Monday, September 17, 2007

Husbands also have role in wives' cancer battle

Everyone knows the devastation a breast cancer diagnosis can mean to a woman, but less explored is its effect on their husbands, who often lack the skills to cope with the myriad emotions they suddenly find themselves experiencing and the role their wife now expects them to play.

Marc Silver was one such husband, a journalist who found himself overwhelmed when his wife was diagnosed with breast cancer in 2001. In response, Silver wrote Breast Cancer Husband: How To Help Your Wife (and Yourself) Through Diagnosis, Treatment and Beyond (Rodale Books), a manual to help men whose worlds are suddenly turned upside down. Silver talked with the Chronicle about what every husband of a breast cancer patient should know but that few people talk about.

Q: You describe the book as a guide for clueless men. Why are men so clueless? We get sick. Do we really want something so different?

A: It's a situation where there's no warning — it's not like one person is ill for a long time and then there's resolution. One minute, everything's fine and the next the woman goes in for a mammogram and it turns out it's breast cancer. There aren't a lot of behaviors to call upon in the past to guide men, who want to jump in and fix the problem but know they can't.

Q: What prompted you to write the book?

A: It was really the fact I felt so lost when my wife was diagnosed. She called me from the doctor's office, where the radiologist said, "it sure looks like cancer to me." My reaction was, "eh, that doesn't sound good." We talked about her next appointment, and then I said, "See you tonight," hung up the phone and stayed at work all day. Looking back, I ask myself, "What was I thinking?""

Q: What's the hardest thing for a man about his wife getting breast cancer?

A: Their own feelings and what to do with them. I remember all my fears about how I would lose it, how I might not be able to cope, but I didn't want to tell my wife because how could I go to this woman facing chemotherapy, surgery and radiation and say, "I'm really scared for me." You have a right to all those feelings, but you just don't know what to do with them.

Q: What are the most helpful things a man can do?

A: I often joke that the book's motto is shut up and listen, but I'm really serious.I think being there with her physically is very important — she's going to be bombarded with information. At that time, it's hugely helpful to have someone along to take notes and keep a list of questions you might want to ask the doctor so she can turn to you and ask, "was there anything else we wanted to know?" You can really do a lot of little things that can add up to be a great help.

Q: What do women with breast cancer not get about their husband's response?

A: They don't know what they're thinking inside, that they care even though they may not be showing it. One woman told me how upset she was that her husband didn't seem to be taking her diagnosis to heart, until he told her that after the surgery he came home to have breakfast and his hand was shaking so badly he couldn't lift the spoon of cereal from the bowl to his mouth. I think there's a lot of that sort of miscommunication going on.

Q: What kind of toll does breast cancer take on a marriage? How often do couples break up as a result?

A: There are two conflicting studies on the subject — one that found similar rates of marital dissatisfaction in women with breast cancer and women without; and one that found men caring for women with breast cancer left the marriage more than women caring for men with cancer. I couldn't find a study that found tons of guys walking out, and psychologists told me they don't see mass numbers of divorces after a diagnosis. What I wanted to emphasize in the book is that that's not the end of the marriage, that that's not the norm.

Q: How's the book done? Aren't a lot of men likely to benefit from it unlikely to read it?

A: I think their wives buy it for them and hit them over the head with it. Seriously, I've got incredibly moving e-mails from guys who found the book and told me how much it meant to them. I wanted the book to be not my story, but the story of many men and couples who've dealt with the disease, so men would understand if you cry in the car, that's pretty normal.

Q: The breast-cancer support world can seem an alien girl's club to a man, what with all the pink colors and touchy-feeliness. How do you suggest men overcome that?

A: Tell me about it. But you just have to plunge in and do it. Breast cancer walks to raise money, where it's like 800 women, 40 guys and a lot of pink, can be intimidating, but guys who participate find they get enormous respect and props. Your presence means so much to the patient. It's like you're going through a war together.

Q: Did your experience change your relationship with your wife?

A: It made me appreciate her incredible strength. I don't know if I could have been so courageous. I learned that we're very different — that I'm more optimistic and she's more pessimistic, and I guess I'd never noticed that. But that was OK — she could cope her way and I could cope my way, we didn't always have to be in sync


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