How Couples Can Cope Well with Breast Cancer Bone Metastasis

For patients and their partners who are dealing with the woman’s breast cancer, the most effective way to face the challenges and stressors is to take a “we” approach. This is especially true if the patient’s disease spreads to her bones, now adding more anxieties and fear of pain. While both patient and partner are experiencing the stress and strains of their shared situation, each of them bears them differently in terms of her or his personality, cultural gender differences, and household role.

How can couples best cooperate so that each of them copes individually, while also coping as a unified twosome? According to Badr et al. (2011)ⁱ, there are three relationship aspects that can either be supportive or destructive:

1. How well each person communicates her/his stress to the other,
2. How well each person is able to respond to the other’s needs, and
3. How well they work together to manage stress and maintain balance in the relationship.

Asking for support/expressing needs

Many people are brought up with the belief that asking for help meeting their needs is selfish. It may take some effort for either partner to initiate a request, but there’s little point in waiting for the other person to ask. Partners can give each other permission to express when coping is difficult. Remember that requests for understanding and support should be free from a blaming or accusatory tone, since that is likely to add to the recipient’s stress and complicate the situation.

Supportive responses

The other partner can help the other manage the stress she/he is feeling. Here are suggestions for ways to respond to an expressed need that show support:

• Show interest, let your partner know that you care and want to be helpful
• Be empathic (“That must add to your worries” or “You must feel very tired and discouraged”)
• Express commitment to the partnership (“We’re in this together” or “You know I’m here for you”)
• Offer strategic advice and practical help with household tasks, medical appointments, planning child care, etc.
• Stay positive, avoiding hurtful sarcasm, criticism, snapping at your partner, “clamming up” and saying nothing, minimizing the impact of the stressor, having unrealistic expectations, etc.

Co-managing stress in the relationship

Creating and embracing an attitude of teamwork allows both patient and partner to feel less alone with the blended burdens of life’s responsibilities and metastatic breast cancer. Badr et al. write that successfully sharing the challenges facing both patient and partner “…involves joint problem solving, coordinating everyday demands, relaxing together, as well as mutual calming, sharing, and expressions of solidarity.” This requires commitment, the ability to think strategically, and being mindful of the love that constitutes the bond between them.

Couples should remember that they are not alone. Neither member can always have the physical, mental, emotional and spiritual energy to “pull their weight.” As a couple, they can work together to identify support beyond family and friends (work/school/church community, nonprofit organizations, hospital support groups, public assistance/resources, etc.) Patients and partners dealing with metastatic cancer often feel so overwhelmed that the idea of locating additional resources seems daunting, and they may feel like it’s probably not worth the effort.  This is where medical social workers can be of great assistance.

No matter how great the patient’s medical care is, nothing can replace the comfort, consolation and encouragement of a committed partnership. While physicians and nurses attend to the ailments of the body, the couple’s hearts and minds need to be supported and uplifted for the journey ahead.

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ⁱBadr H, Carmack CL, Kashy DA et al. Dyadic coping in metastatic breast cancer. Health Psychol. 2010 Mar;29(2):169-80.