Angelina Jolie made headlines this week with the announcement that she recently had a double mastectomy as a preventive measure following the discovery that she carried a gene mutation that sharply increased her chance of developing breast cancer and ovarian cancer. Her husband, Brad Pitt, said in a statement that, "having witnessed this decision firsthand, I find Angie's choice, as well as many others like her, absolutely heroic." Further, he said, "All I want is for her to have a long and healthy life, with myself and our children. This is a happy day for our family."
For her part, Jolie wrote in an op-ed published in The New York Times: "I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition."
Pitt and Jolie have learned what so many couples already know: That "for better or for worse" takes on new meaning when a spouse faces cancer, whether she's taking meaures to prevent it or treat it. When Dan Wackershauser's wife, Rachelle, received a diagnosis of breast cancer seven years into their marriage, he took a month off to help care for their infant and 6-year-old daughter and to accompany his wife to doctor’s appointments and chemotherapy treatments. "I tried to stay positive so I didn’t add to her stress," says Wackershauser, 37, a communications specialist at the University of Wisconsin-Platteville. “My focus was to get her better.”
The American Cancer Society estimates that more than 226,000 cases of invasive breast cancer are diagnosed in women each year, so there are a lot of husbands in Wackershauser's shoes. His advice: "Hold her hand, comfort her, listen and do the best you can. I never once thought, ‘I can’t do this,’ even when helping her with her drainage tubes after surgery.”
Unfortunately, not all husbands stick around. For a study published in The Cancer Journal in 2009, researchers followed married cancer patients for five years. They found that 11.6 percent of the subjects' marriages broke up during that span, which is on par with results for the general population. But here's the difference: The marriages in which the partner with cancer was a woman were six times more likely to break up than those in which the man had cancer.
“I don’t think most men were raised to be caregivers and often don’t know what to do or how to feel," says Brenda Coffee, 63, of Boeme, Texas, the founder of breastcancersisterhood.com and the author of Husbands & Heroes (BookSurge, 2009). And it’s even more complicated when a wife has breast cancer because of the sexual dimension and the potential impact on attraction and intimacy.
“Men may be worried about their sex lives, how they'll feel about her being minus a breast, if they'll still find her sexually attractive or that she may feel differently about being sexually intimate,” Coffee says. Of course, she notes, in most of the marriages that fall apart after a breast cancer diagnosis, “there was probably a pre-existing major problem. But to tuck your tail and turn and run at that time is still a cowardly thing to do.”
What Breast Cancer Patients Need
Breast cancer is not just the wife’s fight, Coffee says. "Marriage is a team. When something happens to one of us, the other team member is called upon in every way imaginable," she says. Husbands should be proactive about offering support, even if it’s just sitting in the chemo room with their wives, reading a book. “We couldn’t do this without our caregivers and our spouses to cheer us on when days are tough and to celebrate our victories even when it’s only, 'You’ve got five chemos down and one to go; look how far you’ve come.'"
Coffee says her husband, James, was her “rock” during her battle with breast cancer. “He told me in no uncertain terms that we were in this together.” Sometimes, she recalls, “he would just look at me and say, ‘It looks like you want your husband to hold you.’ And he would pull me out of my chair and lead me into the bedroom and lie down and just put my head on his shoulder and hold me. He just wanted to feel close to me. He needed it as much as I did.”
Women who receive a diagnosis of breast cancer need to know that their husbands still love and are attracted to them, even when they’re hanging over the toilet throwing up, Coffee says. That’s not necessarily the time to tell her she’s beautiful, Coffee says jokingly, “because she won’t believe you. But when she’s dressed up to go out, tell her she looks great in her wig, or remind her: ‘I don’t care that you don’t have hair; that’s temporary. You are still the beautiful, sweet, wonderful woman I fell in love with. You are not your cancer.’”
"It's times like these that truly test the merit of a man," Coffee says. “Whatever he does, I hope he doesn't ask her to cover up or keep the lights out or tell her he doesn't find her attractive. That would be nearly impossible to recover from.”
For a husband having difficulty coping with the fact that his wife's breasts have changed or been disfigured, she says: “I would urge him to role reverse. How would he feel if his penis were scarred or misshapen? He would be devastated and emotionally scarred if his wife were to reject him. He would hope she could move past that and still want to touch him and make love with him."
The loss of a breast is another challenge couples have to face. Many women feel deformed and fear that is how their husbands will feel about them, too. “The first time my husband and I were intimate after my mastectomy, I wore a black lace camisole because I was afraid he wouldn't find me sexually attractive,” Coffee remembers. “He put me at ease by saying that he didn't love me because of my breasts. Then he winked and said, ‘Besides, I've always been partial to your other attributes.’” When sex recommences after surgery or treatment, Coffee says, men shouldn't be afraid to touch their wives, Coffee says. "You’re not going to hurt her." Counseling can also help a husband deal with these issues.
What Husbands Can Do
Most men don’t leave their ailing wives, but there is more than one way to abandon a spouse, according to Marc Silver, author of Breast Cancer Husband: How to Help Your Wife (and Yourself) Through Diagnosis, Treatment and Beyond (Rodale, 2004).
For husbands, staying emotionally connected with their wives through honest communication and attention are crucial, says Silver, 60, of Chevy Chase, Md., whose wife, Marsha, is a cancer survivor. "Men have the urge to fix things, but in this case, you can’t," he says. "You can’t run her cancer treatment like you’d run a meeting at work. You are not in charge here. You can offer advice and support, but let your wife make her own decisions, even if you disagree, and don’t second-guess her.”
Men may be terrified about losing the woman they love and the mother of their children, but they tend to hide their feelings, out of fear of being vulnerable or a reluctance to add to their wife’s burdens. “A lot of guys feel they have to suck it up and be strong during this period. They don’t want to admit, 'I’m scared,' but it’s natural to be angry, frustrated and scared.” Silver admits to crying in his car so his wife wouldn’t see him, but adds, "If I had told her how I felt, maybe she would have been able to give me a hug and it would have helped both of us.”
Meeting other men who have been through the experience can be therapeutic. Hospitals can point couples to local groups that offer a place to go for advice, support or a place to vent. Organizations like Men Against Breast Cancer and Susan G. Komen for the Cure can help men find such groups as well. When his wife, Karen, received her breast cancer diagnosis in 2009, Shawn Means, 54, of Wellington, Fla., joined Men in Pink, a support group founded by Komen's South Florida affiliate.
“Most men don’t have a clue about breast cancer” until it strikes someone they love and they're suddenly faced with an array of doctors, reading material and high-pressure decisions, says Means, director of sales and marketing for the women's magazine company HerLife. Groups like Men in Pink, he says, can spread information and support so each new husband doesn't have to start from scratch. “The more you can learn from another guy who’s been there, the better.”
In the end, breast cancer can strengthen a couple’s bonds. “We are closer than we were before because we’ve been through something so tough together,” Silver says. “I didn’t start as the best husband, but I think I’ve improved. She gives me a B-plus.”
Advice From a Husband Who's Been There
Marc Silver says he learned some of these lessons the hard way:
- Buy her flowers after every chemo. You can’t make her pain go away, but the little romantic things matter.
- Take an occasional escape from cancer together, like a dinner out or a weekend away.
- Tell her, “You look beautiful" — or, even better, sexy — "to me."
- Maintain intimacy even when sex is not an option after surgery or during treatment. A back massage or foot rub can keep you close physically and make it easier to reconnect after treatment ends.
- Don't be a martyr: Continue to take care of yourself. You need to recharge your batteries so you can be a good caregiver and spouse. This includes continuing to do fun stuff with the guys to get a necessary break and to focus on yourself.
- Know that you will make mistakes and say the wrong things. Don't stop trying.
Bethany Kandel is a New York City author and journalist. She received a diagnosis of breast cancer in October 2007 and is thriving in remission.