Andrew Roth, attending psychiatrist at Memorial Sloan Kettering Cancer Center who treats men and couples affected by prostate cancer. “There are lots of spouses who will tell me cancer didn’t just hit the husband, it hit [the wife] as well,” he says.
Makes sense. Like all cancer diagnoses, telling a man he has prostate cancer can force him — and his loved ones — to confront his mortality for the first time. “When you hear the words, ‘you have prostate cancer,’ pretty much everything stops,” says Kababik, whose husband was diagnosed in 2005.
But unlike many other cancers, prostate cancer often has a direct effect on the significant other, particularly in the form of erectile dysfunction, a common (albeit often temporary) side effect of treatment, according to the Prostate Cancer Foundation. “Erectile dysfunction is not only affecting the patient, it’s affecting the patient and the partner,” says Dr. Mohit Khera, associate professor of urology at Baylor College of Medicine. “That’s very obvious.”
Less obvious is how the diagnosis can influence a man’s mental health and, in turn, his relationship. A 2008 review of studies in the journal Clinical Medicine: Oncology found that men with prostate cancer are at risk for anxiety and depression, which can hurt their relationships and might even make their treatments less effective. “The diagnosis of cancer has a psychological impact on the body and mind,” Khera says.
Some side effects of treatment like incontinence can also influence a man’s behavior, adds Roth, also a professor of clinical psychiatry at Weill Cornell Medical College and author of the book “Managing Prostate Cancer: A Guide for Living Better.” “[Men] may not feel comfortable socializing, and so spouses will believe he must be depressed,” Roth says, “but he’s actually just anxious and doesn’t know how to deal with it.”
Then there’s the communication issue. Men may clam up after a diagnosis, causing their wives to feel “shut out,” says Kababik, who launched the site HisProstateCancer.com to provide support and information to wives, partners and family members of men with prostate cancer. “Every man is different. Every couple is different,” she says. “If you had communication problems before prostate cancer, likely you’re going to have communication problems during prostate cancer.”
On the upside, it’s possible for the mental health and relationships of survivors to actually improve after prostate cancer, says Dr. Scott Eggener, associate professor of surgery at The University of Chicago Medicine, where he codirects the Prostate Cancer Program. “Most men that go through treatment end up on the other side with a great quality of life, and their relationship is the same — sometimes even better because they have a new perspective on the important things in life,” he says.
Here’s what experts suggest you do if your significant other is diagnosed with prostate cancer:
1. Get the facts.
Prostate cancer is the most common type of cancer among men after skin cancer, affecting 1 in 7 American men in their lifetimes, according to the American Cancer Society. The majority of diagnoses are among men over 65 years old, and it’s rare before age 40, ACS reports. While the disease will take about 27,540 American lives in 2015, ACS estimates, most diagnosed men don’t die from it. Plenty live with it, and those who choose to treat it generally have “very good” outcomes, Khera says. “This cancer is very treatable.”
So treatable, in fact, that Kababik and her husband view prostate cancer as a chronic condition rather than a fatal disease. “We want to make sure that he dies with prostate cancer, not from prostate cancer,” she says.
2. Know your options.
Depending on its stage, prostate cancer treatment options can range from not intervening at all to undergoing surgery or radiation. “There’s all different side effects and recovery times, so you actually have a lot of choices if the cancer is localized [and] hasn’t spread around,” says Kababik, whose husband opted for surgery to remove his prostate gland.
If the cancer has spread too far to be treated with surgery or radiation, men may choose hormone therapy, which aims to reduce the male hormones affecting the prostate cancer cells through drugs or surgery that removes the testicles.
Whatever you choose, keep in mind that there’s no right or wrong treatment — if there was, all experts would agree on one, Roth points out. In retrospect, “[couples] probably made the best choice they could have made,” he says. You never know if another choice would have resulted in a worse outcome.
3. Get a second (or third) o pinion.
If the cancer doesn’t need immediate treatment, be sure to meet with at least one other medical professional before deciding how to proceed, Eggener advises. “It’s always a good idea to get second opinions and hear about all the options,” he says.
Kababik, who interviewed several surgeons with her husband before deciding on one, points out that doctors’ recommendations are likely influenced by their specialty: The radiologist might push for radiation therapy while the urologist might be more likely to suggest surgery. “You may want to meet with both types of doctors to hear what each has to offer,” she says.
Even once you decide on a treatment, shop around for a provider with that expertise, Khera suggests. When it comes to surgery, he says, the more experience the better.
4. Ask to be his second set of ears.
How men react to learning they have prostate cancer is as different as the men themselves. “Some men have been perfectly healthy up until that point, and it’s really an awful experience to be told, ‘You have cancer,'” Eggener says. “Other men kind of roll with it.”
Either way, learning about treatment options, risks and statistics is a lot for anyone to absorb. That’s why it can be helpful to act as your partner’s second set of eyes and ears at doctor’s appointments and meetings with potential providers. “Two heads are better than one,” Roth says, the exception being if you’re more anxious than your spouse. In that case, encourage him to bring another friend or relative and offer to help in another way, such as scheduling his appointments, he suggests.
Still, some men may want to handle the doctor visits themselves. “Let your man know that you’re there for him, that you want to help, that you want to support him as best you can,” Kababik says. “But then sometimes, you have to let him take the lead.”
If your partner is open to you tagging along, Kababik recommends bringing a pen and paper to appointments or even asking to audio record discussions. “You’re going to hear a lot of information, so it’s helpful to write it down,” she says. “Later on, when you go to do more research, you’ll need to go back to those notes.”
5. Don’t take it personally.
Kababik often reminds women who want to be more involved that patience is a virtue. “It’s a lot for men to deal with,” she says. “Some of the issues of prostate cancer affect their manhood, the side effects are embarrassing, they may not feel comfortable talking about it.” Instead of taking offense, “you have to kind of respect that,” she says.
Some men experience physical side effects like erectile dysfunction even before treatment begins, Khera says. During and after treatments, men may experience mood swings from hormones or not want to have sex because they’re embarrassed about incontinence. “The partner needs to realize it’s not her,” Khera says.
Still, it’s important to let your partner know he’s desired. “When a man is first diagnosed, a lot of women will say, ‘I don’t care if we never make love again,'” Kababik says. But that can hurt their feelings if they don’t feel wanted. “It can be a little bit of a double-edged sword.”
Roth recommends fostering intimacy, even if that simply means massaging each other or cuddling. When it comes to penile rehabilitation after surgery, at least, “the partner’s involvement in recovery of sexual activity is important,” Khera says.
6. Seek professional help.
When Roth goes into the waiting room to call a man with prostate cancer into therapy, usually two people stand up: the patient and his spouse. So long as the man is OK with it, Roth says he welcomes them both. “Their communication has probably hit a rut,” he says. It’s his job to coach them through it, perhaps by helping a woman recognize that saying “don’t worry, everything will be fine!” isn’t always welcomed. “It’s well-intentioned, but the guy is thinking, ‘How do you know?'” Roth says. If you’re feeling frustrated or overwhelmed by how the diagnosis has changed your relationship, don’t hesitate to turn to a therapist or other professional to help you work it out. “If you need outside help, go and get it,” Kababik says.
7. Take care of yourself.
The partner of a man with prostate cancer is often the one listening to his fears, coping with his mood swings, preparing his meals and being “the constant cheerleader,” Kababik says. “But we also have our own fears and anxieties.” That’s why it’s important to cultivate your own support system, be it through friends, support groups through local hospitals or online forums for spouses and other partners like you. “You don’t have to do it alone,” Kababik says. After all, she adds, “You can’t be there for your man if you don’t take care of yourself.”
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When Your Partner Has Prostate Cancer originally appeared on usnews.com
