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Family Dynamics After a Cancer Diagnosis

Network - Fall 2009


By Bayan Raji

Cancer doesn’t discriminate. It hits without warning and affects the rich and poor, young and old. And it may significantly impact the way a couple relates to each other.

As treatment begins, individual needs and expectations may change and clash. This shift in dynamics can create conflict, but with improved communication, many can get through this difficult experience.

Phyddy Tacchi

“A cancer diagnosis carries elements of stress and anxiety that each partner may react to differently. It is the uncertainty of the future and fear of death that become the elephant in the room that couples avoid talking about,” says Phyddy Tacchi, a licensed marriage and family therapist and psychiatric advanced practice nurse at M. D. Anderson who specializes in treating couples and caregivers.

Most people live by the calendar year. With cancer, it’s important to learn how to live one day at a time, she says. Following an initial period of instability, a “new normal” often evolves as a different routine becomes established.

“Couples may initially notice increased conflict,” she says. “It often helps to have an objective third party assist with communication about these new difficulties. It can be a bumpy ride, although opportunities exist for greater closeness and intimacy.”

Tips for a healthy relationship

Tacchi says patients and caregivers can use these tips to help facilitate a healthy relationship.

  1. Issue an invitation for dialogue. Learning to “interview” the other partner in a non-threatening manner can deepen understanding and create intimacy. Asking “What is this like for you? What frightens you the most about this? What do you hope for?” reduces loneliness and the sense of grieving in isolation.
  2. Get away from cancer, even for a short time. Activities to diminish stress, such as exercise, meditation, music, knitting or puzzles help.
  3. Caregivers sometimes over-function for their patient. This may encourage patient dependency in ways that can become problematic later on. It’s critical that the patient remain as self-sufficient as possible. To maintain patient independence, it’s helpful for caregivers to learn to differentiate between the things that patients “won’t do” versus “can’t do.”
  4. It’s important for both parties to learn the symptoms of depression and anxiety and seek appropriate treatment if needed. Help is out there.

Tacchi says many cancer patients feel guilty for the responsibilities cancer creates for the other partner. “Most cancer patients grieve the burden their illness places on loved ones.”

Caregivers, however, see the situation differently. “They often place their entire lives on hold to provide care for their loved one,” Tacchi says. “This dedication takes daily acts of selflessness. It may be the hardest thing they will ever do, but also the most honorable thing they will ever do.”


© 2014 The University of Texas MD Anderson Cancer Center