Getting through cancer treatment can be really tough for a man who is not in a long-term relationship. You may not have a friend or family member who can be there for you like a spouse could be. Maybe you also worry how a current or future partner will react when they learn you've had cancer, so that you want to avoid dating.

Some of the scars left by cancer are public. These include the loss of hair during chemotherapy, a lost limb, or disfigured face. Other scars will not be seen by a casual onlooker. For example, there's no way to know that a man walking down the street has a colostomy or only 1 testicle. These private scars can be just as painful, though, since the few people who do see them are often the ones whose acceptance matters most.

Perhaps the most private scar left by cancer is the damage done to how you see yourself. You may be wondering about how active you can be and even how long you will live. If you had hoped to marry or to remarry, you may not want to involve a partner in an uncertain future. Homosexual men who are not in committed relationships have the same worries.

Concerns about having children can also affect your new relationships. Perhaps you have lost your fertility because of cancer treatment. Maybe you can still have children but fear that cancer will not give you time to see your child grow up. Maybe you are worried about their future.

When dating, men or women who have had cancer often avoid talking about their illness. At a time when closeness is so important, it can seem risky to draw a potential lover's attention to your problems. During treatment, you may want to be brave and not complain. And after the cancer has been controlled, you may want to forget that the illness ever took place.

Sometimes you can ignore the cancer for a time. But when a relationship becomes serious, silence is not the best plan. Before you and your partner decide to make a strong commitment, you should talk about the cancer. This is especially true if the length of your life or your fertility has been affected. Otherwise, cancer may become the skeleton in your closet, a secret that will limit your ability to confide in your partner. A loving partner needs to accept you as you are.

When to talk about your cancer

It is always a delicate choice when deciding to tell a new or prospective lover about your cancer. Ideally, a couple should discuss cancer when a relationship begins to get serious.

How to bring it up

Try having "the cancer talk" when you and your partner are relaxed and in an intimate mood. Ask your partner a question that leaves room for many answers. The question gives them a chance to consider the new information and respond, and helps you see how your partner takes this news.

One way is just to mention it, followed with your question. "You know that I had leukemia several years ago. How do you think that might affect our relationship?"

You can also reveal your own feelings: "I guess I don't want to bring up my treatment for cancer because I'm afraid you'd rather be with someone who has not had the disease. It also scares me to remember that time in my life, but I need you to know about it. Five years ago I was treated for colon cancer and I'd like to talk with you about that. What are your thoughts or feelings about my having had cancer?"

If you have an ostomy, genital scars, or a sexual problem, you may be concerned about when to tell a new dating partner. There are no hard and fast rules. It is often better to wait until you feel a sense of trust and friendship with your partner -- a feeling that you are liked as a total person -- before sharing such personal information.

The possibility of rejection

The reality is that some potential lovers may reject you because of your cancer or cancer treatment. Of course, almost everyone gets rejected at some time. Even without cancer, people reject each other because of looks, beliefs, personality, or their own issues. But the sad truth is that some single people who have cancer or have had it in the past limit themselves by not even trying to date. Instead of focusing on their good points, they convince themselves that no partner would accept them because of the cancer and the effects of treatment. Although you can avoid being rejected by staying at home, you also miss the chance to build a happy, healthy relationship.

Here are some ways to help you make decisions about talking about your cancer:

• Tell a potential partner about genital scars, an ostomy, or sexual problems when you feel that the person already accepts you and likes you for who you are.

• Discuss your cancer in depth when a new relationship starts to deepen, especially if you have life expectancy or fertility issues.

• Prepare for the possibility of rejection: imagine the worst possible reaction of a new potential partner, and how you would respond. But don't let fear of that reaction keep you from going after a relationship that might work.

You can even rehearse how to tell your date about your experience with cancer by having a close friend play the date's role. What message do you really want to give? Try some different ways of saying it, and ask a friend for feedback. Did you come across the way you wanted to? Ask your friend to take the role of a new partner who rejects you because you have had cancer. Have your friend tell you what you dread hearing the most, and practice your response. Can you express your feelings in a dignified and satisfying way?

When you feel some confidence in your self-worth and your ability to handle rejection, you are ready for the real world. Then, when you start to meet people or to date, think of it as part of a learning process rather than a situation demanding instant success.

Improving your social life

Try working on areas of your social life other than dating and sex. Single people can avoid feeling alone by building a network of close friends, casual friends, and family. Make the effort to call friends, plan visits, and share activities. Get involved in a hobby, special interest group, or classes that will increase your social circle.

Some volunteer and support groups are geared for people who have faced cancer. You may also want to try some one-on-one or group counseling with a mental health counselor. You can take a more positive view of yourself when you get objective feedback about your strengths from others. Make a list of your good points. What do you like about your looks? What are your good points? What are your talents and skills? What can you give to your partner in a relationship? What makes you a good sex partner? Whenever you catch yourself using cancer as an excuse not to date, remind yourself of your assets.

If you feel shy about meeting new people, practice how to handle it. Talk to yourself in the mirror, or ask a close friend or family member to play the part with you.

Men who have sex with men

Some men who have sex with men may be at special risk for a delayed diagnosis of cancer because they may less often take part in screening programs for cancer. Some have concerns about:

• past negative experiences with health care providers or "medical homophobia"
• poor access to care due to lack of health insurance
• fear of discrimination
• lack of social support systems
• lack of information about health needs of men who are intimate with other men

Health care providers need to know, for instance, that men who have sex with men are at higher risk of becoming infected with hepatitis and human immunodeficiency virus (HIV, the virus that causes AIDS). They need to know how to test for and manage these kinds of problems. Often, men who have sex with men will need extra tests and vaccines. (See the "Frequently asked questions" section for more information on HIV.)

There are special health guidelines for men who have sex with men, so you should seek care from doctors and nurses who are sensitive to your social situation and respect your privacy. They should also be aware of the extra care you may need. If you are in a relationship, you will want to find health care providers who understand and encourage your partner to be involved in your health care. Check the "Additional resources" section for information on getting referrals to doctors and nurses who are sensitive to health care and sexuality concerns for men who have sex with men.

All men, regardless of sexual orientation, have relationship and self esteem concerns -- with or without a cancer diagnosis. But relationship issues are different for men who are already in a long-term relationship than they are for men who are not. Men who are in relationships often share some communication issues that are much like those of married couples as they go through cancer. But they often must also deal with discrimination -- sometimes even from family members and old friends. This can cause emotional pain and greatly complicate their lives when one member of the couple has cancer.

If your long-term partner is more likely to know your health wishes than your family, it is important to write advance directives. That way, everyone knows who is to make decisions for you if you become unable to do so. Make sure your doctors, your partner, and your family know what you want and give them copies of your advance directives. Otherwise, family members who do not know what you want may be the ones legally expected to make decisions for you in the event that you become unable to speak for yourself. (See our document, Advance Directives for more information.)

Last Medical Review: 02/02/2009
Last Revised: 02/02/2009