When you learn that your partner has Prostate cancer, you both probably have a lot of questions about the sequel. There will be many things you will need to talk about. But what do you say – and what shouldn’t you say – as you face illness together?
Before choosing your words, focus on the “together” part. Your partner will greatly benefit from having you around. Go on his dates with him and support him.
“If the man has a partner, I always encourage that partner to be there,” says urologist Jesse Mills, MD, director of the Men’s Clinic at UCLA in Los Angeles. “It’s a disease that couples suffer together.”
Urologist Clayton Lau, MD, agrees.
“Tell your partner you want to get involved, go on dates, ask questions,” says Lau, director of the prostate cancer program at City of Hope Hospital in Duarte, Utah. California. “A lot of men diagnosed with prostate cancer turn off their brains and worry, so it’s really important for the partner or spouse to process the information and provide emotional support.”
Stay positive for your partner
As scary as the word cancer is, prostate cancer has a very high cure rate, especially when caught early. In fact, nearly 100% of men diagnosed with prostate cancer that hasn’t spread to other parts of the body live at least 5 years with the disease, according to the American Cancer Society.
If your partner feels overwhelmed with fear, remind them.
“Most men diagnosed with prostate cancer don’t die from the disease, and you need to let him know that,” Lau says. “He wants to know that everything is not catastrophic.”
When prostate cancer doesn’t need treatment
Often, prostate cancer grows slowly and poses no immediate threat. In such cases, doctors often recommend something called active surveillance. (You might also hear it called “watchful waiting.”) This involves regular checkups to make sure the cancer hasn’t progressed.
The advantage: you avoid the side effects associated with surgery or radiation. However, it can cause anxiety if both of you are worried that things will get worse. What are you saying?
“Remind your spouse or partner that the doctors are on top of things and that you’re being checked regularly,” Lau says.
If you’re the one worried about what cancer might do if left untreated, tell your partner how you feel. Then accept that it is his decision to forgo treatment, at least for now, if he and the doctor think active surveillance is the right choice.
“You have to be able to give your partner that space,” says Mills.
If you and your partner have never faced cancer before, this is a whole new world for you. You will need help finding ways to talk about it.
“There are many support groups for couples going through therapy“, says Mills. “They are operated by cancer centers, hospitals, churches” and other organizations. Ask your partner’s cancer care team to refer you to local groups. You can check the American Cancer Society Patient Programs and Services, too. Psychologists and social workers can also help you.
Coping with the side effects of treatment
Prostate cancer surgery can have two major and potentially long-lasting side effects: urinary incontinence and erectile dysfunction. Both can be quite daunting. The radiation can also affect your bladder and your ability to have an erection.
Remind your partner that these side effects are often temporary and let them know that you are there with them until things get better.
If your partner does not have full control of his bladder – a side effect that can take months or more to disappear – which can discourage him from wanting to resume the social life you had before treatment or even limit his desire to leave the house.
“Be understanding and don’t minimize her feelings,” Mills says. “But encourage him to be a little adventurous and realize that the new normal means he will have to make more toilet stops.”
Talking about sex with your partner
A harsh reality of treatment is its impact on your partner’s ability to have an erection. You may not be able to have sex the same way you used to, at least not for a while. Talk about it early.
“Have an open conversation as a couple,” Lau says. “Talk about how important sex is to both of you, as it is often more important to one spouse or partner than the other. And remember he wants to feel loved and be seen romantically.
Mills says recovery from treatment can take up to a year, and your partner should know they are still wanted during this time.
“Tell him you want to be intimate with him even if you can’t be intimate like you used to be,” Mills says.
Don’t tell your partner that you no longer care about his inability to get an erection.
“Even if you say it from a supportive standpoint, that’s exactly the wrong thing to say, because being able to get an erection is fundamental to being a man,” Mills says. “Instead, say ‘I understand you’re not able to get an erection now, and I still love you.’ It’s really important that the partner doesn’t say it’s okay to be impotent Instead, say I want you to feel like you’re doing everything you can [to recover your ability to get an erection].”
Sex, however, may be something you’re used to doing rather than talking about. If you’re having trouble starting a conversation, Lau recommends speaking with a sex therapist, who can help you navigate changes in your sex life. Your partner’s healthcare team should be able to make a recommendation.
If it is advanced prostate cancer
Sometimes prostate cancer is aggressive and difficult to treat. It can spread to other parts of the body. Treatment of such cancer requires hormone therapy, which stops the body’s production of testosterone. This has significant side effects. Your partner will likely face the following:
- Emotional changes and mood swings
- Loss of interest in sex
- Weight gain
- Lack of interest in eating well, exercising, or sleeping
“It can be devastating,” says Mills. “The quality of life takes a huge hit.”
Your partner may become moody, restless, and withdrawn, both as a side effect of treatment and because they are faced with the reality of advanced illness. Give him the space he needs, but also be generally supportive, Mills says. Encourage him to exercise and have a healthy diet.
“Say, ‘I’m in the same boat as you,'” Mills advises. “Say, ‘Let’s go for a walk’ or ‘Let’s skip the fast food and eat a nice piece of salmon, brown rice and steamed vegetables’. Be part of this solution.
Help your partner at the end
What if all treatment options have been exhausted and the cancer is terminal? You will always face it together.
“At this point, it’s important to be there and reassure your partner that they’re loved,” Lau explains. “Show affection, show your presence, both your physical and emotional presence.”
You can also support their decisions about obtaining palliative care, where he wants to spend his remaining time, and ensure that any pain is controlled and that his end-of-life medical preferences are respected. (These should be in his advance directives.)
One thing you shouldn’t do is be dishonest about how things are going. “You can’t just tell them things will magically improve,” Lau says.
Tell your partner that you’ll be with them no matter what and that it’s okay to let go when it’s their time, Mills says.
“I think sometimes people just need to hear that,” Mills says. “They need to hear from people they love that they have nothing left to do and that it’s okay, that death is not a failure but a condition of life.”