Tip Sheet: Coping with cancer

Tip Sheet: Coping with cancer

University of Michigan School of Nursing Prof. Laurel L. Northouse is an internationally recognized scholar in oncology nursing. She is a specialist on cancer and the family. Her research has been supported by grants from the National Institute of Nursing Research, National Institutes of Health, Wayne State University and the American Cancer Society. She holds an endowed chair at the U-M School of Nursing: the Mary Lou Willard French Professorship. Reporters interested in learning more about her work should contact Amy Reyes at News and Information Services.When men get cancer, women take on more roles and stress.

When men are diagnosed with colon cancer, their wives take on more responsibility and in some cases suffer from more distress than their husbands, according to a winter 2000 study by Northouse published in the journal Social Science and Medicine.

The study, “Couples’ Patterns of Adjustment to Colon Cancer,” is based on 56 colon cancer patients (34 males, 22 females) and their spouses who were interviewed one week after diagnosis, but before surgery; 60 days after surgery; and one year after surgery.

Regardless of whether they were patient or spouse, women reported having more distress than their husbands, more role problems and less marital satisfaction.

Both male and female patients said that role problems peaked at 60 days after diagnosis, but then decreased as the recovery process began. On the other hand, spouses—especially female spouses—continued to have some difficulty adjusting to their roles as care-givers. Both the patient and spouse reported disruption in family functioning and social support.

Northouse found that because women are involved in more interpersonal relationships, they assume more care-giving roles, thus putting them at risk for more emotional distress.

“Women are responsible for managing more roles inside and outside the family and hence, experience more role disruption and distress when illness occurs,” Northouse said. She also said that women are more comfortable than are men talking about their feelings, which may also explain the results.

Other studies have shown that care-giving wives provided approximately twice the hours of assistance to their partners as did care-giving husbands. Also, female patients more often received care from others as well as the spouse, but male patients tended to rely exclusively on their wives.

“Partners need to acknowledge and accept one another’s unique ways of adjusting to the illness rather than assume they will always experience the illness in the same way and at the same time,” Northouse said.Life is good for African-American women who survive breast cancer.Beating breast cancer isn’t the last hurdle for women who struggle to regain a sense of normalcy in life after cancer. Recovery leads to a host of other stressors that can negatively impact quality of life, Northouse says in a newly published study that focuses on the quality of life for African-American women with breast cancer.

Northouse and her research team interviewed 98 African-American women who were, on average, four years post-diagnosis. “For the most part, they appraised their illness as slightly less stressful than has been reported by a heterogeneous sample of cancer patients,” Northouse said in the study, “The Quality of Life of African-American Women with Breast Cancer.” The study appears in the
Most of the women in the study were optimistic and maintained a strong family structure, but that’s not to say they didn’t experience the common physical discomforts of cancer, such as loss of energy (56 percent), sleep disturbances (49.5 percent) and pain (45 percent).

Don’t leave him in the waiting room.When a woman battles breast cancer, health care professionals tend to talk with her about adjustment problems at home because clearly the woman’s role at home changes, but so will her husband’s.

In a 1998 study in Psycho-Oncology, Northouse shows that husbands of women who suffer from breast cancer also need support. Husbands suffer from nearly just as many role adjustment problems as do their wives, she said.

“The study provides evidence that husbands are affected by the illness and also need family care. If we accepted the fact that they are affected by the illness, we would involve them in the programs of care, we wouldn’t leave them in the waiting room,” Northouse said.

Most studies have focused on women with breast cancer, but overlooked the adjustment problems of their husbands. “We found that they need care-givers to listen to them and provide emotional support, just as they do for the patient,” Northouse said.

Northouse and her research team looked at 131 couples—58 couples facing breast cancer and 73 couples with benign breast disease. They were evaluated at the time of diagnosis, 60 days later and then one year after diagnosis. The study assesses marital satisfaction, family functioning, social support, emotional distress, feelings of uncertainty and role problems.

Among some of the findings, Northouse found that illness—for both groups—did not place undue strain on the marriage. “The marriages were not at risk. We are not seeing tremendous marital strain, but we are seeing some strain, which was expected. These are very resilient people,” she said.

Husbands of women with breast cancer reported having less social support from extended family and friends after 60 days, while the social support for the wives tapered after one year. “The stress of the disease has not gone away, but the support system drops significantly,” Northouse said.

School of NursingSocial Science and MedicinePsycho-Oncology