A supporting role in breast cancer
When Marsha Dale was diagnosed with breast cancer in September 2001, she called her husband, Marc Silver, with the biopsy results.
Ordinarily, Dale considered her husband to be the epitome of sensitivity. So his initial response to the news -- “Ewwww, that doesn’t sound good” -- left her stunned and angry.
“If I could’ve jumped through the phone and strangled him at that moment, I would’ve,” said Dale, 56, a teacher in Virginia. “I thought, ‘Ewwww? Who is this guy?’ ”
Even today, Silver feels some embarrassment when he recalls that moment. But he more than redeemed himself in the months after, accompanying her to doctor visits and chemotherapy treatments and, most important of all, his wife said, “making me laugh when I needed it most.”
When Dale entered remission, Silver, an editor at U.S. News & World Report magazine, wanted to do more. So he wrote a book, “Breast Cancer Husband,” as a guide to help men be more sympathetic caregivers and to better cope with their own feelings.
Because of society’s glorification of the female breast, mental health experts say, some men’s reactions to a breast cancer diagnosis are complex, often leading to feelings of guilt and embarrassment.
Lurking behind a man’s desire to be supportive are his sexual needs, which naturally seem inappropriate during a crisis. Some men also might blame themselves, thinking they somehow caused the tumor by not being more careful or gentle during sex, some psychologists say. The result, often, is that men tend to shame themselves into silence about their feelings.
Considering that the American Cancer Society estimates that about 216,000 women were diagnosed with breast cancer in 2004, there’s a large group of men out there who need more help than is available through cancer support groups, said Silver.
“At the time I didn’t know what to do or where to turn,” he said. “But I didn’t think I could ask. I mean, it’s not supposed to be about us.”
The relationship of men to breast cancer is certainly overlooked. No nationwide awareness campaign exists for men, but that isn’t a surprise, said Wendy Mason, helpline manager for the Susan G. Komen Breast Cancer Foundation, a national organization focusing on outreach and networking for breast cancer patients. “Traditionally support has always focused on the patient first,” she said. “That’s the case for any disease.”
And it’s also the case for contemporary books on breast cancer, which say little about -- or to -- men. The authoritative “Dr. Susan Love’s Breast Book,” for example, devotes only a few of its 700 pages to couple issues -- and most of those pages concern how the wife, not the husband, feels after a mastectomy.
But caregiver support is evolving, Mason said, “and it’s picking up and spreading outward to include these men.”
During the last decade therapists have placed increasing importance on the way that the husband’s coping affects his wife’s recovery from therapy and mastectomy.
“The more social support a woman can utilize, the quicker she recovers,” said Ross Carter, a clinical psychologist with the Medical College of Wisconsin. “And who’s her closest contact? That man who’s in her bed.”
Carter and his wife, Charlene, also a clinical psychologist there, have counseled couples for more than 20 years and reported their observations in periodicals. The shock of diagnosis, they write, can cause some men to withdraw and others to become overprotective.
Neither response is healthy for the patient. Even being overprotective can work against a woman’s recovery. A husband might think he’s showing how much he cares by arguing with the doctors, but this can undermine the patient’s confidence in her treatment, they suggest.
But, Charlene Carter said, most husbands “want to help but just don’t know what to do or say.”
Silver’s book is for them. He walks men through their first reactions to the news, methods of diagnosis and the various kinds of biopsies, treatment, remission and what to think if the prognosis turns bleak.
The text is laced with the stories of about 100 husbands and health professionals -- stories of men talking to their kids about what’s happening to Mom or coping with the burden of keeping a household running.
There’s plenty of guy talk on every page. Silver scolds men who forget things like romance in the panic of the crisis: Simple gestures like giving flowers “harken back to the days when you were courting your wife.... Those pretty petals conjure up carefree days of the past. They’re a promise that your love hasn’t disappeared.”
He also offers candid advice on mastectomy. When his wife faced the possibility of a mastectomy, Silver writes, he tried to be generous. He told her that he loved her, not her breasts, and that he didn’t care what happened to them. Her reaction, he writes in the book, stunned him:
“How would you feel if a doctor wanted to cut your penis off?” she snapped.
His mistake, he tells readers, is that he made it about how he felt about the mastectomy.
“I realized I was guilty of the crime of being a husband who wanted to fix things, to say the magic words that would banish Marsha’s depression,” Silver wrote, “when what I needed to do was to shut up and let her mourn the potential loss of her breasts.”
The book also includes the kind of sex advice that some men might feel more comfortable reading about than discussing in a group. “I didn’t realize how much of our private life would have to be told,” Dale said.
After months of writing that kept the house in disarray, Silver finished a book that his literary representatives struggled to get published.
“Publishers don’t believe that men will buy self-help,” said Stephanie Rostan, an agent with the Levine Greenberg Literary Agency, which represents Silver. “The cliche we encountered everywhere is that your average guy doesn’t want to admit he has a problem.”
Silver encountered it also.
“I found a lot of men who cried in the shower, like I did, or on the drive home from work,” he said. “I didn’t realize how many there were. We’re truly a silent brotherhood.”
In fact, the old cultural stereotype that says men aren’t supposed to show their feelings can reinforce an attitude that breast cancer is a woman’s issue, said therapist Ronnie Kaye, the author of “Spinning Straw Into Gold: Your Emotional Recovery From Breast Cancer.”
“We don’t bill our sessions as ‘women only,’ but they inevitably turn out that way,” said Kaye, who has traveled the country holding workshops on behalf of the American Cancer Society. “Childbirth was treated this way years ago when the man waited in a distant room while the woman delivered their child.”
Signs of change are gradually appearing. Dale is glad that she and her husband have contributed something toward a growth in awareness.
“In the end it helps all of us,” she said. “It may sound corny, but I’m glad that doing something like this would make lemonade out of my lemon.”
