Although it is you who has been ill, you may find yourself coping with more than your own feelings about cancer. Your relatives and friends may have feelings of sadness and uncertainty similar to your own, and these emotions may spill over into their relationship with you. Relatives, friends, and work colleagues may be embarrassed and tongue-tied, and feel angry and guilty that cancer has happened to you. Your cancer may have reminded them of their own mortality.

People may try to hide their feelings from you because they feel that you have had enough to cope with. However, silence – even when well intended – can block communication. Discussing feelings and bringing them out into the open can help you to understand each other better and can bring you closer together. It may be very difficult to discuss the feelings that cancer can cause. There is often no easy way to do this, but acknowledging that you feel sad, upset or angry can often help you to talk things through more easily.

Once your treatment is behind you and you are on the road to recovery, the people closest to you may not seem as attentive and caring as they were when you were ill. They will have been through a very difficult time too (but may not necessarily have shown it) and may now need a period of rest, while still caring very much about you. You may not be the only person who needs to recover, and you may need to understand and appreciate this as much as your loved ones do.

If your family seem scared to talk about what has happened, you may need to ask them some open questions which need more than an ‘I’m OK’ reply. For instance, you could ask: `What's the worst part for you of my having had this cancer?' rather than simply `Are you all right?'

Cancerbackup has a section, 'Lost for words', written for relatives and friends of people with cancer. It looks at some of the difficulties people may have when talking about cancer and suggests ways of overcoming them.

When people ask you questions about your health, they may want you to say that you are cured. This may be difficult because your doctor may wish to wait for several years before she or he can tell you for sure that your treatment has been effective. It is better to be honest about this when people ask, even if it disappoints them.

Problems can sometimes arise, even between close and loving couples, if there are differences in your expectations of the future, or in how you want to deal with talking about the cancer. For example, a partner can be overly optimistic, even though the outlook for you may be uncertain. If this happens, you might consider asking a third person such as a doctor or specialist nurse whether they would be willing to discuss the situation with your partner. You, or your partner can also contact Cancerbackup or any of the support organisations listed for help and support.

Children will have been affected by your illness. Younger ones especially may have convinced themselves they were somehow to blame. Even if you explained the situation carefully when you were first diagnosed, you may need to reinforce what you told them and provide repeated reassurance that you are really on the road to recovery.

It can be even harder for children than for adults to find the right words to talk about cancer, and older children may find this especially difficult. Try asking them open questions such as `What would you like to know about the illness I had?' Young children may ask the same question over and over again. This is their way of trying to make sense of what has happened. It can be irritating to have to answer it several times over, but they are just curious and you can give simple answers over and over again.

Children of all ages may become difficult and show what is sometimes known as ‘challenging behaviour’ when they feel insecure or uncertain. Teenagers may find it particularly difficult to cope with the situation because they may feel that they have been forced back into the family just as they were beginning to break free and gain their independence. The normal rows and acts of rebellion which occur at this time can become difficult and painful for them and you. You may find that you are blaming your teenager’s bad behaviour or silences on your having had cancer when it may simply be part of growing up. Perhaps another adult who is close to your teenager could talk to him or her and help them make sense of what is going on.

It is not unusual for sexually active people to have difficulties with sexual relationships as they recover from cancer. You may feel very tired, or worried, and sex may be the last thing that you feel like. Sometimes partners feel, mistakenly, that they could catch the cancer, or that sexual activity could make the condition worse. Talking to your doctor or a Cancerbackup nurse may help to ease some of these concerns. It is important to remember that any problems you are having are not unusual in this situation, and should reduce as time passes.

The ongoing side effects of treatment may also make sexual activity difficult, although these can often be treated. For instance, some cancer drugs can cause long-term vaginal dryness, and special creams or gels may need to be prescribed by your doctor. Simple lubricants such as Aquaglide, Senselle or Replens, which can be bought from most chemists, can also help to ease any discomfort felt during intercourse.

If treatment, particularly surgery, has altered your physical appearance, it may take time for you to adjust to these changes. It is natural to want to try to hide parts of your body from your partner because you are worried about his or her reaction. However, your partner may not have a problem with your changed appearance at all and it can be helpful to try and discuss it if you feel that there is awkwardness between you. If, as a result of your treatment, intercourse is not possible, you may find that slow, sensual touching, stroking and kissing can bring just as much enjoyment and intimacy.
Reluctance to make love can sometimes lead to misunderstanding. Your partner may feel you have lost interest and that your feelings for him or her have changed. Treatment may have reduced your sex drive and you may not want to have intercourse so often. This is fine, but cuddles and affectionate kisses are also very loving ways of showing how much you care for someone, even if you don’t feel like having sex.

If you want to make love, but find you are unable to, don’t feel guilty or embarrassed about asking for professional advice. If you feel uncomfortable discussing this face to face with your doctor, you may want to ring the Cancerbackup Cancer Support Service helpline or speak to a specialist sexual therapist. You can contact a therapist through the British Association of Sexual and Relationship Therapy.

Cancerbackup's section Sexuality and cancer discusses the possible problems following treatment for cancer and has tips on ways of dealing with them.

Sometimes cancer is blamed for problems that may have existed long before the diagnosis. The stress of a major illness may in some circumstances widen the cracks in a difficult relationship. If you and your partner feel that you need counselling about your relationship, you can contact the Cancer Counselling Trust or Relate.

Finding a way of talking about problems, and resolving them, can sometimes bring couples closer together.