Single with breast cancer

Over the years, I have worked with many single women going through breast cancer. In many ways, of course, their experience is no different than others who are partnered. Surgery is surgery, radiation is radiation, and chemo is chemo. However, life circumstances do affect the months and how they can be best managed. Although I have twice been through extensive breast cancer treatment, have worked as an oncology social worker for more than 30 years, and was divorced and a single mom the first time that I had breast cancer, I have not lived as a single woman with cancer during or after treatment. When the first cancer happened in 1993, I had a partner who later became my husband. It was not exactly like being married, especially in my panic about my daughters’ needs and futures, but it also wasn’t exactly being alone. I know that.

Although flavored by my personal experiences, my observations are from my experience of working with many single women as they moved through diagnosis and treatment and recovery and, hopefully, onto ongoing good health. There have been some who were less fortunate and who had to contend with advanced cancer alone. That is even harder.

The very first days after diagnosis are a typhoon of strong feelings for everyone. We all go immediately to the Is this going to kill me? worry, and then we rapidly expand our concerns to include everything else about our lives. Single women may not have to worry about their children, although of course some do, but they may have to worry even more about continuing to work and receive a paycheck and about the logistics of their care. Let me point out that being in a really bad marriage can be functionally harder than being single through cancer treatment. Friends likely will assume that a spouse will take care of a lot of things, and a rotten spouse may not do so and may even place extra demands on the patient. I recall a woman who was unhappily married to a man who maintained a rigid vegan diet. When friends delivered meals for her family that included animal products, he smashed them on the floor.

There are a number of issues single women need to consider: managing physically, psychologically, and logistically as well as staying in or re-entering the dating world. Very honestly, I have known only a handful of people who tried to date during cancer treatment. It may have briefly seemed like a good way to feel more normal and try to have fun, but it usually turns out to be challenging if not almost impossible. Think of it along the same lines as looking for a new job while in the middle of chemotherapy. It is very hard to explain the way you look, the way you are feeling, the many demands on your time, and the gaps in your resume. There are, of course, exceptions to any rule, and some people have found dating an excellent strategy to enhance their coping and general quality of life through cancer. I think of one 50 year old woman who had a delightful fling, while going through chemotherapy, with a 28 year old man. They both knew this was not a permanent relationship, but it suited them both at the time. Most women find it simpler to step away from the dating world for the months of active cancer treatment.

Re-entering the dating world after cancer brings its own set of questions. What do you say about your health history and your possibly changed body? Even after your hair has returned, you have some scars, and you may be missing a breast or two. A reconstructed breast looks different than a natural one, and you will need to share this information before becoming intimate with a new partner. Young women who have been through breast cancer treatment are often grappling with the loss of fertility, or at least the need to delay pregnancy for a number of years. This, too, can be important in any new relationship and must be shared early on.

Figuring out how to manage the demands of treatment: the need for rides, assistance with meals or housework or dog walking, are all harder without a partner. Remind yourself about the plate-smashing husband described above. Single people often have wonderful friends, families by choice, and this is a time to rely on them.

There are a number of good websites that enable you to maintain as much privacy as you want while trying to organize help. Look at Lotsa Helping Hands care calendar website and CaringBridge. You can ask a friend to manage the site for you, and it is almost always a helpful way to enable friends, colleagues, or neighbors, who may not know one another, to work well together on your behalf. If you don't feel that you have a network of friends who can or will come to your aid, talk to a social worker at your hospital or treatment center. There are various community programs that can help, and she can also help you identify resources that you may not have considered.

The emotional challenges may be more daunting. You may feel very alone in the middle of the night and wonder if you will ever again feel strong, pretty/handsome, and desirable. Meeting new people and dating is rarely easy, and adding cancer to the mix complicates it more. I promise that I have known many women who found a loving and committed partner after cancer. It happens.

This is the honest report of my decades of listening to stories: Yes, there are a few men or women who will flee when you disclose your health history. It is painful, but remind yourself that these people would not be reliable, loving partners in life. If you are not very young, remind yourself that no age-appropriate potential partner comes without personal baggage or with a perfect body. A few women have told me about men who expressed genuine empathy for their situation, but explained that their wife had died of cancer and they just could not manage the risk again. More women have reported men who said something like: "I wish I had known you then and could have helped." My very favorite story came from a woman, post-mastectomy without reconstruction, who told a new man about her changed body. This tattooed, chained, leather-wearing biker responded this way: "Honey, that just means that, when I put my head on your chest, I will be that much closer to your heart."

Don't share your cancer history, just as you would not share any important intimate history, until you think there might be a future and until you are thinking about physical intimacy. Then you must tell the truth, share the genuine hope, and trust that any good man or woman worth having will want to be closer to your heart.