Dating is difficult enough. Add cancer into the mix and it creates a whole new series of questions. But ultimately, as in any relationship situation, when and how to tell a prospective relationship partner that you’ve been diagnosed with cancer comes down to trust and timing.
“I think it’s different from person to person,” says Melissa Moffitt, MD, a gynecologic oncologist at Roswell Park Comprehensive Cancer Center. “There are a lot of similarities between this issue and other issues that you feel you may have to disclose at some point: prior divorce, bankruptcy, chronic diseases. I certainly don’t think it’s first-date information.”
Your cancer diagnosis is like any other experience in your life, present or past, she says, and if a relationship is more casual, it might never come up at all.
If the relationship is new, or just starting out, it might feel emotionally safer to reveal a little information at a time, suggests Erin Brewer-Spritzer, a medical psychology trainee in Roswell Park’s Young Adult Program. “Sharing your history and cancer experience may be a personal aspect of your identity, and you have the power to reveal this part of yourself at your own pace and comfort level,’” she says.
“As a patient or survivor, not only are you in control of sharing your cancer experience, but you also have the power to determine how much information you feel emotionally safe sharing,” she continues. “Depending on the level of trust and commitment established in the relationship, disclosing some of the harder moments of the cancer experience (disease progression, a terminal prognosis) may feel too vulnerable at first.”
On the other hand, Brewer-Spritzer suggests, if you feel that withholding this aspect of your life from your prospective partner is secretive or like a constant elephant in the room, you also hold the power to share your cancer experience at any point you choose.
“Creating and holding on to those boundaries is important,” Brewer-Spritzer says. “If this information is something you are still processing and don’t feel ready to share openly with your prospective partner, that is okay.”
Time, distance from cancer can make a difference
Whether you’re in mid-treatment or your cancer is behind you can also influence how much information you share — and when.
If you had cancer as a child and are now well into adulthood, you might view that experience as something that happened a long time ago but doesn’t weigh much on your current life. Or it could be very present as you consider finding a long-term relationship that might involve children.
“Some survivors of pediatric cancers may have questions regarding their fertility or ability to start a family, while others may know they will face certain fertility challenges, including possible infertility,” Brewer-Spritzer says. “Navigating dating or a new relationship with this added burden of disclosing fertility challenges may feel overwhelming.”
Some people, regardless of whether they’ve been out of treatment six months or 16 years, view their cancer as a larger part of their identity, because they’re survivors of something that helped shape their identity and made them stronger.
“Whatever came after, whatever comes in the future, that word, cancer, is something most people can’t even imagine,” Brewer-Spitzer says. “And you’re here. Every day you’re learning how to navigate the path of your survivorship as your relationship to your cancer journey may change and evolve each year out from treatment.”
Everyone has a past
In some respects, dating after or during cancer is no different from dating without it.
“It’s not the only thing people have to disclose,” Dr. Moffitt says. “Maybe you went bankrupt last year. Maybe you’ve got herpes. Maybe you’re taking care of your mother. There are things on people’s plates that need to be discussed at some point in a relationship, but it doesn’t have to be in the beginning.”
Brewer-Spritzer agrees, adding that when someone feels comfortable divulging this information, it can help to remember that everyone has faced different obstacles in their past. No one reaches adulthood unchallenged.
Dealing with intimacy
For cancer patients who have undergone surgery of any kind as part of their treatment plan, the idea of undressing with a new partner can add more levels of stress and anxiety. Their partner might know the scars exist or that a prosthesis is being used, but allowing someone to see those scars for the first time can be scary.
“That’s what I do in the clinic a lot, try to help people regain their confidence and get back on their feet,” Dr. Moffitt says. “A lot of times it’s psychological body image: ‘I don’t feel like a woman because my breast or uterus is gone.’ It’s overcomeable, like other body image issues. The way our brains work, it’s the same thing as when you’re a teenager and there’s a pimple on your face. It’s all you can see, but no one else has noticed it, because you’re just like every other teenager with pimples on their faces.”
“Seeing the physical scars and body changes of your cancer experience may bring back unwanted memories of pain or body distrust, it may even feel, at times, that you don’t recognize yourself,” Brewer-Spritzer adds. “Allowing yourself time to process these changes and rebuild trust within your own body before being intimate with a partner may help you learn what aspects of intimacy you are comfortable with and where you want to hold your emotional and/or physical boundaries."
The Young Adult Cancer Program
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How comfortable you feel in your own skin, scars and all, can be an ever-shifting thing, but it’s important not to let the little doubting voice in the back of your mind create a bad self-image.
“The voice in our head can be is our own worst enemy, but that’s not its role,” Brewer-Spritzer says. “It can be very hard not to listen to and believe our own negative thoughts, especially around body image. However, the thoughts are just that: thoughts. They are not facts and they do not have to have the power to stop you from fully engaging in your life and finding a partner. This isn’t saying, ‘Don’t dive into a relationship until you’re a fully whole person.’ It’s not always easy, but allowing yourself time to process your experience either on your own or with the support of a loved one or mental health professional will help you unpack some of the tiny boxes that may be up on that cancer shelf. Hopefully that can help you move toward understanding what you want and value from another person and why you’re pursuing a relationship.”
Dating can be a confidence booster
After months of treatment and feeling less than wonderful, once you decide to reenter the dating world, you might find connecting with new people to be a great medicine in and of itself.
“In my experience, it takes about six months after finishing active treatment before life normalizes enough that people want to go back to less survival-type activities and doing more living activities, like having sex, and maybe that extends to dating,” Dr. Moffitt says.
“Getting a cancer diagnosis really reprioritizes people’s lives. It can really change what they’re looking for and what they want out of life, what’s important to them now. It happens for the patient, and it can happen for existing relationships, too.”
A new relationship in which cancer is not disclosed right away might falter when the news is shared, but in a way, that’s a good filter for finding a solid partner, she says. “If they’re not accepting of whatever the situation is, that’s great, because you’ve found out early on that this person is not right for you. It can be really healthy and good, if you’re going through treatment and you want to meet new people and start dating.