When you find out that your partner has prostate cancer, both of you probably have a lot of questions about what comes next. There will be plenty you need to talk about. But what do you say — and what shouldn’t you say — as you face the disease together?
Before you choose your words, focus on the “together” part of this. Your partner will benefit greatly by you being at his side. Go to his appointments with him and be supportive.
“If the man has a partner, I always encourage that partner to be there,” says urologist Jesse Mills, MD, director of the Men’s Clinic at UCLA in Los Angeles. “This is a disease that couples suffer together.”
Urologist Clayton Lau, MD, agrees.
“Say to your partner that you want to be involved, go to appointments, ask questions,” says Lau, director of the prostate cancer program at City of Hope Hospital in Duarte, CA. “A lot of men diagnosed with prostate cancer just turn their brains off and worry, so it’s very important for the partner or spouse to process information and give emotional support.”
Scary as the word cancer is, prostate cancer has a very high cure rate, especially when it’s detected early. In fact, nearly 100% of men diagnosed with prostate cancer that has not spread to other parts of the body live at least 5 years with the disease, according to the American Cancer Society.
If your partner feels overwhelmed with fear, remind him of that.
“Most men diagnosed with prostate cancer do not die from the disease, and you need to let him know that,” Lau says. “He wants to know that it’s not all doom and gloom.”
Often, prostate cancer grows slowly and does not pose an immediate threat. In such cases, doctors often recommend something called active surveillance. (You might also hear it called “watchful waiting.”) This involves regular checkups to be sure the cancer has not progressed.
The advantage: You avoid the side effects that come with surgery or radiation. However, it can cause anxiety if you both worry that things will take a turn for the worse. What do you say?
“Remind your spouse or partner that the doctors are on top of things and that you’re being regularly checked,” Lau says.
If you are the one who worries about what the cancer might do if left untreated, tell your partner how you feel. Then accept that it’s his decision to forgo treatment, at least for the time being, if he and the doctor think active surveillance is the right choice.
“You have to be able to give your partner that space,” Mills says.
If you and your partner have not faced cancer before, then this is a whole new world for you. You’ll need help finding ways to talk about it.
“There are a lot of support groups for couples going through therapy,” Mills says. “They’re run through cancer centers, hospitals, churches,” and other organizations. Ask your partner’s cancer care team to refer you to local groups. You can check the American Cancer Society’s patient programs and services, too. Psychologists and social workers also can help.
Surgery for prostate cancer can have two major and potentially long-lasting side effects: urinary incontinence and erectile dysfunction. Both can be quite disheartening. Radiation also can affect your bladder and ability to have an erection.
Remind your partner that these side effects are often temporary and tell him that you’re there with him while you both wait for things to improve.
If your partner doesn’t have full control of his bladder — a side effect that can take months or longer to clear up — that may discourage him from wanting to resume the social life you had before treatment or even limit his desire to leave the house.
“Be understanding and don’t minimize his feelings,” Mills says. “But encourage him to be somewhat adventurous and realize that the new normal means he’s going to have to make more stops to go to the restroom.”
A tough reality of treatment is its impact on your partner’s ability to get an erection. You may not be able to have sex in the same way you used to, at least not for some time. Talk about that early on.
“Have an open conversation as a couple,” Lau says. “Talk about how important sex is to both of you, because many times it’s more important for one spouse or partner than the other. And remember that he wants to feel loved and be seen in a romantic way.”
Mills says that recovery from treatment can take up to a year, and your partner needs to know that he’s still wanted during that time.
“Tell him you want to be intimate with him even if you can’t be intimate in the way you used to be,” Mills says.
Just don’t tell your partner that you no longer care about his inability to get an erection.
“Even if you’re saying it from a position of support, that’s exactly the wrong thing to say, because being able to have an erection is fundamental to being a male,” Mills says. “Instead, say ‘I understand that you are not able to achieve an erection now, and I still love you.’ It’s really important for the partner to not say it’s OK to be impotent. Instead, say I want you to feel like you’re doing everything you can [to recover your ability to get an erection].”
Sex, though, may be something you are used to doing rather than talking about it. If you have trouble starting the conversation, Lau recommends talking with a sex therapist, who can help you both navigate the changes to your sex life. Your partner’s health care team should be able to make a recommendation.
Sometimes, prostate cancer is aggressive and hard to treat. It can spread to other parts of the body. Treating such cancer requires hormone therapy, which shuts off the body’s testosterone production. This has significant side effects. Your partner likely will face the following:
- Emotional changes and mood swings
- Loss of interest in sex
- Weight gain
- Lack of interest in eating right, exercising, or sleeping
“It can be devastating,” Mills says. “Quality of life takes a huge hit.”
Your partner may become sullen, agitated, and withdrawn, both as a side effect of treatment and because he’s facing the reality of advanced disease. Give him the space he needs but also be generally encouraging, Mills says. Encourage him to exercise and eat a healthy diet.
“Say, ‘I’m in this with you,’” Mills advises. “Say, ‘Let’s go for a walk’ or ‘Let’s skip the fast food and have a nice piece of salmon and some brown rice and some steamed vegetables.’ Be part of that solution.”
What if all treatment options have been exhausted and the cancer is in its end stage? You’ll still face it together.
“At that point, it’s important just to be there and reassure your partner that he is loved,” Lau says. “Show affection, show your presence, both your physical and emotional presence.”
You can also support his decisions about getting hospice care, where he wants to spend his remaining time, and make sure that any pain is under control and that his end-of-life medical preferences are honored. (These should be in his advance directives.)
One thing you should not do is be dishonest about how things are going. “You can’t simply tell them that things are magically going to get better,” Lau says.
Tell your partner that you will be with them no matter what and that it’s OK to let go when it’s his time, Mills says.
“I think sometimes people just need to hear that,” Mills says. “They need to hear from people they love that there’s no more that they need to do and that that’s OK, that death is not a failure but a condition of life.”