Supporting a partner with cancer

She is 35 years old. She found a lump in her breast… what now? There is extreme anxiety for both partners as the breast sonar, biopsy and mammogram is done. Waiting for results, although only a week, feels like a lifetime and fear makes one’s mind go to very scary places. It is a seesaw between is it benign or is it cancer. Life all but becomes suspended in a bubble where it goes by in slow motion. Although you feel you have ‘prepared’ yourself for both outcomes, the shock of the diagnosis still knocks you off your feet. Triple negative metastatic breast cancer… what now? Triple-negative breast cancer is cancer that tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein. These results mean the growth of the cancer is not fuelled by the hormones estrogen and progesterone, or by the HER2 protein. The cancer responds to chemotherapy, 4 cycles of AC (the Red Devil), 12 cycles of Taxol and then either a lumpectomy with 30 sessions of radiation or a double mastectomy, and reconstruction.

In a single instant your life changes and the way you think about everything changes. All your goals and dreams take on a new meaning. Then there is loss. The loss of time, and the loss of the dream to have a baby. We start talking about her bucket list. The present and future becomes unfamiliar. We start talking about treatment versus no treatment. Getting affairs in order like wills, policies, DNR’s. Between the whirlwind of brokers and doctor’s appointments, scans, blood tests, chemotherapy, life becomes a process of one step at a time, day by day and sometimes just moment to moment. It is a very helpless process, but one has to remember that there is joy and still good things in life. Remember to love each other and to still laugh and enjoy what you are able to. Spiritual health takes on a new meaning.

It is important to take the time to have the hard conversations and allow your partner to share their wishes for treatment options (or not) and wishes for end-of-life care. This is a very emotional and scary process but by openly talking about it and respecting the wishes of your partner and that they know you will honour their wishes are the most important. There is a lot of fear and uncertainty and although you are affected by her decisions, they have to be her decisions and your role is supportive and to ensure that her wishes are respected all the way to the end. Having this conversation isn’t just a one-time thing, it is the first of many conversations over time as the treatment progresses and outcomes change.

As the patient and the partner, it is important to know all the details about the condition and treatment options so that informed decisions can be made and to be able to have a say in every health care decision. Some people prefer not to know how quickly the disease is progressing however others opt to know the best estimation of the cancer returning / how long she will live. Quality of life becomes more important than quantity and she has decided that she is only going to go through this process once and to live everyday as if it is her last. She wants to spend minimal time in the hospital and therefore considering the options of home-based care. She wants her loved ones to do exactly what she has requested, even if it makes them a little uncomfortable. There are some family members and friends that are already uncomfortable with the basics like her hair loss. That is one of many losses like loss of appetite, nausea, going into early menopause, chronic fatigue, bone pain and a host of other uncomfortable symptoms. Minimal contact and staying safe become high on the priority list so that she does not pick up any colds, flu or infections that could compromise and delay her treatment.

Support through this process from family, friends and colleagues is paramount. COVID-19 has created additional challenges as the doctor’s appointments, scans and chemotherapy that are restricted to the patient alone. This is a very stressful process for both parties as one feels very isolated in the times that you would naturally be there for each other and walk the path together. We can only hope that when the time comes for surgery that the hospital will not be on COVID lockdown that she does not have to go through the hospitalisation on her own.

To learn more about home-based care options, visit www.medwell.co.za