OncoCare
At OncoCare Cancer Centre, Singapore, we are frequently amazed at the support that spouses or partners of our patients show to them. Effective cancer care thrives on these positive family dynamics, where love and support are active and vital components. After all, facing cancer can be daunting, but with combined strength and commitment, it becomes a shared journey of courage and hope.
Of the patients who attend our cancer clinic, it is the women who frequently shed tears rather than the men. Nevertheless, the necessity for emotional support spans all genders when faced with a cancer diagnosis. This guide is crafted with insights primarily from women's experiences but is universally applicable to all partners striving to support their loved ones through this challenging time.
But first, it's essential to acknowledge that cancer can profoundly affect relationships, be it with your spouse, your friend, or even a friend's husband.
The diagnosis may not immediately alter your connection, but as you navigate this challenging path in an attempt to support the patient, changes often unfold. This is mainly due to the fact that illness introduces significant stress into both your lives, impacting daily routines and long-term plans alike.
During this time, both partners may experience heightened stress due to:
These changes could potentially lead to your partner feeling overwhelmed, which might manifest as irritability, withdrawal, or profound fatigue, causing tension and more frequent disagreements. While some couples grow closer, finding new strength together, others may struggle more than before, as cancer can exacerbate pre-existing relationship issues.
As mentioned, as your partner or spouse deals with the diagnosis of cancer, your relationship dynamics may shift significantly. Often, you may find yourself taking on tasks and responsibilities that your partner previously handled. These changes can be challenging and exhausting, affecting your own time for relaxation and social activities.
This redistribution of roles can sometimes create feelings of resentment or guilt, as you may feel overwhelmed or believe you're not doing enough. Moreover, supporting the cancer patient emotionally might also seem daunting if you're unsure what to say, how to provide comfort or if you're grappling with your own fears about the future.
It's crucial to recognise that these feelings are a natural part of adjusting to your partner's illness. Both of you are navigating this new reality together, and it's perfectly valid to seek support for yourself, too. Engaging in open communication about these role changes and seeking external help when necessary can ease the transition for both of you, allowing you to maintain a supportive environment throughout the cancer journey.
Supporting a loved one through cancer involves more than just being present; it’s about maintaining normalcy and understanding their unique needs. Changes in behaviour, while well-intentioned, may make them more conscious of their illness. Therefore, it is important to openly discuss what type of support they find most helpful to prevent misunderstandings and ensure your efforts align with their needs. Here are a few tailored ways to provide meaningful support during this challenging time:
I remember this patient with ovarian cancer whose husband is always present at our discussions and consultations. He would hold her hands tightly when we were going through the results of tests. The gestures were not always noticeable but the touch and comfort were definitely felt by her. Hugs have been reported to reduce stress hormones, make a person less anxious, and say that, “I am with you in this”. The prescribed frequency is daily as needed.
Seeing a spouse accompany a patient is always heartening. Even if a husband is preoccupied with work on his phone, his presence alone can be immensely supportive. This is especially so in Singapore, where both spouses often work, and taking leave for medical appointments isn’t always straightforward. The patient may receive medical leave, but it's harder for the spouse.
Even if it is for the first few appointments, it helps to have an understanding of what is going on. There is often quite a bit of information to assimilate, and having another listening ear to clarify what was discussed is important. The patient herself might sometimes be emotional and might have forgotten some details of the discussion with her oncologist doctor. An additional listening ear being around is good.
There is a lot of information and misinformation on the internet about cancer. Myths abound, and recommendations on what supplements, herbs, diets, and lifestyle changes are available a click away. However, there are reputable, objective sources of information, and there are subjective personal experiences that may not apply to the patient. Differentiating the wheat from the chaff is not easy, and learning involves time and reading.
Husbands are sometimes surprised at what troubles the wife. Some frequently associate the concerns to be related to the chemotherapy. One lady with lymphoma reported that her husband was not helping much, as her main concern was her son’s PSLE preparation during the period that she was undergoing cancer treatment. She was concerned her fatigue or nausea might affect her tutoring her son and was hoping her husband could help out.
Other concerns might be more intimate. Patients who undergo surgery for cancer may have physical changes and a different body image. Colostomy (an opening or stoma created for stools for colorectal cancer), mastectomy (breast surgery), hysterectomy (removing the womb), and other surgeries can create physical changes in a woman. In addition, hormonal changes related to disease or treatment can also affect intimacy and a patient’s sex life. Listening to a spouse’s needs is the beginning of supporting that need.
Flowers are lovely. It is often a winning formula when you do not know what else to say or do. Some husbands might shake their heads and say it is an unnecessary expenditure, but it works!
Hair loss, including alopecia, is a frequent side effect of many chemotherapy treatments and can also result from radiotherapy to the head. The specific chemotherapy regimen, including the type and dosage of medication, largely dictates the severity of hair loss experienced. While some treatments may not lead to hair loss, they may not always be the best option for managing the cancer.
Given all these changes, supporting your partner’s body image during this time is crucial, and gestures like shaving your head can profoundly affirm your support. Such actions, though significant, demonstrate solidarity in a tangible way. A poignant example comes from a husband of a lung cancer patient who, despite his own thinning hair, humorously noted that every hair he shaves off is now even more valuable.
Friends and family often wish to stay informed about your loved one’s health. However, some patients prefer privacy regarding their illness and treatment. It is essential for a trusted individual, often the spouse or partner, to manage the flow of information about their condition. Well-intentioned friends and relatives may want to help or offer support through prayers. As the patient might be overwhelmed or fatigued from managing their health updates, having a supportive spouse who can coordinate this support is invaluable. Remember, the well-being of the support provider is crucial; ensuring they also maintain their health and rest is vital for sustained assistance.
There might be a need to take over or manage some of the chores that the spouse had been doing such as fetching the children, bringing them to their tuition classes, applying for leave, settling household bills or arranging meals. In Singapore, most families are small, and harnessing the help of friends and relatives to do little bits of work can make things more manageable.
Clinic visits can be long (at OncoCare Cancer Centre, Singapore, we try to reduce the time patients spend in the clinic if we can) and visits for blood tests, CT scans and other appointments may sometimes require a friend or relative to accompany them if a spouse cannot make it.
Navigating the financial aspects of cancer treatment can be overwhelming. Many patients are not sufficiently prepared for the sudden expenses that arise, nor are they familiar with their medical insurance details, which can add to the stress. Often, patients discover that their policies—purchased years ago—cover more than expected, yet they may still worry about the costs. It's important to know that claims can often be made from Medishield Life for treatments at private cancer clinics.
The jargon of medical and cancer finance—like co-payments, deductibles, MediSave, MediShield Life, and integrated shield plans—can be confusing. Specific plans from providers such as AIA, Prudential, Great Eastern Insurance, NTUC, and Aviva offer chemotherapy coverage that exceeds what Medishield Life provides. However, it's crucial to ensure the coverage category matches the needed treatment type. At OncoCare Cancer Centre, Singapore, we facilitate this process by handling e-filings for outpatient claims, significantly reducing the administrative burden for our patients.
In many Singaporean families, the spouse manages health insurance. Revisiting these documents can provide crucial peace of mind. Additionally, employee benefits might be available through one’s employer and can be verified through the company’s HR department. Times like these also prompt some families to consider reviewing their wills and estate plans, ensuring all affairs are in order.
Taste and smell perception is an important and enjoyable aspect of eating. In that sense, this makes cancer treatment in Singapore so much more difficult for foodies! Side effects of cancer treatments and radiotherapy, as well as cancer itself, can cause altered sensory perceptions in some patients. Some chemotherapy medications used for common cancers like lymphoma, breast, lung and colon cancer affect the taste buds.
Other cancers affecting the gastrointestinal tract, such as oesophageal cancer, stomach (or gastric) cancer, and oral cancer, are associated with significant weight loss after surgery or radiotherapy. Easy satiety or feeling full very quickly happens when the stomach is reduced in size following surgery. It can also happen when food tastes bad to the patient or when the patient is following certain medications and radiotherapy. Being able to understand and plan meals accordingly shows sensitivity to the spouse and encouragement.
In other situations, putting on weight is a real danger! Some patients may require steroids as part of their treatment. These medications are used for non-Hodgkins lymphoma, myeloma or as premedication for certain chemotherapy drugs such as docetaxel (Taxotere) and paclitaxel.
This increases the appetite, and for one patient, it affects her eating habits. She might have a craving to eat certain food, but at certain times, she would refuse when the food is served. Her husband should dutifully finish the food for her!
When speaking to someone with cancer, it's essential to avoid overly optimistic comments that dismiss the gravity of their situation.
Avoid comparing their experience to others' cancer journeys, as each path is uniquely personal.
And before discussing the latest cancer treatments or research, seek permission; unsolicited advice can be overwhelming.
Also, be mindful of sharing your emotions; while it's healthy to express feelings, overwhelming a person with cancer with your grief can add to their burden. If you're not sure where to get started, here are a few phrases that cancer patients may not want to hear:
Understanding how to support your partner or a friend whose spouse has cancer and knowing what to say to your partner or someone whose spouse has cancer are essential skills that can significantly impact the healing journey. But beyond that, do not downplay the fact that that emotional rollercoaster can include shock, grief, anger, and anxiety, all of which are normal responses to such a diagnosis.
Whatever emotions you are going through, openly discussing feelings and concerns can help both of you cope more effectively. Supporting each other through these trying times involves more than just dealing with the illness; it's about maintaining a connection and ensuring that neither of you feels isolated.
“Expert knowledge means better care for cancer”
Written by:
Dr Peter Ang
MBBS (Singapore)
MMed (Int Med)
MRCP (UK)
FAMS (Medical Oncology)
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