To tell or NOT to tell – dating and disclosure after breast cancer

I certainly remember that fear.

1. Do you introduce yourself as “Hi, my name is Elna and my breasts were trying to kill me, so I had them removed”?

2. Do you wait until you’re ready to take this relationship to the next level and then drop the “C” word?

3. Or do you postpone the discussion until you’re ready to shed your clothes and then shout SURPRISE? Yes, these are fake.

Disclosure of one’s cancer status is difficult; often a shock and no two people react in the same way to the news. Responses can range from involvement, caring and support on the one hand, to abandonment, indifference, and antagonism on the other.

Should I disclose my Cancer status

Whether or not to disclose your cancer status is a difficult decision to make, because disclosure (or non-disclosure) is often followed by major and life-changing consequences.

Consider the benefits as well as the negative consequences that disclosure may have for you as individual. Trained counsellors can really assist in helping you weigh these possible consequences up against each other. Because disclosure is a very personal and individual decision, all relevant personal circumstances should be taken into account.

You should also decide if you want full disclosure (i.e. publicly revealing your status) or partial disclosure (i.e. telling only certain people such as, a potential new partner, relative or friend). Disclosure can be accompanied by the following benefits:

• It can help you to accept your cancer status and reduce the stress of coping on your own.

• It can help you to access the medical services, care and support that you need.

• It may help to reduce the stigma, discrimination and denial that surround Cancer.

• It promotes responsibility. It may encourage the person’s loved ones to plan for the future.

Disclosure can also be accompanied by negative consequences such as: problems in relationships (e.g. with sexual partners, family, friends, community members, employer or colleagues), rejection, and the conviction that people are constantly judging you.

You should think through all the pros and cons very carefully and plan ahead before disclosing your cancer status.

Guidelines to disclose your Cancer status

The following guidelines may help a person who wants to disclose their cancer status.

• Take time to think things through. Disclosure is a process, not an event. Try to think of the implications of disclosure. Consider in advance what the reaction of family, friends, colleagues and others might be. Make sure it is what you want to do. Plan how you are going to do it.

• Be practical. Develop a “plan” before disclosure – who you will inform first, how and where the disclosure will take place, and what the level of disclosure will be.

• It may be a better idea to disclose gradually rather than to everyone at once.

• Choose the person/people you want to disclose to carefully: It must be someone who is accepting, mature, empathic and supportive.

• Make sure that the time and place are right for disclosure.

• Identify sources of support, such as support groups for cancer survivors (Such as Bosom Buddies) and counselling organisations.

• Counsellors can help you to role play to help you prepare for disclosure.

• Accept yourself just as you are.

• Be prepared for a shocked and even hostile reaction from some people. The people close to you will probably learn to accept your cancer over a period of time – if not immediately.

• Once a decision to disclose has been made, it may be easier to begin with those nearest to you: relatives, family, friends, or someone to whom you are very close and whom you trust.

• Think about the likely response of the person you decided to disclose to. Assess how much the person you plan to disclose to know and understand about Cancer. This will help you to decide what you need to tell the person and how to tell them. Such preparation will make disclosure less traumatic for both of you.

• Be strong enough to allow others to express their feelings and concerns after your disclosure.

• If you do not want to disclose your status to somebody, don’t feel unduly pressurised to disclose.

• Ask a counsellor’s help if you need him or her to mediate the disclosure process if the need arises (e.g. to be present when you disclose your Cancer status to a partner).

• Keep in mind that disclosure can be very empowering.

Disclosure can be particularly difficult for young, single women or divorced women. You might find it difficult to discuss your sexuality with a support group of women that are in relationships – who may be prejudiced or who may simply not understand the issues involved. Ask your counsellor to refer you to a support group that is sensitive to the needs of single women.

Written by Prof Elna McIntosh