“A Caregiver’s Marriage”: The Impact of Blood Cancer on the Spousal Connection

Abstract

Spouses are the most common type of cancer caregiver and a primary source of support across the cancer continuum. While studies show that cancer can impact caregivers’ health outcomes, less is known about how blood cancer impacts the spousal relationship. We sought to examine the impact of blood cancer on the relational connection of married couples from the perspective of the spousal caregiver. We thematically analyzed transcripts of in-depth interviews with caregivers of a spouse diagnosed with a blood cancer. Caregivers (n = 27) identified positive and negative relational impacts related to physical intimacy, emotional intimacy, marital roles, discordance between spouses in coping, and a disrupted relational future. Spousal caregivers must navigate ongoing relational impacts across the care continuum. These relational effects illustrate how cancer jointly impacts diagnosed individuals and their caregiving spouses, altering their relational connection, roles, and future as a couple. While marital bonds can become strengthened after cancer, it also challenges couples and how they typically relate, which may be informed by gendered norms in some marital relationships. To provide better support, educational resources and interventions are needed to help couples prepare for and address challenges with intimacy, gender roles, discordant communication and coping preferences, managing discussions about their future, and coping with uncertainty. To support individuals living with blood cancer and their caregiving spouses, their needs must be understood from a family-centered or relational perspective to better facilitate psychosocial adjustment during and after cancer treatment.