For many people, the first few weeks after the diagnosis are very stressful. You may have trouble thinking, eating or sleeping.  

Common responses to a diagnosis of cancer include feeling shocked, angry, scared, anxious, powerless, sad or depressed. Some people feel a sense of loneliness or isolation or that they have lost their identity. 

It’s important to give yourself time to adjust and to seek the emotional, practical and financial support you need. 

Read more about what you can expect and ways to manage the emotional aspects of living with cancer. 

Complementary therapies may help you cope with the side effects of your treatment, and improve your wellbeing. Please discuss with your treating team if you would like to consider complementary therapies alongside your conventional treatment. 

Talking to your family and friends

A cancer diagnosis also has a significant impact on the people close to you, including children, partner, parents, friends and colleagues. Their support throughout your cancer journey will be invaluable, and it’s important to talk to them openly.  

For partners of people with breast cancer

A diagnosis of breast cancer can be extremely stressful for partners, too. 

There is a lot you can do to support how to support your partner through breast cancer and what you as a partner can do. But it’s also important to look after yourself, accept any help offered to you, and seek support if you need it.  

Find more information for partners of people with breast cancer. 

Find out more about:

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How you might feel after a diagnosis of breast cancer

Common responses to a diagnosis of breast cancer include feeling shocked, angry, scared, anxious, sad or depressed. Some women feel a sense of loneliness or isolation or that they have lost their identity.

Impact of diagnosis on children

Children are likely to be affected by a parent’s cancer diagnosis. Depending on their age, children may know something is wrong without even being told. Change can be frightening for children. It can be difficult for them to adjust, especially if their parent looks different or is in hospital for a time. Children may worry about what the diagnosis means for them — whether they will be left alone and whether they might also develop cancer.

It can be helpful for parents to talk to their children about a cancer diagnosis and treatment so they understand what’s going on. It’s important to answer their questions as honestly as possible in words they can understand. What they imagine to be happening is possibly more upsetting to them than the reality will be once it’s explained.

The following tips may be helpful:

• Ask each of your children how they’re feeling and recognise their distress.
• Try to understand what it is that they fear will happen. This will help you to decide what information they can handle and how it should be given.
• Talk to them about feelings as well as facts.
• Give simple, honest answers to their questions and correct any misunderstandings. Children respond well when they feel they are being given time especially for them.
• Try to explain what will happen next.
• Don’t make promises you may be unable to keep.
• Maintain a sense of routine and encourage them to socialise with their friends and participate in their usual activities.
• Reassure them that the cancer is not their fault — this is especially important for younger children.
• Adolescents may have mixed emotions, loyalties and coping abilities. In some respects, they thrive on being regarded as an adult, but during times of illness in the family, it can be really hard going. Be aware of this and look for signs that an adolescent needs a little extra support and encouragement.

Cancer Council NSW has developed a booklet about talking to children about cancer called When a parent has cancer: how to talk to your kids.

Impact of diagnosis on family and friends

A diagnosis of cancer can have a significant impact on family and friends. Many people find that friends and family are very supportive, but sometimes it can be disappointing when people don’t offer the support they feel they need. Some people find that family and friends don’t know how to talk to them about their cancer and tend to stay away. Others say that they are pleasantly surprised by the level of support and understanding provided by others.

Your family and friends may try to support you by putting on a happy face or by being overly caring. They may deny your illness or play down your anxiety or symptoms. Let your family and friends know when their behaviour upsets you. They will probably appreciate some direction on how to act. They might need support themselves and they may need advice about how they can help you.

The way family and friends cope and react has a direct impact on a person’s cancer experience. Supportive family and friends can make all the difference.

As you express your own feelings, remember that others may need to do the same. They may experience similar fears and anxieties, and need as much information and advice as you do. Family members may feel angry too. They may express their own hurt at your outbursts, at the possibility of losing you, and at their inability to do anything about the disease. They may also fear how the illness will change their lives.

Often, family members are ready to talk at different times. Give them the space to talk when the time feels right.

If your family has difficulty talking about cancer to one another, it may help if they speak to a counsellor or the hospital social worker. If family members deny the reality of cancer or refuse to discuss it, encourage them to come with you to the doctor or the hospital when you are having treatment. This may help them accept your illness.

Impact of diagnosis on partners

Many partners find the diagnosis and treatment of cancer distressing but are reluctant to seek help for themselves because they feel they need to be ‘strong’. Partners can experience higher levels of stress than the person diagnosed with cancer. They also have different information needs. Everyone is different and will have his or her own way of coping.

It’s important that people with cancer and their partners are open with each other about how they are feeling. Going to appointments together can provide valuable support and can give partners the opportunity to ask questions. Some partners choose to make a separate appointment with their doctor or another member of the team to discuss how they are feeling. Some couples choose to see a counsellor or other trained professional together.

People in same-sex relationships

You may feel that your sexuality isn’t mentioned when discussing the effects of treatment on sexuality. Many of the issues are the same for you as for other people. You may also feel distressed by the impact on your body image, sexual functioning and fertility.

Tips:

• Try to be open with your doctor about your sexuality. This will help them understand your needs. This will be easier if you find someone you can trust.
• Take your partner along to doctors’ visits. This will show your doctors who’s important to you and your partner can be included in discussions and treatment plans.
• Talk to someone who has a greater understanding of same sex lifestyles. Call the Cancer Council Helpline on 13 11 20 for suggestions.

Regaining sexual confidence

For most people sex is more than arousal, intercourse and orgasms. It involves feelings about intimacy and acceptance, as well as being able to give and receive love.

If we are not comfortable with the way we feel about our bodies, this may affect our confidence and desire for sex.

Some people worry about being rejected by their partner, or any new partner, because of changes to their body, whether these changes are visible or not.

It is sometimes difficult to communicate sexual needs, fears or worries with your partner in an intimate relationship, but you may be surprised and encouraged by the amount of tolerance, trust, tenderness and love that exists between you.

However, problems can arise because of misunderstandings, differing expectations, and different ways of adapting to changes to your sex life. If this happens, you may find counselling helpful, either with your partner or on your own. You may be able to work through these challenges towards a new closeness and understanding. Even if it's difficult, try to talk with your partner about how you are feeling and share your fears and concerns. Ways can be found to adapt to your situation and help you feel closer to each other.

What if I don't have a partner?

Finding a new partner can seem daunting after cancer treatment. You may be worried about how a new partner will react to your cancer, even if your body appears unchanged.

Deciding when to tell a new partner can be difficult. You may want to wait until you’ve been out a few times and feel it could develop into a relationship before sharing the information. It may help to show them any body changes before any sexual activity so that you can both get used to how that makes you feel. Ultimately, you need to rely on your own judgment about what to say and when.

If a new relationship doesn’t work out, don’t automatically blame the cancer. Remember that not every relationship worked before you had cancer. Sharing your concerns with someone who has been in a similar situation can help.

What you as a partner can do

Cancer treatment or surgery can change your partner’s body. Areas where touch used to feel good may now be numb or painful. Some of these changes will go away. Some will stay. For now, you can figure out together what kinds of touch feel good, such as holding, hugging, and cuddling. Your partner needs to know that you still love them and find them attractive. Remind yourself of their other qualities: sense of humour, intelligence or personality.

Talk to your partner. Ask them to tell you or show you what feels good or what areas are sensitive to touch. You might feel awkward about sexual contact because you think your partner is not ready for sex or that physical contact may hurt them. These feelings may affect your libido. These effects are temporary and will improve with time.

Make dates. Many couples find that it helps to plan special occasions. Some days may end up being better than others for these dates, depending on how your partner feels. So you may need to be okay with last-minute changes.

You don’t have to be fancy. It’s about spending time together. That can mean watching a video, going out to eat, or looking through old photos. It can be whatever you both like to do. You can also plan these dates to include other people, if you miss being around others.

A counsellor can help you find ways to help each other. There are many who deal with intimacy and sexuality issues with cancer patients.

Call the Cancer Council Helpline on 13 11 20 for more information, or talk to your treatment team.

After diagnosis

For many people the first few weeks after the diagnosis are very stressful. You may have trouble thinking, eating or sleeping. Common responses to a diagnosis of cancer include feeling shocked, angry, scared, anxious, sad or depressed. Some people feel a sense of loneliness or isolation or that they have lost their identity. Others blame themselves for their cancer or find themselves questioning why cancer has happened to them.

It is crucial that you take steps to enhance your wellbeing at this time to help you adapt to the stress that you are facing. Nurturing your body and mind by eating nourishing food, doing some enjoyable physical activity, and taking some time out to do meditation or relax can help you to feel more balanced and improve your vitality.

Having support and seeking help when needed is also an important aspect of living with a diagnosis of cancer.

There are many different sources of support:

• the treatment team can provide support and advice
• sharing feelings with your partner or another family member or friend can be helpful
• some people find it helpful to talk to other people who have experienced cancer
• some people seek help from a specialist or ask for additional therapy.

Anxiety and depression

Anxiety and depression are common feelings after diagnosis and treatment for breast cancer.

Signs of anxiety include:

• constantly feeling agitated or angry
• sleeping difficulties
• having difficulty concentrating or making decisions
• avoiding distressing issues and situations
• feeling a constant need for reassurance.

Some of the key warning signs of depression include:

• always feeling low or flat
• losing interest in things that used to be enjoyable
• having difficulty sleeping
• poor appetite (although this may also be a  side effect of treatment).

Depression can make it harder to deal with physical symptoms and to cope with breast cancer. Some women avoid talking about their emotional concerns or seeking help because they feel they should be coping or they don’t want to be a burden to others. Others are encouraged by those around them to be strong and positive, which can make it hard to ask for help.

Knowing whether what you’re feeling is ‘normal’

Sometimes it can be difficult for women to put into words how they’re feeling.

Tools such as a distress thermometer can be very helpful in explaining to others what you’re experiencing. You may be familiar with a pain scale, where you’re asked to describe your level of pain on a scale from 0 to 10. A score above 5 indicates significant pain.

Similar to the pain scale, a distress thermometer allows you to pinpoint exactly how you’re feeling on a distress scale from 0 to 10. The thermometer can be filled out while you’re waiting for treatment or an appointment. It asks you to rate how much distress you have been feeling over the past week including today.

The scale ranges from ‘no distress’ (0) to ‘extreme distress’ (10). People with a distress level above 5 on the thermometer will usually need some form of professional support.

The thermometer also comes with a list of specific problems different people face and asks you to circle any that have been an issue for you in the past week including today. This can open up the opportunity to work through specific issues.

To view an example of a distress thermometer tool, see the 'Cancer - how are you travelling?' guide.

What can help manage emotional changes

Some of the things that might help manage emotional changes due to breast cancer include:

• relaxation: can help to control pain
• muscle relaxation and imagery: can help with anxiety and can help reduce nausea and vomiting
• support groups: some women find it helpful to meet with other people in the same situation to share their experiences, concerns and fears; meetings can be face-to-face or held over the telephone or internet
• counselling: counselling with a trained health professional can help to clarify feelings and help women deal with issues that may have been brought up by their diagnosis and treatment.

Antidepressants and breast cancer

Up to half of women with early breast cancer will experience some degree of depression or anxiety. If this is severe or doesn’t settle over time, antidepressants or anti-anxiety medication can be very effective, in combination with other treatments such as relaxation therapy.

There’s no evidence that anti-depressants are addictive, and most people will only require this medication for a few months, but sometimes it can be longer depending on the individual woman’s situation. Most of the medication for anxiety will only be used for a few weeks. Needing medication doesn’t mean a woman is ‘weak’ or ‘crazy’, and many people who have taken medication feel so much better that they wish they had started treatment earlier.

Talking to people

Some people find it easy to talk about their feelings. Others may never feel comfortable. You need to decide when you are ready to talk. It’s OK to tell people you’re not ready to talk and that you’d rather wait for another time. Try not to put it off for too long. Talking about your feelings to a good listener is helpful.

Sometimes talking to family and friends isn’t enough. You may want to talk to other people, such as:

• Nurses: support and assist you through all stages of your treatment
• Social worker, physiotherapist and occupational therapist: link you to support services and help you to resume normal activities
• Psychologist and psychiatrist: talk with you and your family about your worries. They can help you figure out what upsets you and teach you ways to cope with these feelings. Psychiatrists can prescribe drugs if you are depressed
• Support group: offers support and information to people with cancer
• Pastoral care worker: helps you explore spiritual concerns
• Tele-counselling: support group meetings that take place by telephone.

You may not want to talk about your fears and concerns with family and friends. This may be because you think you don’t have the words to describe how you feel, or you fear breaking down if you talk. You may also want to avoid being a burden to family and friends or fear appearing as if you are not coping.

Research has found that support helps people adjust to the diagnosis. The longer you avoid communicating the harder it will be. If you feel your family won’t understand, join a support group or talk to a health professional.

Antidepressants and cancer

If depression or anxiety is severe or doesn’t settle over time, antidepressants or anti-anxiety medication can be very effective, in combination with other treatments such as relaxation therapy.

There’s no evidence that antidepressants are addictive, and most people will only require this medication for a few months, but sometimes it can be longer depending on the individual person’s situation. Most of the medication for anxiety will only be used for a few weeks. Needing medication doesn’t mean a person is ‘weak’ or ‘crazy’, and many people who have taken medication feel so much better that they wish they had started treatment earlier.

Impact of breast cancer on sexuality and intimacy

Treatment for breast cancer can affect a woman's relationship with her partner, including their sexual relationship. Different treatments can affect how a woman feels about herself and her attractiveness. This can happen to any woman, whether or not she has a partner.

Some of the sexual difficulties that may arise as a result of treatment include:

• feeling less attractive because of treatment
• breast tenderness after treatment
• lower libido because of feeling unwell, tired or worried
• vaginal dryness due to the impact of different drugs.

Managing these symptoms may require some effort – and open communication between a woman and her partner.

What can help with sexual difficulties caused by breast cancer?

Even if it's difficult, try to talk with your partner about how you are feeling and share your fears and concerns. Ways can be found to adapt to your situation and help you feel closer to each other.

• You and your partner may find it helpful to talk to a health professional about your concerns – you can do this together or separately. You may want to ask for advice from a trained specialist such as a relationship counsellor or sex therapist.
• There are some practical things that can help overcome some of the physical changes due to treatment. Water-based lubricants, vaginal moisturisers and creams can help with vaginal dryness. Talk to someone you feel comfortable with in your healthcare team to find out more.

Same sex couples and breast cancer

Women in same sex relationships may feel that a lot of attention is placed on heterosexual couples and that lesbian sexuality is not mentioned when the impact of breast cancer on sexuality is discussed.

Talking with someone you feel comfortable with in your healthcare team may help you and your partner feel more supported.

Cancer and self-confidence

Cancer treatment can change the way you feel about yourself (your self-esteem). You may feel less confident about who you are and what you can do. Dealing with the cancer diagnosis and the treatment can make you feel like you’re on an emotional rollercoaster.

Cancer treatment can also change the way you feel about your body. Cancer and its treatment can mean changes to the way your body looks and how you feel about your body. Body image may not depend on how you look but how you think you look.

Regardless of what treatments you have or how your body looks after treatment, you may feel differently about your body after treatment for cancer. You may be unhappy with your body size or shape or about scars from surgery. This can affect your self-confidence.

Some people worry about how their body changes will impact on relationships with others, especially intimate relationships. A change in body image may not affect your ability to have sex but it may make you feel less sexual.

These feelings are common. It may help to talk about how you feel with your partner or other people who have had cancer.

Some people find that physical activities — sports, dancing classes, exercise — improve their body image. Creative activities such as painting, playing music, and craft can also increase your self-confidence.

Others find that they love themselves and their body more after cancer, as they come to terms with what they have been through and realise that they have an inner strength that they didn’t recognise before.

Tips:

• Give yourself time to adapt to what you’ve been through.
• Draw attention to your good points.
• Consider wearing a scarf or wig if your hair has fallen out from chemotherapy.
• Try to stay active and exercise as regularly as you can.

Hair loss

Although losing hair may not seem serious compared to coping with cancer, many people find it upsetting. Hair loss may affect how a person feels about themselves and their sexuality. Hair loss from chemotherapy can range from mild thinning of the hair to total hair loss, including body hair. When the hair grows back it may be more curly, thicker or finer than it was before treatment. It may grow back a slightly different colour.

Some people choose to wear a wig while their hair is growing back. Others choose to wear a scarf or hat, while some people prefer to keep their head uncovered.

Depending on where you live you might be able to go to a Look Good Feel Better workshop. These are free of charge and provide tips and advice about dealing with changes to the way you look while having chemotherapy. Workshops are available in capital cities and other major centres.

Effects on your sex life

Treatment for some cancers can affect your sex life. Many of these effects can be prevented or treated.

• Lack of interest or loss of desire for sex. Low libido is common during cancer treatment. Sometimes it can be brought on by anxiety and worry about your diagnosis rather than the treatment. Libido usually returns after treatment is over.
• Temporary pain. After some types of surgery you may have to wait several weeks before having sex again. In the meantime, kissing, caressing and touching can also be pleasurable.

Tips:

• If fatigue is a problem, try different times of the day to be intimate.
• If you are experiencing low libido, talk to your partner about how you are feeling. They need to know when you feel ready for sex and ways to help you get in the mood.
• Although sexual intercourse may not always be possible, closeness and sharing are vital to a healthy relationship. Explore other ways of sharing intimacy and showing affection for each other such as touching, holding, hugging and massaging.
• Try different sexual positions if your usual ones are uncomfortable. Use cushions or pillows to support your weight.
• Suggest a quick lovemaking session rather than a long session.
• If you have a stoma, the Cancer Council NSW booklet Sexuality for People with a Stoma has more information. For a copy call the Cancer Council Helpline on 13 11 20.

Impact of breast cancer diagnosis on partners

Many partners find the diagnosis and treatment of breast cancer distressing but are reluctant to seek help for themselves because they feel they need to be ‘strong’.

Partners can experience higher levels of stress than the person diagnosed with cancer. They also have different information needs. Everyone is different and will have his or her own way of coping.

It’s important that women and their partners are open with each other about how they are feeling. Going to appointments together can provide valuable support and can give partners the opportunity to ask questions.

Some partners choose to make a separate appointment with their doctor or another member of the team to discuss how they are feeling.

Some couples choose to see a counsellor or other trained professional together.

Information for men whose partners have been diagnosed with breast cancer

Drawing on interviews with men who have faced the same crisis, this section of the website is designed to help men understand what’s happening to the woman they love.

It suggests what men can do to help the woman they love – and themselves – as they travel the cancer journey. Most of the issues covered in this section are relevant to partners, family and friends of all cancer sufferers.

This section of the website was edited by men for men. Find our more informaton for men here.

Where to find support for partners of women who have been diagnosed with breast cancer

• The Cancer Council Helpline – 13 11 20
  The Cancer Council Helpline is a free, confidential telephone information and support service run by Cancer Councils in each state and territory. Specially trained staff can answer questions about all aspects of cancer, including prevention, early detection, and treatment. They can also assist with practical and emotional support and advise callers about specific services appropriate to their needs and location.
  
  Call The Cancer Council Helpline on 13 11 20 (cost of a local call from anywhere in Australia) between 9 am and 5 pm, Monday to Friday. Some states have extended hours, some have health professionals on staff, and some have multilingual services.
   
• Lifeline – 13 11 14
  www.lifeline.org.au
  24-hour telephone helpline staffed by trained volunteer telephone counsellors
   
• Beyond Blue
  www.beyondblue.org.au
  Community awareness campaign designed to reduce the stigma associated with depression and to promote help-seeking behaviour.
   
• Grieflink
  www.grieflink.asn.au
  Information resource on death-related grief for the community and health professionals. Based in South Australia but includes some national information.

Information for men whose partners have been diagnosed with breast cancer

How should a man deal with the fact that the woman he loves has been diagnosed with breast cancer? She's devastated. So are you.

She admits it, acts like it. If you’re a typical man, you don't admit you're devastated (perhaps even to yourself), and you focus on being a tough, tower of strength. You support the woman you love and don't show, or worry about your feelings. This is how guys are supposed to act, right?

Maybe not.

If you really want to support the woman you love through her diagnosis and treatment for breast cancer, you owe it to her and you owe it to yourself to make sure you’re fit, well, and mentally prepared for the task ahead. Spending time on this website is a good place to start.

What she might be feeling

Women with breast cancer often say they don't have time to think about their partner much. Having some insight into how the woman you love might be feeling after diagnosis and treatment for breast cancer will help you respond more effectively.

• She may be distressed if she senses you withdrawing. The feelings you have of fear, sadness and helplessness may cause you to do this to try to protect her.
• Understand the emotional effects of the disease on her. Minor things may become gigantic. She may cry and snap at you – you may barely recognise the woman you love. Recognise that little things can become big issues. Sometimes angry feelings can get spread all over the place!
• Acknowledge the 'bad things' associated with the diagnosis. The treatment may make her sick. It may make her depressed. Breast cancer is a life-threatening illness that she and you need to come to terms with. There’s a great temptation to be 'positive' but this isn’t usually constructive.
• Provide support through listening without judging. When she’s distressed, allow her to express her feelings.

How do you feel?

Make no mistake: the impact of the woman you love having breast cancer is every bit as overwhelming and distressing for partners and other close family members as it is for the patient. Should you even be considering your own feelings when the woman you love is the one with cancer? Yes, you should. A diagnosis of cancer affects everyone, including you.

Is what you’re feeling normal?

You don’t have to pretend everything’s OK. It isn’t.The woman you love has been diagnosed with a potentially life-threatening illness.

She may need to have a breast removed. She may be sick for a long time. She might be ashamed of her body. She may not be able to live the life she once did. You will have to fill some new roles to compensate. You may have to take on more responsibility at home. You will have to fit visits to hospital and doctor around your schedule.

The control you might have thought you had over your life has vanished. It’s hardly surprising therefore that most men in this situation struggle to come to terms with their new situation. If you’re struggling, you’re normal.

You probably don’t really know what you are up against. Or whether you’ll be able to cope. Acknowledge these feelings, and decide to work on understanding them, communicating them, and gradually getting them under control.

You owe it to yourself, and to the woman you love to do so. If you’re an emotional mess you can’t support the woman you love the way you want to, or in the way she needs you to.

Typical feelings

Here’s a list of typical feelings other men have described about their reaction to learning the woman they love has been diagnosed with breast cancer. If it’s on the list it’s because many men in your situation have mentioned it. You’re not alone.

• Feeling guilty? Wondering what you did to bring it on? There’s no cause for the illness which makes it hard to understand.
• Frustrated at not being able to fix the situation?
• Unprepared, shocked, disbelieving?
• Worried about your own ability to cope with the loss of your partner’s breast?
• Isolated? You may feel very alone when the woman you love is in hospital and find it hard to ask for help.
• Feeling moody or lacking in energy?
• Experiencing gnawing fears behind your controlled exterior?
• Difficulty in concentrating, disrupted sleep, appetite changes, loss, sadness, powerless?
• Difficulty in coping with the emotional and physical distress felt by the woman you love?
• Worried and guilty about finances?

It’s never easy to discuss your feelings. You may not know what to say and you may not want to seek help for yourself when you believe the major support should be for the woman you love. Most men find it easier to put their own needs on hold. While it’s tempting to try to protect her by not expressing your feelings, or by trying to be positive, it’s important that the woman you love knows how you feel.

Fear of death

Cancer is a life-threatening illness, not a death sentence. But the issue of mortality is there and should be acknowledged. A sanitised view, that everything will be OK like thinking positively is considered the right thing to do, but isn’t necessarily helpful.

• Acknowledge your fears
  You may fear the cancer itself – that it may come back or that the woman you love may die. You might be concerned about dealing with her emotional changes or you might be concerned about whether she’ll be able to have children in future. These are all natural feelings.
   
• Share your fears with your partner
  Although this can be difficult, it can be very helpful for both of you. Most women are touched to hear their partner’s concerns, and hearing that you’re scared too can open communication about issues you’re both finding difficult.
   
• Focus on quality of life, not on quantity.
   
• Ask for help
  Get professional help if you need it, talk to someone, talk to each other, try speaking to your doctor, minister, priest or other spiritual advisor.

Sexuality and intimacy

Breast cancer has all the issues of the other cancers, plus the added complication of sexuality and body image.The physical effects of breast cancer on the woman you love are a significant aspect of the disease.

Apart from the potential loss of all or part of a breast, early menopause from chemotherapy, infertility and the effect of treatment on libido, there are also issues of body image, sexual attractiveness and femininity.

As a couple, you may experience changes in your sexual relationship. This can be caused by physical or psychosocial reasons or both. Some cancer treatments can have a major impact on sex drive. The physical change to a woman can have a profound effect on her body image and this will affect her feelings of sexuality and love-making. Some women find it hard to undress in front of their husband after surgery.

Getting past the physical appearance

It can be hard to get past the physical changes associated with treatment for breast cancer – for some men, it can be very hard. It may require a conscious re-evaluation of your own attitude. You may need to reprogram your thinking. Keep in mind what you know, that you are in love with a person, not with her body.

How to deal with breast cancer and sexuality

Communication, information and patience are the keys to understanding and coping with the physical and psychosocial effects of breast cancer on sexuality. Here are some suggestions to help you deal with the impact of breast cancer treatment on your sexual relationship.

• Sexuality comes and goes. There’s a need to heal physically and sexually after treatment for breast cancer. If sex is important to you as a couple then you need to take time to re-create the sexual bond.
• Information about how chemotherapy can cause early menopause can help you and the woman you love cope with the effects of this.
• Talk to each other, take things slowly, spend time getting used to being naked together.
• Sexuality is not just about sex. Couples may need to take a few steps back and build on intimacy (emotional not physical), strengthen communication, talk about needs. Our brain is our most important sex organ!
• Don’t avoid the issue. She may interpret your distance (whatever the reason) as confirmation that she’s no longer desirable.
• It’s still OK to have sex throughout.
• The double bind: “It didn’t matter if I told her 37 times it didn’t change my feelings for her.” You may find it hard to convince the woman you love of your commitment. This can cause hostility and feelings of rejection on your part. You can handle these effectively if you’re aware that the situation may occur and have learned methods of dealing with it.
• Be aware that sexual attractiveness and body image extends beyond the bedroom.
• Talk to a professional if you are having problems adjusting. Studies show that mastectomy patients’ partners who received counselling were less distressed and more prepared to help the woman they love cope.

Impact of a breast cancer diagnosis on kids

It’s is a good idea to read up on the impact breast cancer can have on children. Ask your children about the concerns they may have. The children may ‘play up.'

Talking to them about their concerns, understanding what is underlying their behaviour, will help you both cope and should help improve their behaviour.

Knowing what to say

What do you say to someone who, out of the blue, has been diagnosed with cancer? Many men in this situation have admitted that they didn’t know what to say. They were terrified of saying the wrong thing, and upsetting the woman they love. They ended up saying very little. All the evidence suggests that this is the worst thing you can do.

Professional advice suggests you should communicate – as much as possible, more than ever before – with the woman you love. The following tips might be helpful.

• It’s OK to ask her how she is feeling (she wants to know you care). Do this often if you can.
• It’s OK to say “I don’t know what to say” (she then at least knows you are feeling and thinking about her).
• The best advice is to be human – tell her how you are feeling, talk about ways in which she feels you can help and support her most.
• “Don’t worry” sounds reassuring, but is in fact asking the woman you love to do something that’s impossible. Of course she is going to worry. So are you. There is something wrong with both of you if you don’t.
• Understand that small things can really make a difference, both positively and negatively, to the woman you love during her diagnosis and treatment. Many things are affecting her and small things that would normally not upset her now do. Similarly, small things you do for her, which would not usually be noticed or commented on, can bring great joy and comfort.
• Be prepared for the woman you love to react more energetically than usual to lots of small things. Recognise the extra reaction when it occurs, and accept it. There’s nothing either of you can do about it and trying to fight it will only make matters worse. The Americans have a word for your tactics here: “Chill”.
• Be aware that other men in her life – brothers, uncles, fathers, friends and so on – will be facing exactly the same dilemma as you. Make sure they understand that communicating is extremely important, and that they must overcome the fear of not knowing what to say as well.

Help her by helping yourself

You probably also need help and support. The following tips may be useful:

• Ask for help if you’re overwhelmed
  This isn’t a sign of weakness. It takes courage to face reality and take control of the situation. Talk to your friends and family. If they can’t relate find people who can. Find out about cancer support groups in your area. If you’re not a talker find other ways to understand what you are going through. Write them down.
   
• Take time out to recharge your batteries
  Look on it as ‘filling the petrol tank’ rather than trying to run on ‘empty’. Women often worry about their partner and it can be a great relief for them to see you having a break. There’s also some evidence that having some ‘normal’ things in your life helps.
   
• Talking generally helps make it better, not worse
  Open up the subject for discussion. Talk about thoughts, feelings and fears. Some people feel uncomfortable broaching the subject. Bring it up with them. Let them know you need to talk about it. Acknowledge the impact this has on your life.
   
• Active coping not positive ignorance
  You may worry that if you are not being positive and strong, she may take longer to recover. There’s no consistent evidence that this is the case. Keeping all the concerns to yourself adds to the burden. There’s also evidence that active coping (i.e. thinking things through, getting information and talking) helps, and avoidance of issues is associated with more distress.
   
• Monitor your relationship:
  Acknowledge the difficulties you’re facing. If you were having problems with your relationship before, they will be magnified by the stress you’re now under. The same goes for work or social problems. Issues don’t disappear with diagnosis. Be as active (not passive) in thinking through and solving problems as you can. When in doubt – get a second opinion.

Healing strategies – tips that often work

• Get to grips with the subject: research it.
  As men, we like to get a handle on problems. That means you need information and there’s plenty available. Look at all of the links on this site. Read, research, get a better understanding of what breast cancer is. Gather information about treatments, doctors, and complementary therapies and about what resources and services there are to help you.
   
• Don't assume
  You can’t assume the woman you love will provide the sort of facts that will give you the tools to help adjust. You also can’t assume that the woman you love will take in or understand everything her medical support team tell her. She is under significant stress. Make sure you go to appointments with her, and run through everything that was said again afterwards.
   
• Discuss your findings with her
  Make sure both of you know what is going on.
   
• Be the organised one
  Keep a calendar of appointments and treatments, deal with financial and insurance issues. Keep track of the kids' routines and family matters.
   
• Go with her to the doctor: (if she wants you to)
  You can provide support and you may be in a better position to make sense of information provided by doctors. Many women report feeling so shocked during hospital visits that they can’t take everything in. Take a note pad and ask questions if you don’t understand.
   
• Ask for help with practical things
  Friends and family really want to help and will be grateful for a specific request like picking the kids up from school or making a meal to take home. Advice from men who have been through this experience is not to be 'proud', and say you can handle it. Accept all offers of help – it helps friends and family to deal with the illness if they can actively help. Help might mean asking a friend to call every couple of days, for example.
   
• Take time out to be with her
  Be around. Take time off work. Cut down on other activities to be with the woman you love. You may feel it’s not fixing anything, but it’s helping make it better. Asking for help from friends and family will free up your time.
   
• It’s OK to have fun and try to keep your life as normal as possible
  Use humour and laugh when you can. Maintain a social life. Have a holiday. Adapt, don’t switch off.
   
• Resume former activities as soon as possible but be aware that after completion of active treatment, women often feel the pressure to ‘get back to normal.’ This can cause distress or anger as they feel that their experience has been trivialised. In effect, the goal posts have shifted. You can still play the game, but the rules are different. By accepting that things are different, you can take the pressure off the woman you love and yourself.
   
• Think ahead
  Help prepare for hospital stays by organising books, CD's, DVD's, or other items to make her stay more comfortable. Give her extra hugs and assurance. Take the kids out so she can rest.
   
• Be realistic about your financial situation
  During treatment, there will be new expenses to meet and there may have been a drop in family income. Don’t feel guilty if you’re finding it tough. Communication is the key. Talk to employers and see what can be negotiated. Employers can’t offer to help if they don’t know what you are facing. Raise the issue with your doctor. There may be benefits you’re entitled to. Also let your colleagues know what you are going through. They can be a source of help and support.
   
• Celebrate treatment anniversaries and victories
  Acknowledge that she will be stressed around key anniversary times. Don’t ignore this, do something special to mark the date. Celebrate victories too.

Where to find support for partners

Where to find support for men whose partners have been diagnosed with breast cancer.

• The Cancer Council Helpline – 13 11 20
  The Cancer Council Helpline is a free, confidential telephone information and support service run by Cancer Councils in each state and territory. Specially trained staff can answer questions about all aspects of cancer, including prevention, early detection, and treatment. They can also assist with practical and emotional support and advise callers about specific services appropriate to their needs and location.
  
  Call The Cancer Council Helpline on 13 11 20 (cost of a local call from anywhere in Australia) between 9 am and 5 pm, Monday to Friday. Some states have extended hours, some have health professionals on staff, and some have multilingual services.
   
• Men's Line Australia – 1300 78 99 78
  www.mensline.org.au
  Provides telephone counselling, information and referral for men to help manage the challenges encountered when they face disruptions to their family life or primary relationships. Helpline available 24 hours a day, 7 days a week.
   
• Lifeline – 13 11 14
  www.lifeline.org.au
  24-hour telephone helpline staffed by trained volunteer telephone counsellors
   
• Beyond Blue
  www.beyondblue.org.au
  Community awareness campaign designed to reduce the stigma associated with depression and to promote help-seeking behaviour.
   
• Grieflink
  www.grieflink.asn.au
  Information resource on death-related grief for the community and health professionals. Based in South Australia but includes some national information.

Impact of breast cancer diagnosis on children

A woman’s children are likely to be affected by her breast cancer diagnosis. Depending on their age, children may know something is wrong without even being told.Change can be frightening for children. It can be difficult for them to adjust, especially if their mum looks different or is in hospital for a time. Children may worry about what the diagnosis means for them – whether they will be left alone and whether they might also develop cancer.

The information in this section is aimed particularly towards dependent children. However, a parent’s cancer diagnosis can be upsetting even for adults with children of their own. Having open and honest communication is generally helpful. Adult children might find it helpful to access further information about support through the Cancer Council Helpline on 13 11 20.

How children may react to a breast cancer diagnosis

Children are often concerned about changes in the family and are worried that the well parent may also get sick. Children might also worry that they have caused their parent’s illness.

The effect of a woman’s cancer diagnosis on her children may be reflected in their behaviour. It can be helpful for women to tell a teacher at their child’s school about their cancer diagnosis so that the school understands the reason for any changes in behaviour.

Children might have a range of responses to their mum’s diagnosis, such as:

• being angry at her for being sick
• withdrawing from her
• clinging to her
• resenting that they need to help her
• behaving badly to cover up real feelings
• wanting to get sick to get attention
• going through the stages of grief their mother is going through
• being afraid that they will get cancer too.

How teenagers may react to a breast cancer diagnosis

Teenagers may be particularly vulnerable to their mother’s diagnosis of breast cancer. They may be worried about how their mum is coping as well as dealing with their own feelings, and may take on the role of helping to run the house.

Daughters might worry whether they will also get breast cancer. It might be difficult for teenagers to talk about these issues.

Teenagers in the family might need to take on more household chores or help with their mother’s care. Disruption to their social outings or leisure activities can be issues for them. Sometimes this can make them feel that their needs are not being met. They might have an intense desire for life to return to ‘normal’ and feel resentful at the disruption to their lives and the change of roles within the family.

Teenagers might have a range of issues to face at this time, including:

• worry about the effect of the cancer on their parents’ marriage and the stability of the family
• feeling stigmatised because their mother has cancer
• fear about whether treatment will be effective
• concern about their relationship with the other parent
• dealing with any unresolved issues
• anxiety about the well parent
• feeling isolated from friends
• wanting to be closer to their mother.

Talking to children about a diagnosis of breast cancer

It can be helpful for parents to talk to their children about a breast cancer diagnosis and treatment so they understand what’s going on.

It’s important to answer their questions as honestly as possible in words they can understand. What they imagine to be happening is possibly more upsetting to them than the reality will be once it’s explained.

The following tips may be helpful:

• Ask each of your children how they’re feeling and recognise their distress.
• Try to understand what it is that they fear will happen. This will help you to decide what information they can handle and how it should be given.
• Talk to them about feelings as well as facts.
• Give simple, honest answers to their questions and correct any misunderstandings. Children respond well when they feel they are being given time especially for them.
• Try to explain what will happen next.
• Reassure them that even if things are not good at the moment there will be better times.
• Don’t make promises you may be unable to keep.
• Maintain a sense of routine and encourage them to socialise with their friends and participate in their usual activities.
• Reassure them that the breast cancer is not their fault — this is especially important for younger children.
• Adolescents may have mixed emotions, loyalties and coping abilities. In some respects, they thrive on being regarded as an adult, but during times of illness in the family, it can be really hard going. Be aware of this and look for signs that an adolescent needs a little extra support and encouragement.

Cancer Council NSW has developed a booklet about talking to children about cancer called When a parent has cancer: how to talk to your kids.

Impact of breast cancer diagnosis on family and friends

A diagnosis of breast cancer can have a significant impact on family and friends. They might need support themselves and they may need advice about how they can help the person who has been diagnosed with breast cancer.

The way family and friends cope and react has a direct impact on a woman’s cancer experience. Supportive family and friends can make all the difference. Many women find that friends and family are very supportive, but sometimes it can be disappointing when people don’t offer the support they feel they need. Some women find that friends and colleagues don’t know how to talk to them about their cancer and tend to stay away. Others say that they are pleasantly surprised by the level of support and understanding provided by others.

Even if a woman has support from family and friends, there are other sources of support. Local community groups, neighbours, members of the treatment team, support groups and religious organisations can all be a valuable source of help.

Find out more about:

• Breast Cancer Network Australia has produced a brochure Helping a friend or colleague with breast cancer.

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 For more information about symptoms and side effects of metastatic breast cancer, see the issues for women with metastatic breast cancer section.