A friend put it succinctly, "I realized I could lose you."
In a way, a cancer patient is lost to loved ones during cancer treatment. Roles within the relationship change. The big, powerful husband adored by his wife of many years is suddenly too weak to do his longtime duties. The wife and mother who makes Martha Stewart look like an amateur has not only stopped cooking gourmet meals, but can't tolerate the smell of cooking food either, forcing Dad to pick up deli stuff, or order pizza to feed their hungry children.
Everyone has to adjust when a family member has cancer. The roles have changed.
There's a new chapter in the family medical history. The cancer patient is the unwilling author of a family cancer history. Genetic counseling is an option, but family members may not want to know the results. It depends on their comfort level with the sword of Damocles dangling above them.
Partners become caregivers. Suddenly, there are extra duties around the house. Some learn to help with ostomy appliances or continuous infusion pumps. It's common to teach spouses to flush PICCs. I often assess my patient's status by the level of distress expressed by the spouse.
There is an uninvited guest who never leaves: fear of recurrence. David and I married after my cancer treatment. It's a cute story; maybe I'll post it one day. A couple of years ago, my surveillance labs came back with abnormal liver function results. My doctor ordered an ultrasound. Watching the monitor while the tech swabbed my belly with a wand, I said to David, "Look, Honey, I'm not pregnant!" I laughed, the tech laughed, but I will never forget the look of pain in my husbandís eyes as he uncharacteristically admonished me, "This isn't funny." I felt guilty for his fear, for letting someone fall in love with me when the cancer could come back. It turned out, an antibiotic I had taken a few weeks before caused the elevated LFT results. There was no cancer, but our uninvited guest remains.
Oncology nurses cannot make these things disappear for our patients. We can, however, reassure that they're on a well-traveled path, and remind them that the most important thing they can do to help themselves is to talk about the pressures they feel as the cancer patient, or as the partner with increased responsibilities. We can also encourage them to develop strategies against their common enemy as a couple. Finally, we can be prepared to provide information about community resources available to support them. And hope for the best.
What advice do you have for patients and their families regarding changing roles during cancer treatment?