Breast Cancer Husband
By Marc Silver
Rodale Books
304 pp $14.95

When Marc Silver received a grim call from his wife saying she had just been diagnosed with breast cancer, he was so shocked, confused, and frightened he could only respond: "Ew, that doesn't sound good."

Silver, then an editor at U.S. News and World Report, also told his upset wife that he'd be home at the regular time. The insipid reaction, a generic condolence, was the same bland response someone might make to news that their dry cleaner is closing, that their favorite show is going off the air, that gas is high and the dollar low. Ew, that doesn't sound good.

But it also was a thoroughly human reaction to a jarring diagnosis -- and one that Silver makes amends for in Breast Cancer Husband: How to Help Your Wife (and Yourself) Through Diagnosis, Treatment, and Beyond.

Silver's underreaction is certainly not the best way to handle that kind of news. But there are plenty of partners out there grappling with their wives' breast cancer who are making decisions jointly, despite all the hardships involved. Democratic presidential candidate John Edwards and his wife Elizabeth chose to continue his political campaign after his wife's diagnosis of incurable breast cancer. Their decision, they said, was mutual.

The big question for many men -- and their wives -- is what they would do if they found out their spouses faced a life-threatening cancer diagnosis. Many husbands will feel driven to be involved with their wives' treatment, while others may feel they lack the medical sophistication to take on this role.

There's no question the book was written for men, and Silver spends ample time delineating the differences between the ways men and women emote and react. But female partners of women with breast cancer may also be able to glean something from the tips Silver gives on how to lend loving support through a partner's crisis.

Breast Cancer Husband is both a primer and a helping hand. When you need to know the basics of needle biopsies and sentinel nodes and Neupogen, Silver offers a painless introduction to such cancer terms in all their chilling variety.

Of course, facts about needles and nodes are something that any partner with a mouse can easily pick up from the Internet. Where Silver really shines is in his willingness to grapple honestly with the question that men plaintively ask in crises they can't control: What can I do?

"Guys feel compelled to 'fix' cancer," Silver writes. "We want to take it on at the basketball hoop, one on one. We want to pull out a six-shooter and start firing away. Perhaps that's why we judge ourselves harshly as cancer caregivers. No husband can defeat cancer. Ergo, we've failed to protect our wives."

Many men fight back anyhow. If they can't just dig into their toolbox for a scalpel and a bottle of iodine, at least they can cheer their partners up, root for them, help them see the glass as half full. Unfortunately, they also can make a woman half crazy.

"Breast-cancer patients don't necessarily want a round-the-clock pep squad," Silver says, mentioning the fellow who kept irritating his wife with tortured sports metaphors.

"This is the ninth inning and there are two outs, but we're going to knock this ball out of the park," he'd eagerly -- and repeatedly -- tell her. Some women may not want a man who masks his fears with sunny platitudes. Others may not want a guy who lets it all morbidly hang out.

Members of a breast cancer survivors group called the Lunch Bunch told Silver about it in no uncertain terms when he asked whether they would have wanted their men to come clean about their anxieties in the dark days after the diagnosis.

"They responded with a resounding roar," Silver writes. "They wanted to draw comfort and courage from a strong, solid and fearless husband... They wanted him to, in their words, 'fake it' if he had to. Ah, the irony."

So, with both unflinching strength and unrelenting sensitivity out of the picture, what's a hapless husband to do? One good pointer comes from Silver via Dr. Sherwin Nuland, the Yale physician who wrote a best-seller called "How We Die."

"It's not about you…" Nuland told Silver with a wink. "It's not about how sensitive or how strong you can be."

It's about figuring out how to give your wife the best of all possible support -- a complex and often frustrating task that does not lend itself to one-size-fits-all prescriptions.

That means, above all, listening acutely, Silver tells us. It means learning when to simply hug your wife and let her cry without telling her that everything's going to be fine -- but also when to remind her of her strength, beauty, and inner resources.

It isn't easy.

When Silver tried to tell his wife Marsha that a possible mastectomy wouldn't change his love for her, she lashed out at him: "How would you feel if a doctor wanted to cut off your penis?"

Months later, she told him how grateful she was that he had been there for her -- but that nothing he could have said at the time would have made her feel better. He took the lesson to heart: "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, when what I needed to do was shut up and let her mourn the potential loss of her breasts."

To be sure, there are plenty of ways for men to help. They can be a second set of eyes and ears at their wives' medical appointments, compiling questions beforehand and taking notes on exactly what the doctor said.

Sometimes, Silver points out, a couple will be given shaky advice. For example, some physicians convince patients that getting a second opinion will take too long and surgery must be performed right away. In most cases, that's just wrong -- and, Silver writes, a husband can help his often overwhelmed wife question it.

Men can also do a hundred valuable things they never anticipated. They can give neck rubs in the chemo room. They can shave their wives' heads in a preemptive strike against chemo-induced baldness They can run interference with relatives, heading off the mother who comes over with a casserole once too often, quieting the sister-in-law who insists that breast cancer is triggered by deodorant. And they should definitely go to doctor appointments to make sure their spouses are getting the information they need to make good decisions.

In addition, they can take over many of the domestic duties their wives normally perform, especially during periods of chemotherapy, radiation, and other times when their spouses feel ill. Silver does, however, get an earful from women he interviewed who felt their husbands, in an effort to demonstrate their love, went overboard with helping out. "I wasn't an invalid. I could go get a drink of water," one woman complained. But if a couple has young children or teenagers, Dad is definitely going to have to take a big role in their care.

And, of course, husbands are still their wives' lovers. Silver does a great job discussing sex during and after treatment -- one of the areas that even men in support groups find hard to discuss with each other.

"How do you come on to a woman when she's undergoing chemo?" he asks. "Gently, without sending any signals that she'll let you down if she's not up to it.''

For men who are nervous about seeing their wives post-surgery, Silver even provides a Web address with before-and-after photos of women who have had mastectomies.

Three years after her bout with breast cancer, Marsha is doing well in the post-traumatic state that Silver calls "the New Normal." And so is Silver, who likes to spread the wisdom of his wife's oncologist.

"You could spend the rest of your life worrying about the possibility of a recurrence," the doctor told Marsha. "If you never have a recurrence, you've wasted all the time worrying. And if you do have a recurrence, you've still wasted all the time worrying when you could have been enjoying life."

-- Steve Chawkins is a staff writer who covers state news for the Los Angeles Times.

First published May 4, 2007
Copyright © 2007 Consumer Health Interactive

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