How Breast Cancer Can Affect Your Relationships, Plus How to Deal

Breast cancer affects everything, even relationships with loved ones and acquaintances. Preparing for change, communicating openly, and delegating support tasks can help you manage.

Along with all of the other life changes, a breast cancer diagnosis will inevitably create change in your relationships.

Everything from romance to friendships to parenthood is affected. Some people will offer you comfort and support, while others may drift away or disappear entirely. Close relationships could become even closer, but they could also be thrown into turmoil.

Of course, the impact on your close relationships will carry the biggest emotional weight. Still, relationships and interactions with acquaintances can have an impact, too.

Here’s how breast cancer can affect various relationships, plus how to cope.

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Breast cancer and romantic relationships

For many, breasts are an important symbol. They’re a culturally significant factor in female attractiveness and one of a woman’s core erogenous zones.

According to the research, breast cancer can have a significantly negative effect on sex drive and marital happiness.

Changes in sex drive and satisfaction

A 2021 study found that 75% of breast cancer survivors experienced some form of sexual dysfunction after treatment. Even more concerning, over 70% of them reported that they weren’t informed of the possible side effects of treatment on their sexuality.

A 2023 study found that women with breast cancer had lower levels of relationship satisfaction. Interestingly, a different 2020 study found that breast cancer survivors did not have lower marital satisfaction than healthy controls.

However, their partners did.

The study found that partners of breast cancer survivors reported less sexual enjoyment, more depressive symptoms, and lower marital satisfaction.

Healthy communication is key

Part of the problem may be a lack of communication.

Couples often feel uncomfortable talking with one another about the diagnosis, says Elizabeth Schandelmeier, a licensed clinical social worker specializing in grief counseling. The person with cancer may feel guilty for being a burden while their partner is anxious and worried about their well-being.

“Connected communication can be shut down, leaving each partner feeling isolated from each other,” says Schandelmeier.

For Dr. Anne Peled, a breast cancer surgeon and survivor, that’s exactly what happened.

“While my husband was incredibly supportive, I found it really challenging to talk with him about some of the fears I had about how I might look and feel after treatment and how this might impact my sense of self and body image,” she says. “I definitely felt somewhat isolated from him.”

One 2022 research study looked at how women with metastatic breast cancer experienced sex and intimacy. For many women, treatment caused a significant loss of desire or pain during sex, which then led to feelings of guilt, shame, and pressure.

The researchers also found that couples who coped well shared several key factors. First, they approached sex and intimacy with an open, flexible mindset. Second, they communicated openly, honestly, and frequently with one another.

Family and children

Many have to grapple with a breast cancer diagnosis while also raising children. No matter how old your kids are, you’re always a parent.

When my mom was diagnosed, for example, I was in my early 20s, and my youngest sibling was in high school. Still, it was hard for her. My son was very young at the time, and my mom was incredibly close to him. Not being able to play with her grandson or pick him up after chemo was one of the most difficult aspects of treatment for her.

That’s not surprising, either.

According to a 2023 study, mothers with breast cancer prioritized their role as parents even after diagnosis. They also reported feeling shame and guilt when treatment made parental duties more challenging.

Fatigue is a big part of chemo, so daily parental activities may be especially strenuous. The emotional impact is often far more upsetting.

One study found that mothers with adolescent daughters felt extremely high levels of guilt, specifically regarding the fact that their diagnosis would increase their daughters’ risk of breast cancer.

Parents may feel that they burden their children with additional expectations and are unsure about how and what to share about their diagnosis.

“Discussing cancer with children and grandchildren requires thoughtful consideration based on their age,” says breast surgeon Dr. Steven Chen. “Even young children often sense the stress and can be more perceptive than we realize.”

It’s vital to prevent children from feeling responsible for the situation. However, they can be helped to feel they can be of support and are entitled to support themselves.

Friends and social gatherings

Cancer can create massive changes in a your social life, too. Fatigue is a common side effect of breast cancer treatment, so many people lack the energy to socialize as often as they would like.

Social gatherings can become something to dread rather than enjoy due to changes in physical appearance, like weight and hair loss, or apprehension about how people may respond to you.

“Friends may not always know how to respond to a diagnosis and can sometimes say the wrong things in an effort to be supportive,” says licensed clinical social worker Diane Botta.

Indeed, a 2023 survey found that 59% of people with cancer said their friends didn’t know what to say about their illness. Results from the companion survey were the same: 59% of people who had a friend with cancer admitted they struggled with knowing what to say.

Additional data points were even more telling:

• 9% of people avoided their friend with cancer.
• 35% of people didn’t know how to cope with their friends’ diagnosis and felt they lost their friendship because of it.
• 42% of people admitted that seeing their friend with cancer was too upsetting for them.

“People often receive an outpouring of support in the first few months,” says Botta. As time goes on, many patients find that support begins to dwindle.

There are also those who fail to offer the type of support we feel they should.

“This can cause ruptures to relationships and feelings of dejection and isolation,” says Schandelmeier.

Many people also receive unsolicited advice or insensitive, even offensive, comments from people in their life. This can lead to even more withdrawal.

Relationship with yourself

Finally, breast cancer can change the relationship you have with yourself. It can impact how you see yourself physically as well as emotionally.

Although people can respond in various ways, some common themes tend to emerge, says Schandelmeier.

Some of the most common feelings can include:

• blaming yourself for not exercising more or eating better pre-diagnosis
• loss of self-identity due to changes in physical appearance as well as cognition and ability to focus
• feeling betrayed by your own body
• discomfort with the way you look and feel
• guilt or shame
• insecurity and loss of self-esteem

“I lost a lot of weight very quickly after my diagnosis due to stress, and I definitely struggled with feeling like my body was betraying me,” says Peled.

Part of her treatment involved a lumpectomy and reconstruction. Although she was happy with the end result, the physical changes still took a toll.

“I had a lot of scarring to adjust to, which definitely impacted my self-esteem in the months after surgery,” she says.

Tips on how to cope

Breast cancer may create change in your relationships, but these tips can help you manage.

Decide who (and what) to tell

While you may instinctively want to keep the news of your diagnosis a secret from loved ones, that can often create even more stress.

The people close to you can offer a great deal of physical and emotional support. You may want or need help with everyday activities, like cooking or running errands.

Simply having people to talk with and lean on can also be extremely helpful.

“It’s important to avoid isolation,” says Chen. “But also remember that you have the right to share on your own terms when you’re ready.”

Prepare your own responses

People often become uncomfortable when learning of a loved one’s diagnosis. They may respond in ways that you don’t like by offering unsolicited, unhelpful, or even insensitive comments or advice. It’s a good idea to prepare your own responses ahead of time.

For people who are well-meaning, you can be kind but firm in stating that their comments aren’t welcome:

• “I know that humor is your coping mechanism, but I’m not ready to make jokes about this yet.”
• “I know that you’re just trying to help, but I’m not in a place where I can hear about other people’s cancer stories right now.”
• “Thanks, but I’m trusting the advice of my doctors and medical team.”

Sometimes, though, people might say things that are downright rude. In that case, you can shut it down easily by saying, “That’s not helpful to me right now.”

Ask for help

Many people find it difficult to ask for help, but it’s important to remember there’s nothing wrong with getting support. People usually want to help, but they don’t always know how.

You can take the pressure off by telling them exactly what you need.

If the mere thought of doing that sends you running for the hills, consider designating a trusted person in your life to do it for you.

Choose a partner, friend, or family member and tell them what kind of support would be most helpful for you.

Ideas include:

• cooking or ordering meals
• buying groceries
• rides to appointments
• house cleaning

Then your designated person can help delegate those tasks, sharing with other friends or family members exactly what you need.

Utilize self-care strategies

Cancer is tough to deal with, so it’s important to be kind to yourself and engage in self-care activities regularly, such as exercise or meditation.

“Many people benefit from working with a therapist specialized in helping people through cancer treatment,” says Peled.

Therapy is especially helpful when it comes to improving your self-esteem, she says. It can be equally good for couples dealing with cancer.

It’s also important to treat yourself with kindness and compassion.

“Grieving is a natural reaction to a cancer diagnosis,” says Chen. “It’s OK to feel shattered, and many come out stronger.”

He adds that it’s beneficial to acknowledge and accept your own feelings and stresses the importance of taking care of your own needs.

“Self-care is your anchor,” says Chen. “Focus on what keeps you mentally and physically afloat.”