Talking with Your Partner
Talking with Children and Teens
Communicating with Other Family Members

How families communicate with each other changes throughout the cancer experience. There may have been times when you and your loved one were communicating well with each other. At other times you may have found it hard to share your feelings, worries, and hopes.

Many caregivers say that going through treatment together made their family closer. Some worry that once treatment ends, things may feel different and that communication might be harder. For some families who were having trouble talking before the cancer, the problems may seem more intense now. Roles may change, which can trigger different emotions. It can affect families in ways they never expected. For example:

• Adult children may have trouble accepting that recovery may take more time than expected.
• Adult children who have been taking care of a parent may have a hard time letting her make her own decisions again.
• Parents of adult children with cancer may still feel a need to protect their chilren and stay involved.

It's easy to say that good communication is even more important now that treatment is over. But it can be hard to know how you, family members, and your loved one can keep growing together after treatment. Try to remember that this period of time is new for all. It will take some time to sort things out.

Talking with Your Partner

After your partner's treatment, here are a few things to consider:

• Give yourselves time. Many problems that you and your loved one have now may get better over time, as each of you adjusts.
• Your partner may need extra emotional support to cope with physical changes or with feeling less adequate as a parent, partner, or friend.
• If either of you are feeling constantly anxious or sad, it can be a strain on both of you.
• Keep in mind that if your partner is acting angry or frustrated with you, it could be that he is still trying to adjust to recovery.
• Couples who have honest and caring communication often find that their relationship becomes stronger after cancer.
• Ask your loved one how she is doing now that treatment has ended. The answer may help you both.

Intimacy

"We're inseparable now, on a certain level. We were pretty tight before, but now there's a level of trust and dependency that goes both ways that's hard to describe. All the little things that we bickered about are gone, now that we've faced death together." - Jim

You may find that sex with your partner is different than it used to be. This can be caused by feeling tired or being afraid of hurting him. Treatment may also have affected your partner's interest in sex or ability to perform. You can still have an intimate relationship with him in spite of these issues. Intimacy isn't just a physical connection. It also involves feelings. Here are some ways to improve your intimate relationship:

• Talk about it. Choose a time when you and your partner can talk and concentrate only on talking. Talk about how you both can renew your connection.
• Try not to judge. If your partner isn't performing, try not to read meaning into it. Let him talk about what he needs right now. Or give time and encouragement to talk when he is ready.
• Make space. Protect your time together. Turn off the phone and television and, if needed, find someone to take care of the kids for a few hours.
• Go slowly. Plan an hour or so to focus on each other without being physical. For example, you may want to listen to music or take a walk. This time is about reconnecting.
• Try a new touch. Cancer treatment or surgery can change your partner's body. Places where touch once felt good may now be numb or painful. While some of these changes will go away, some may not. For now, you can figure out together what kinds of touch feel good. If you find it hard to get back to your sexual relationship, talk to a specialist about your sex life after cancer.

Talking with Children and Teens

Give your loved one time to store up the extra energy needed to nurture children. There may be times when she feels guilty for being too tired to play with the children. Rest and emotional support will help these feelings go away over time.

What you decide to tell your children after treatment depends on what you have told them so far. Try to be honest about any aspects of the patient's health that affect them. Tell them what to expect over the next few weeks and months. Be positive and hopeful. Also be prepared to repeat yourself over the next few months and years. Your children will hear only what they are ready to hear. As they mature, even week to week, they will become ready to take in more.

Protect your children from the anxiety of waiting for test results and from the ups and downs of judging potential problems. Only tell them when you know something definite that may change things at home. Try to avoid telling them about problems that they can't help with, such as medical bills. If your bills force you to make drastic changes to your lifestyle, then present this as a fact of life. Adjusting to changing finances teaches your children about facing challenges and loss.

You don't have to tell children about every checkup or every symptom that occurs. But do tell your children if there are long-term side effects that make certain daily activities hard for your loved one. If he is not able to do an activity or go to an event, the children may think that he is unhappy or mad at them.*

If you're not sure how your children are feeling, talk with them. And more importantly, listen to them. You may also want to check with teachers, coaches, and other adults in their lives to find out if they notice any changes or concerns.

* Harpham, W. 1997. When A Parent Has Cancer: A Guide to Caring For Your Children. New York, NY; HarperCollins Publishers Inc. Adapted with permission.

Ideas to Reinforce with Children

"Ever since my husband has been sick, my kids are scared to go near him. They don't know how to react. For them, it's a big change, because they've always been close to their father, and now it's like he doesn't have the energy to go to the ballgames and do stuff with them." - Harriett

One of the best things to do during this time is to keep telling and showing your children that you love them no matter what. Here are a few things you might say:

• "We'll still be here to take care of you."
• "Even though treatment is over, it will take time for (Mom, Dad, Grandpa, etc.) to feel better. He may not have the same energy as before. But even though he may not be able to do all the things he used to do, he still loves and cares about you. And he wants to come up with new ways to spend time together."
• "(Mom, Dad, Grandma) will keep going to doctor's appointments to make sure that we're doing all we can to keep her healthy."
• "If you have aches or pains, it doesn't mean that you have cancer. But it's good to let us know how you're feeling so that we can take care of you."
• "What you do doesn't change the cancer in any way. We're okay with you just being yourself. You don't need to be perfect all the time. We'll love you no matter what."
• "You can ask or tell us anything, and we won't be upset. We'll be glad that you told us." (Good communication with your children can help them counteract wrong information they may hear.)
• "It's okay to have a lot of different feelings--mad, sad, happy, afraid, worried, and thankful. It doesn't always feel good to have certain feelings. But it does help to talk with us about how you're feeling."

Here are some other things you can do:

• Thank your children for all they did during treatment. Many children take on a lot of adult tasks during treatment, such as chores or helping with younger siblings. Let them know if you and others are now able to take on some of these roles again, so they don't have to. Assure them that it's okay to be a kid again. And if they are angry about all that they've been doing, try to understand where they're coming from. Listen to them, and let them tell you how they feel.
• If one of your children felt bossed around by a sibling that was in charge during treatment, tell your child to express his feelings at you, the parent, rather than at his brothers and sisters. Let him know that you care about his feelings. Make it clear that you are back in charge.
• Tell your children that even though the cancer survivor may look or act differently, she is still the same loving, caring person inside. Invite the children to ask questions and share their feelings. Spending time together as a family and making sure that your children spend time with your loved one can help.
• Try to spend extra time with your kids. Plan some fun things and special activities with them. You can also help them re-engage in social or school activities they may have been missing.
• Teens may have mood swings or start acting out now. Some may feel embarrassed that their family is different because of cancer, and may act distant or angry. Others assume life will go back to the way it used to be, acting as if nothing has happened. And teens who plan to leave home after high school may feel torn about leaving now. Whatever the case may be, try to remember that they, too, have coped with a loved one's cancer, as well as the other issues that take place at this age. If possible, try to stay involved and communicate as best as you can with them.

Communicating with Other Family Members

Your loved one's cancer may have triggered feelings and changes in your family that you never expected. Some family members may have been very helpful and supportive, which strengthened your relationship. Others may have had conflicts and hurt feelings during treatment, which may take time to heal. Likewise, some people may choose to stay involved and continue to offer love and support. Others may not be as involved as they once were. And some people may have unrealistic expectations for your loved one's recovery time. Like your children, they may assume life will return to normal more quickly than possible. Here are some things you can do to help improve communication with other family members:

• Talk about issues with them. Be honest about what is needed now that treatment is over.
• Ask the doctor or other member of the health care team to talk with them. Have her explain what to expect in the coming months.
• Ask a counselor or social worker to lead a family meeting. Family members can then express their concerns in front of a third party.
• If your family doesn't communicate well, ask a social worker for printed information or Web sites to help explain the situation. You can give this information to your relatives.
• For other relatives who continue to want to help, be specific about the situation. Let them know how your loved one is doing and what types of help are needed.

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