After diagnosis and treatment, sex is the most frequently discussed topic among couples facing cancer. While there is work about improving sexual communication, the experiences of people with advanced cancers have been overlooked
Amanda Denes, a professor in the Department of Communication in the College of Liberal Arts and Sciences, has received funding from the National Cancer Institute to conduct a pilot study that investigates the relationships between communication and sexual, relational, and individual well-being for individuals diagnosed with metastatic breast cancer.
Metastatic breast cancer, also called stage IV breast cancer, is a late-stage cancer where cancerous cells have spread beyond the breast to other organs.
Denes, who is a principal investigator at UConn's Institute for Collaboration on Health, Intervention, and Policy (InCHIP), will explore how metastatic breast cancer patients communicate with their partner about their sexual, relational, and individual well-being. Patients will complete an online survey about their relationship with their partner, how cancer has changed their sexual relationship, and if and how they communicate with their partner about these changes.
"Despite the recognition that sexuality should be part of end-of-life care and is vital for couples with cancer to maintain connection, sexual needs are rarely assessed among metastatic cancer patients. Their needs for intimacy may be even stronger than before cancer, given the limited time and highly emotional experience of facing a terminal diagnosis," says Denes.
A cancer diagnosis is a life-altering experience that impacts not only physical health, but also mental and emotional well-being, and social relationships.
For married or committed couples, a cancer diagnosis becomes a shared challenge as they cope with the diagnosis and adjust to their new reality. Cancer can impact and change the communication patterns that couples have established, as well as their roles and responsibilities in the relationship.
Although being married or in a committed partnership has health benefits and may improve quality of life, couples navigating a cancer diagnosis may also experience heightened levels of stress and breakdowns in communication, a major cause of divorce or breakups.
Mutual, constructive communication has been shown to ease psychological distress, sustain closeness and intimacy, and improve outcomes. It is particularly important for couples to engage in discussions about their sexual health, even if they may be reluctant.
"Sex is one of the most frequently discussed topics among couples facing cancer, so there is evidence that talking about sex is important in this context. There has been some work demonstrating the benefits of interventions focused on improving sexual communication between reproductive cancer patients and their partners, but much of this work overlooks the experiences of people with advanced cancers, like metastatic breast cancer," says Denes.
Denes is collaborating with Keith Bellizzi, a professor of gerontology in the Department of Human Development and Family Sciences. He has expertise in cancer survivorship and quality of life, including sexual function.
"While there has been growing attention to psychosocial impacts of cancer, intimacy in couples is much less understood, particularly among women with metastatic breast cancer," says Bellizzi.
Denes and Bellizzi previously collaborated on projects exploring couples' communication about sexuality in the context of reproductive cancers. They also conducted preliminary testing of the study's survey tool.
"Identifying specific forms and features of talk that may help or hinder couples as they navigate intimacy in the context of metastatic breast cancer is a pivotal first step in understanding if and how communication can benefit individual and relational well-being. Findings from this study will help identify aspects of communication that patients find beneficial when navigating sexuality and intimacy in their relationship," says Denes.
To expand data collection, the research team received bridge funding from InCHIP. This will enable Denes and Bellizzi to survey an additional 200 participants and test their exploratory model, which will serve as the foundation for a future external grant application.
For Denes, studying how couples with cancer successfully talk about cancer-related changes is both a personal and professional endeavor.
"I am particularly interested in the experiences of couples facing cancer given the ways that cancer has affected my own life. I have watched friends and family members battle cancer and experience changes to roles, relationships, and the communication that occurs within them. This has made me want to understand how couples facing cancer can successfully communicate about cancer-related changes," says Denes.
Denes' research focuses on interpersonal communication and how it impacts relational, mental, and physical health, with the goal of identifying communication practices that contribute to individual and relational thriving. She currently serves as principal investigator on two projects that explore couples' communication about sexual and relational changes in the face of a cancer diagnosis and treatment.
These projects were supported by internal funding from UConn and a U.S. Scholar Award from the Australian-American Fulbright Commission, and investigate communication about sexuality and intimacy among heterosexual and LGBTQI+ cancer patients.
According to the World Health Organization (WHO), sexual health extends beyond the absence of disease, dysfunction, or infirmity and encompasses physical, emotional, mental, and social well-being. WHO also recommends acknowledging that sexual experiences can and should be pleasurable.
"Despite sex being an essential part of human existence and connection, it is still a topic that many consider taboo. Seeing how the silence that surrounds sex and sexuality can negatively impact individuals and their relationships led me to focus my research on the communication processes that contribute to satisfying relationships," says Denes.
