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Vanderbilt-Ingram Cancer CenterVanderbilt-Ingram Cancer Center


Stress within the Family or Couple

Cancer affects everyone in the family, not just the person with cancer. Daily routines are disrupted during the diagnosis and treatment period. Typical duties and activities performed by one family member may change or shift onto other family members. There may be money issues, and other family members may need to work more if the patient needs to work less. Dealing with insurance claims and medical bills can be time-consuming and stressful.

Sometimes families find it hard to share their concerns and feelings with one another, and problems with communication can arise. This may happen when someone is afraid of saying the wrong thing, afraid of bringing up a topic at the wrong time, afraid they will upset their loved one, or afraid of facing the possibility of losing their loved one. It can be especially difficult to talk about the future and make plans if there is the fear that the cancer can’t be cured.

In addition, family members may experience a range of painful emotions as they face cancer together. When the cancer is diagnosed they may feel shock, disbelief, or numbness. As time goes on they may feel angry, resentful, frightened, sad, or overwhelmed. They may also feel guilty about having these feelings. Several studies have found that the husband or wife feels as much or more emotional distress as the person with cancer feels.

Sometimes a person with cancer needs a family member to help with things such as preparing and eating food, taking medicine, and bathing and dressing. Being a caregiver can be demanding physically and emotionally. Signs that a caregiver is over-stressed include social withdrawal, excessive fatigue, sleeping or eating too much or too little, anxiety, and irritability or anger at loved ones or oneself. Some caregivers may also become depressed.

What can help with keeping up with the demands of daily life?

  • Stay organized. Make a schedule for your family, and remember to schedule time for things you enjoy.
  • Let others help you. Often people want to help and are happy to do things such as offer a meal, a ride, errands, grocery shopping, lawn work or house work, or simply keep you company.
  • Consider forming a team of supporters who can take turns lending a hand. You can reach out for support from friends, extended family members, neighbors, your place of worship, school, or from community volunteer groups.
  • Make a list of things that others could do to take some of the burden off of your family, and let your helpers choose the things that they are best able to help with.
  • Take care of yourself. Eat balanced meals, Try to get exercise each day. Use a relaxation technique or meditate each day. Try to keep a regular sleep schedule, and talk with your doctor if you aren’t sleeping well. Taking good care of yourself will help you stay well and cope with stress better.
  • Take a regular break from caregiving. Find a friend, family member or a professional who can stay with your loved one while you get out of the house for a while. This can refresh you and give you more energy for caregiving.
  • There are several agencies that can provide home care or respite care (someone to stay with the person with cancer while the caregiver takes some time off).
  • If you need help arranging support, the local chapter of the American Cancer Society may be able to assist you. The social worker in the Pain and Symptom Management Program may also have ideas of agencies that can help.

What can help with communication problems?

  • Remember that it is o.k. to talk about the cancer. Take your cues from the person’s responses and let them lead the conversation.
  • You can bring up the subject by talking about how hard it is for you to talk about the cancer. The two of you can set a time to discuss difficult issues.
  • Be realistically optimistic—don’t try to fake cheeriness or pretend that nothing is wrong.
  • Ask your family member what they are feeling rather than saying “I know how you feel.”
  • Don’t tell the other person that they shouldn’t feel what they are feeling.
  • It’s o.k. to cry.
  • It’s o.k. to laugh.
  • Sometimes your presence alone communicates how much you care; affectionate smiles and touches let your family member feel loved.
  • Remember to share with your family member how much you love them.
  • Be a good listener: maintain good eye contact, listen without interrupting, don’t give advice unless you are asked, and make comments that show you are listening and understanding what your loved one says.
  • You can schedule a family or couples session with one of the psychologists to address communication problems or other difficulties your family is experiencing.

What can help with emotional distress?

  • Find a safe way to express how you are feeling. Confide in a trusted friend or family member who can listen without passing judgment or telling you what to do.
  • You can write about your feelings in a journal or express your feelings through art or some other creative outlet.
  • You could join a support group for families of cancer patients, or read books or articles written by other families dealing with cancer. It can be very comforting and reassuring to hear how other families feel and cope.
  • Make time every day to do something you enjoy (even if for only 15 minutes). This could be taking a walk, going out to meet a friend, reading something fun, or spending time in some hobby that you enjoy. One recent study found that family caregivers had less emotional distress when they continued to participate in valued activities and interests.
  • Plan fun, distracting activities to share together. This can help reduce the stress of long clinic visits, or time spent waiting for test results.
  • Take time as a couple or family to celebrate the small victories along the way such as getting good news, or completing each cycle of treatment. Also make it a point to notice daily pleasant events such as a lovely meal, beautiful weather, kind words from others, a funny story, or a restful nap. And plan to celebrate holidays and special family events together in ways that everyone can enjoy.
  • Nurture hope. Seek out uplifting stories and talk about your hopeful feelings.
  • Seek spiritual support. You may want to contact your spiritual community, or our pastoral care staff can offer support to you.
  • Consider seeking professional help. The Psychological Oncology team offers therapy for family members to help reduce their distress and enhance their ability to cope with the challenges that cancer presents.