When Cancer Is a Couple’s Disease: Advancing Relationship-Centered Oncology Care in the Postsurgical Phase of Hormonal Cancers

Introduction When individuals undergo surgery as part of their cancer treatment, much of the attention focuses on their recovery. However, there is often a partner on the journey who is underprepared and undersupported. This burden is especially heavy immediately after surgery when the partner provides functional (eg, physical, emotional) and instrumental (eg, financial, advocacy) care for the patient. What is often overlooked is the long-term nature of surgical recovery, with the patient’s complex physical, emotional, and logistical needs extending well beyond the hospital stay. Vague discharge instructions and unanswered questions can leave the partner feeling isolated, an experience that often leads to negative health consequences for the partner. Yet despite the central role partners play in recovery, most cancer care systems still treat them as secondary, if they are acknowledged at all. It is time to change that. This editorial argues for a relationship-centered oncology care model that prioritizes partners as essential stakeholders in postsurgical recovery, including the integration of a dedicated oncology nurse navigator (ONN) whose responsibilities explicitly extend to the partner. From managing postsurgical drains to navigating intimacy loss, partners need structured education and compassionate guidance—not incidental inclusion, but intentional, proactive support. Hormonal Cancers as “Couple’s Diseases” Some cancers, particularly hormonal cancers such as breast and prostate, are referred to as “couple’s diseases” because their treatments, especially surgery, can significantly impact not only the patient’s quality of life but also the partner’s emotional well-being, sexual and emotional intimacy, and the overall relationship dynamic. As such, supporting the health of the relationship becomes just as vital as supporting the patient’s recovery. Research shows that partners are valuable in the care of the patient, as they influence recovery trajectories and adherence to follow-up care.1 Therefore, it is important that partners not only understand how cancer diagnosis and treatment may affect them personally but also are empowered to care for their own emotional and relational well-being. The Partner’s Experience Postsurgery Partners are often faced with becoming the patient’s primary support person following surgery, all while managing their own mental and physical well-being. They may find themselves responsible for wound care, surgical drains, pain management, monitoring for complications, and coordinating medical appointments, often without any formal medical training. While the immediate postoperative period presents urgent and hands-on responsibilities, the partner also plays a critical role in navigating the long-term effects of surgery. For example, following a prostatectomy, the patient may experience urinary incontinence and erectile dysfunction, both of which can affect self-esteem, intimacy, and the emotional connection between partners.2 Similarly, patients who undergo mastectomy may face altered body image, reduced sensation, and discomfort during physical closeness, which can also challenge intimacy and communication within the relationship.3 To facilitate partner understanding and empowerment, we recommend a roadmap and guide for this process: structured instructions and an ONN focused on helping partners through the postsurgical phase. Relationship-Centered Oncology Care Roadmap A key component of relationship-centered oncology care is the development and delivery of a clear, structured roadmap that supports both the patient and partner through the surgery, recovery, and survivorship. This roadmap is a comprehensive guide outlining the physical, emotional, and relationship effects of surgery. The topics to be addressed in the roadmap should include body image changes, impact on intimacy, potential role transitions, emotional and physical distress, and challenges with helpful solutions. The roadmap is not a discharge checklist; it is a thoughtfully designed tool to highlight the potential needs of the patient and partner and provides guidance at each stage in the journey. By involving both the patient and partner, this roadmap empowers the couple to work together, equips them to navigate transitions with reassurance and support, and fosters a feeling of connection throughout the recovery process and beyond. The ONN should introduce this roadmap to the patient and their partner before surgery, during discharge planning, and throughout recovery. Expanding the Nurse Navigator’s Role ONNs are specially trained to assess barriers to care, coordinate multidisciplinary services, and deliver tailored education throughout the cancer continuum. Expanding their role to integrate partners into this process reflects a shift toward relationship-centered oncology care, an approach that acknowledges the interdependence of patient and partner well-being. This model is a natural and necessary extension of patient-centered care.4 Rather than treating the partner as an ancillary support figure, the ONN should be empowered to engage them directly, before surgery, during discharge planning, and throughout recovery. This would include providing anticipatory guidance about physical and emotional changes in the patient, helping couples prepare for shifts in intimacy, and offering referrals to counseling or sexual health resources when needed. For example, in prostate cancer, where treatment frequently impacts sexual functioning, hormonal identity, and masculinity, an ONN can normalize these changes, support emotional adjustment, and connect couples to appropriate resources. Similarly, in breast cancer, ONNs can help partners understand body image concerns and emotional recovery after mastectomy or reconstruction.5 While many ONNs already provide emotional support to partners and may engage them in parts of the process, there remains an opportunity to place greater and more intentional emphasis on partners’ distinct needs. This includes offering a structured roadmap that addresses the emotional and relational challenges they may face, helping them feel supported not just as partners but also as individuals undergoing their own parallel journey. Crucially, the ONN can provide this roadmap, offering guidance on what to expect throughout treatment and recovery, how treatment effects may negatively impact the relationship, and where to seek support. This would empower the partner to prepare emotionally and to navigate intimacy changes. Addressing these issues early and openly promotes resilience, connection, and better long-term outcomes for both partners and the relationship as a whole. The impact of nurse navigation is well-documented. Research shows that ONNs can reduce patient anxiety, improve satisfaction, minimize delays in treatment, and ensure continuity of care.6 ONNs are also associated with improved coordination of services and enhanced communication across the care team, key factors in supporting both patients and their partners.7 When an ONN is involved early, this can improve the patient experience, reduce problems in care, and decrease anxiety of the patient and their partner.6 Expanding the ONN’s role to provide this roadmap to both patients and partners would be a critical step forward in relationship-centered oncology care. This model offers a scalable, evidence-informed solution to a deeply personal and often neglected dimension of hormonal cancer postsurgical recovery. Call to Action and Conclusion Breast and prostate cancers do not just affect the patient; they reshape the emotional and physical closeness of a couple, often altering roles, routines, and intimacy. Recovery after surgery is not limited to wounds and medications; it includes learning how to live in a changed body, navigating relationship shifts, and rebuilding connections. For couples, this phase can be deeply disorienting, especially when partners are left without guidance. It is time for cancer care to acknowledge that when one partner undergoes surgery for a hormonal cancer, both partners are impacted. Hospitals and cancer centers need to do more than discharge patients with basic postoperative instructions; they must build care models that recognize the partner as part of the recovery team. This means integrating partner-focused education and providing access to an ONN who is empowered to guide the patient–partner dyad through what lies ahead. Conversations about intimacy, role changes, body image, and emotional well-being should not be left for couples to figure out on their own. Offering a clear roadmap, one that outlines the physical, emotional, and relational effects of surgery, can empower partners to anticipate challenges and find their footing. This support would not only improve patient recovery but also strengthen the relationships that are at the core of healing. Hormonal cancer surgery is never just a medical event. It is a deeply human experience shared between two people. By embedding these principles into routine practices, we shift toward relationship-centered oncology care, which honors the interconnected experiences of patients and their partners.