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Coping with pain, emotions of wife's breast cancer

  When a woman receives a diagnosis of breast cancer, does her husband mask or admit his fear?

If his wife must have a mastectomy, should he advocate for breast reconstruction?

Must he listen patiently as his partner repeats the same concern for the umpteenth time?

When his wife, Marsha Dale, a high-school teacher, received a diagnosis of breast cancer in 2001, Marc Silver, an editor at U.S. News & World Report, had no guide for such questions.

His initial response to her diagnosis was callous, Silver says. But as the couple struggled through Dale's treatment and recovery, Silver found his footing as a supportive "breast-cancer husband."

His book, "Breast Cancer Husband: How to Help your Wife (and Yourself) During Diagnosis, Treatment, and Beyond" (Rodale, $14.95), is a guide for other men in the same situation.

"I wanted to write as a guy for guys," says Silver. "There really aren't very many books that talk about the male reaction."

Men "tend to want to fix things and protect their loved ones," Silver says. "And those aren't always the best instincts to bring into a situation like this."

Tips for husbands Your wife might want to tell you the same story more than once. It's therapeutic for her — and it's good-hearted of you to listen with a sympathetic ear. Your wife may need time to mourn the loss of her breast. You can tell her how much you love her and not her breasts, but this is not the time to play cheerleader. There's no time limit on when breast reconstruction can be done. If your wife is not interested at present, you (and the doctors) should respect her opinion. Make sure your wife goes to a wig shop that regularly deals with cancer patients. She'll get good care, and she won't be hit with fees for trying on wigs. During chemotherapy, just because you're on hiatus from sex, don't forget to show affection. Source: "Breast Cancer Husband: How to Help Your Wife (and Yourself) Through Diagnosis, Treatment, and Beyond," by Marc Silver

"A crash course" in cancer

"I think relationships are really tricky and hard and challenging in general. When breast cancer hits, these relationships become more strained, and it's those very relationships women really, really need," Weiss says.

To be supportive, "men do need a crash course in the disease," says Lillie Shockney, administrative director of the Johns Hopkins Avon Foundation Breast Center and a breast-cancer survivor. "They need to understand the basics so that they can reinforce when to be anxious and when to not be, how they can constructively, physically help, and when they need medical professionals to handle it."

Little attempt has been made to "actively engage men and try to define for them what their role should be in all this," says James Zabora, dean of the National Catholic School of Social Service at Catholic University in Washington, D.C.

Zabora and former colleague Matthew Loscalzo, in collaboration with Men Against Breast Cancer, a Maryland nonprofit group that educates the partners and caregivers of breast-cancer patients, designed a study that measures the value of teaching problem-solving and communication skills to men who have loved ones with breast cancer.

Funded by a $1.1 million grant from the federal Centers for Disease Control and Prevention, the five-year study concentrates on "underserved men" in black, American Indian and Hispanic communities.

Resources Men Against Breast Cancer: www.menagainstbreastcancer.org; 866-547-6222 Y-ME National Breast Cancer Organization: www.y-me.org; 800-221-2141 Breastcancer.org: www.breastcancer.org

"We believe we can show that by dramatically increasing problem-solving skills, you not only decrease the distress in a husband, you simultaneously decrease stress in the breast-cancer patient and simultaneously improve the quality of life for both," says Zabora, former associate director for community research for the Johns Hopkins Oncology Center.

Rushing to fix things

Rather than admitting that he wants his wife to have reconstructive surgery, a husband may say, "Darling, it doesn't matter," Loscalzo says. Instead of discussing their feelings, "men rush too quickly to try to make it better," he says. But trying to fix it, he adds, "often makes it more broken."

"Breast Cancer Husband" meets an important need, says Dale. The book is aimed at men who "clearly care," she adds, but aren't sure how to take the initiative.

On a personal level, Dale says, "If there was one downside to Marc's writing this book, it was that when I just wanted to move on (after treatment), I felt like I never left breast cancer." It was particularly difficult for Dale when her husband interviewed the spouses of women who had died of the disease, she says.

As he interviewed breast-cancer husbands and partners for his book, Silver underestimated the complexity of his task. "I went in thinking there would be very simple solutions and straightforward advice to give. (Then) I realized that what worked with one couple might not be a good solution for another couple," he says.

Silver also assumed initially that honesty was the best policy — that after his partner's diagnosis, a man should be able to admit to "feeling afraid," for example.

But when he asked breast-cancer patients and survivors whether they would have wanted to know if their spouses were afraid, they often said, "Hell, no," Silver says.

When you don't acknowledge your fear, "you're not lying," Silver explains. "It's just that certain emotions that are normal to have in those awful days when you first get the news are very intense. Sometimes those emotions fade away a bit as you speak to chemo doctors and go through treatment."