Impact of cancer on relationships

Though, with early diagnosis and improved management, the diagnosis of cancer does not necessarily mean a death sentence, it brings about an irrevocable change in one’s life and interpersonal relationships, writes Dr Amrinder Bajaj.

Though early diagnosis and improved management have made cancer no longer synonymous with a death sentence, the diagnosis still brings about an irrevocable change in one’s life and relationships. The initial reaction is often one of shock and numbness, as it takes time to absorb and process such distressing news. This is followed by fear, anxiety, and profound sorrow.

Meditation, deep breathing, and family support go a long way in combating stress. However, some patients continue to suffer from panic attacks that can mimic heart attacks. Others, like my husband, may remain in a state of denial until the very end.

Anger can follow, sometimes directed at family and friends. Some lash out at those trying to help, or at the Almighty for what they perceive as betrayal. Others experience guilt, reflecting on past habits like smoking, ignoring warning signs, or delaying the diagnosis — fearing they’ve put their loved ones through unnecessary stress.

Despite being surrounded by a loving family, cancer often brings with it a sense of isolation, as social interactions with colleagues and friends decrease due to the illness and its treatment. At times, patients may experience a feeling of helplessness and loss of control. However, over time, most come to a stoic acceptance.

If negative emotions continue to fester and interfere with day-to-day life or relationships, psychological help may be necessary. And then there’s the caregiver, who often receives little attention. The focus tends to be on the patient, but at times, the caregiver’s stress may be even greater. In addition to caring for the ill person, they may need to manage the rest of the household, possibly give up their job, and face the financial strain cancer brings — since it is an expensive disease to fight. The emotional burden of nursing a terminally ill loved one can lead to burnout, and in some cases, emotional bonds break down, giving way to resentment and bitterness.

Sexual inadequacy is another challenge. Changes in physical appearance, weakness, and fatigue can lead to decreased libido and poor sexual performance. This can result in frustration for the healthy partner, particularly if the couple had an active sex life before. The caregiver may also be so exhausted that sexual intimacy no longer interests her, leading the cancer survivor to feel rejected — especially if they wish to continue their sexual relationship while they still can. Matters worsen if there’s a communication gap, as misunderstandings and emotional distance can form just when closeness is most needed.

However, if both partners are open, they can still enjoy sexual intimacy without the fear of transmitting cancer or aggravating the disease. It is important to avoid pregnancy during chemotherapy or radiotherapy due to the risk of congenital malformations, while surgery in the pelvic area can make intercourse painful. If a cancer-stricken young woman desires children, she can consider freezing her eggs before starting treatment. Married women can also opt to freeze embryos, which have a higher pregnancy success rate than eggs alone.

Early menopause can occur after cancer treatment, leading to vaginal dryness and further complications for sexual health. For children, the impact varies depending on age and personality. They may feel confused, scared, angry, or sad, particularly as their education, career plans, or even marriage may be disrupted. Those who care for their parents can offer financial support, visit or call for emotional support, and take over caregiving duties for a while to give the primary caregiver a much-needed break. It’s crucial that caregivers do not feel guilty for needing respite or help. Time spent resting and rejuvenating before burnout sets in is time well spent.

Writing in a journal, talking with a friend, or having an open conversation with the spouse can offer emotional release. Nourishing food is essential for both the patient and caregiver. In short, cancer impacts each family differently. It can either break them apart or bring them closer. Severe stress often brings out the best or the worst in people, and much depends on the dynamics of the relationship before the diagnosis, the compatibility between spouses, the children’s personalities, and the stage of the disease, along with financial factors. If at any point the family struggles to cope, they should not hesitate to seek professional help.

(Dr Amrinder Bajaj is an obstetrician and a gynaecologist, and the author of Letting Go: A Novel that was recently published by Bloomsbury.)