Troubles for Couples
This study from Psycho-Oncology really has no new information, but it looks carefully at issues for couples in which the woman has metastatic/advanced breast cancer. Frankly, I think that the issues are the same for couples dealing with early breast cancer, but, in those situations, there is hope that things will improve. When a woman has advanced disease, the realities are difficult. She is on treatment, of one kind or another, for the rest of her life. We all know that cancer treatments, especially chemotherapy, come with side effects. It is pretty tough to feel sexy when you are sick, bald, fatigued, and probably quite worried about the future.
One irony is that couples often find it hard to be intimate at the very moments when that kind of closeness is especially needed. Instead, each person can easily end up feeling more alone, sad, and disconnected from one another. When I talk with couples, I always bring up the physical part of their relationship. If sex feels impossible, there are other ways to be close: back or foot rubs, showering together, spooning during sleep, holding hands while walking. Touch brings great comfort, and we need to reach out to one another.
Here is the abstract for this study and then a link. If you read it, remember that the concerns do apply, too, to women/couples with early cancer.
Sexual problems, communication patterns, and depressive
symptoms in couples coping with metastatic breast cancer
Kathrin Milbury, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Hoda Badr, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA
Background: The treatment of breast cancer tends to result in physical side effects (e.g., vaginal dryness, stomatitis, and atrophy) that can cause sexual problems.Although studies of early-stage breast cancer have demonstrated that sexual problems are associated with increased depressive symptoms for both patients and their partners, comparatively little is known about these associations in metastatic breast cancer(MBC) and how patients and partners cope together with sexual problems. We examined the links between sexual problems, depressive symptoms, and two types of spousal communication patterns (mutual constructive and demand-withdraw) in 191 couples in which the patient was initiating treatment forMBC.
Methods: Patients and partners separately completed paper-and-pencil surveys.
Results: Multilevel models indicated that high levels of sexual problems were signi!cantly associated with more depressive symptoms only for patients who reported low levels of mutual constructive communication (p<0.01) and high levels of demand-withdraw communication (p<0.0001). In contrast, for partners, greater sexual problems were associated with more depressive symptoms regardless of the communication pattern reported. These associations remained significant when we controlled for patients' reports of average pain and functional and physical well-being and couples' dyadic adjustment.
Conclusions: Sexual problems were associated with depressive symptoms for both MBC patients and their partners. The way in which patients and partners talk with one another about cancer-related problems seems to in"uence this association for patients. MBC patients may benefit from programs that teach couples how to minimize demand-withdraw communication and instead openly and constructively discuss sexual issues and concerns.