Original Research

Communication About Prostate Cancer Between Men and Their Wives

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The men’s communication with people other than their wives was even more restricted. Not all men feel comfortable enough to reveal their diagnosis to family and friends. Some of the men relied on their wives to inform others about the diagnosis, and the men who told others reported talking predominantly to other men. If they had children they talked to their sons, while not necessarily telling their daughters. If the men had conversations with others, the information was limited to stating the diagnosis and the outcome of check-ups. No man reported ever turning to other men to deal with feelings or fears about cancer, even though they assumed that some of their friends might have it as well. At best, men received factual information from other men but never emotional support or information about others’ experiences and adjustment to the disease. The wives’ communication network was larger and the quality of their support network different. Generally wives reported that others, such as daughters, relatives, church members, and neighbors who were friends, were available to them for support.

Perceptions of Changes in Spouse

Despite the complicated communication patterns, including an avoidance to disclose feelings about the effects of protate cancer, most couples denied that cancer caused other changes in their mates or in their marital relationship. Most of the couples denied that cancer caused other than physical changes in their mates or their marital relationship. The men generally said that their wives treated them just the same. Most of the wives confirmed this, stating that they have not increased their attention. However, the accounts by the husbands and the wives make references to changes that did occur. One man told the interviewer that his wife finds him difficult to get along with since his cancer treatment. Another man admitted being frequently irritable and having angry outbursts. Another change that was reported involved the men’s altered social network. Some wives talked about a decrease in their husbands’ interactions with friends. Some husbands confirmed that they underwent certain social changes. One husband stated that they socialize more as a couple, since he believes it to be important to his wife.

A few wives reported changes, such as their husbands’ jealousy. The women said that there was no reason for their husbands to be jealous since their commitments to their husbands remained unchanged. Jealousy was also brought up in the men’s focus groups. Both husbands and wives told the interviewer about the breakups of other marriages. The women referred to wives who left their husbands because they had prostate cancer, and the men reported that other men left their wives because they feared their wives were betraying them. One man explained:

I don’t try to worry about it, because really if you go to worrying about it, a person doing something, you can’t do it and with the going out or something like that, but I will just let her go, you know, if I’m going to sit there and worry, cause I’m not going to try to hurt myself. Now I’m concerned where she goes, but I won’t think of that…. I don’t want it on my mind. If it ever got on my mind, she may as well be doing it, see what I mean. I don’t even think about it.

Although it was a small minority that voiced worries and fears about betrayal and jealousy, it was an indication that this emergence of insecurity might have been triggered by the most radical change in couples’ lives: their changed sexuality.

Sexuality

In the interviews, husbands and wives described the implications of prostate cancer on their sex lives. With regard to communication in couples, however, most communication about sexuality took place when men were presented with treatment options that had impotence as a side effect. Husbands and wives described how they discussed the threat of giving up their sex lives. One man said, “we had quite a few discussions…. We just cried a little bit and that was it.” The same man revealed that his decision to choose hormone shots over surgery was also influenced by the belief that if he were to stop taking the hormones his sexual functioning would return, and surgery was permanent. Another man disclosed that after surgery he was depressed for months because he lost his ability to have sexual relations.

Several women let their husbands know that when faced with a choice between prolonging his life and having sexual relations, they would opt for his prolonged life expectancy. One woman stated, “I would rather have him than sex until I am 100.” Some men described having been motivated by the same tradeoff. The men’s descriptions, however, are dominated by references to the difficulty of consenting to a treatment that deprived them of their sexuality. One man explained its importance by stating, “I wouldn’t care if I had to walk around straddle-legged or not if I could have sex. This testicle removal hurt the desire for my sex life. It took it, and it dissolved my self away.”

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