A breast cancer diagnosis can have a devastating effect, not just on a woman with the illness, but also on her partner, who may be reluctant to voice his concerns and fears, writes Nadine O'Regan
Vinnie Byrne is nine years older than his wife Mary. He often jokes that he was lucky to find himself a young wife to take care of him in his old age. Before she got breast cancer, he never imagined that she could die before him.He recalls the moment he heard the news with perfect clarity.
"I was sitting in my office at work when Dr Stephens rang," he says. "It was a terrifying phone call. I wasn't tuppence. My mother died from breast cancer so I knew what could happen. I had to face the possibility that Mary was going to die." It is unquestionable that women will always suffer most when they are diagnosed with breast cancer. But their partners and loved ones will also have a heavy burden to carry.
Every day, men all around the world hear the same horrifying news as Vinnie, and are forced to envisage the same nightmarish scenario. Even as they provide emotional and practical support for their partners, they must deal with their own feelings of fear, uncertainty and helplessness.
Until recently, few support networks had been provided to help them cope with their circumstances. Men were considered tough enough to manage all on their own. The fact that many men were reluctant to disabuse people of this notion only prolonged the situation.
Mary Byrne recognises this scenario only too well. "Vinnie is the fixer," she smiles. "The one to make things all right. He was very good to me, but I know him so well that I could read him like a book. He was being brave for me, but I could see the fear in his eyes."
The advent and success of organisations such as Men Against Breast Cancer (MABC), Men's Crusade Against Breast Cancer and Bosom Buddies, and courses such as the Dublin-based ARC Breast Cancer Partners Programme are testament to men's need for advice, support and information.
"Men are in distress," says Ursula Courtney, director of ARC Cancer Support Centre. "You can't just hand them a booklet anymore. They need somewhere private to talk and to feel peer support. Their biggest fear is that their wife is going to die. So practically the first sentence spoken on day one is the fact that four out of five women are going to live. We immediately try to get rid of the blackness. The partners programme can only do good."
Marc Heyison, co-founder of the non-profit organisation MABC agrees. "Knowledge is power. The more men are together and can share their feelings, the more confident they feel, and the more they realise they have a role to play. We want to get men involved, and educate them to be effective care-givers when breast cancer strikes the family."
Often, it is women who take the first step in recommending that men seek help from such organisations. When Ken McKinley's wife, Carmel, was diagnosed with breast cancer and underwent a mastectomy three years ago, she encouraged her husband to attend the six-week partners' programme at ARC. Ken was initially apprehensive about going, but once there, quickly found the course to be of enormous assistance.
"I can't praise ARC enough," he says. "The biggest benefit of the sessions was meeting the other men. I'm not the type of guy who would speak openly about many things. But these guys knew what I was talking about. They had been there."
The course provides free educational, psychological and emotional support. Guest speakers share their perspectives on dealing with cancer, and a counsellor advises the men on any problems they may be facing.
The men often seek advice on complex emotional matters, but they can just as easily be concerned with entirely practical difficulties.
"Cooking and shopping are big things," smiles Courtney. "'What else can you do with a pound of mince?' was what a fellow said one day. That was all he knew how to cook. The kids were sick of it. They were going to McDonalds and takeaways, so then the expenses were going up." Taking care of the family is important, but both organisations stress that men must look after themselves as well.
"If a guy likes to play golf and his wife is dealing with breast cancer," says Heyison, "he may not do that because he feels guilty. But if men are not there for themselves, then they're not going to be able to be there for their family." These kinds of issues can be quickly resolved through advice and information. But there are other, more deep-seated difficulties for which even experts can propose no immediate remedy.
Breast cancer can have an enormous impact on the sex lives of the women who are affected by it. After mastectomy, women often feel extremely insecure about their image. They may also experience a loss of libido or early menopause. Recovering any semblance of their pre-cancer sex life can be extremely difficult.
For their partners, the whole area can be fraught with a corresponding tension.
"I wondered whether our sex life would be the same," says Ken, "whether the attraction would still be there, whether it would have changed. But I felt a bit of a so-and-so for thinking like that. Because Carmel was going through this hell, Carmel's life was threatened.
"That's what I found most comforting about sitting down with those other men. Talking to six other guys who were experiencing exactly the same thing made me realise that these were normal thoughts."
Have the couple now got through this stage? "Yes, we have," Ken says. "Carmel had reconstruction surgery a year ago, but even before that we had a sexual life as well. And the reconstruction has done wonders for her self-esteem and self-image. She just looks great, and it's great to see her looking great."
These days, both Carmel McKinley and Mary Byrne are free from cancer. Both couples try to live as normal lives as possible, but they still worry that the cancer will return.
"The hardest thing is when she goes back for her check-up. You get uptight. You're wondering if it will be all right," says Vinnie.
"The threat of re-occurrence is a major problem," agrees Ken.
"There was another scare last week when Carmel found a lump. Thankfully, everything is fine, but she had to go through the tests again, and it's just a rollercoaster. Obviously, the ups and downs are nothing compared to the first year. But there are still concerns and worries."
These couples are not alone in their fears. According to statistics from the National Cancer Registry, 1,738 women were diagnosed with breast cancer in the Republic of Ireland in 1999. The American Cancer Society estimates that there will be 211,300 new cases of female breast cancer in America in 2003. Worldwide, the numbers are increasing slowly but steadily each year.
Marc Heyison believes this upward trend will have at least one positive effect - namely that breast cancer will soon be such a normal feature of society that men will be forced to learn how to cope with the issues surrounding it.
"Men are not going to have a choice whether to get involved," he says simply. "Breast cancer is going to be a part of their lives for a long time."
For further information, contact the ARC Cancer Support Centre, 65 Eccles Street, Dublin 7. Tel: 01-8307333.
[ www.menagainstbreastcancer.orgOpens in new window ]
Men's Crusade Against Breast Cancer at http://home.earthlink.net/~rkupbens/mcabc and
Bosom Buddies at www.bosombuddies.org