Supportive Care in Cancer

, Volume 27, Issue 2, pp 659–668 | Cite as

Perpetuating the cycle of silence: the intersection of uncertainty and sexual health communication among couples after breast cancer treatment

  • Mollie Rose CanzonaEmail author
  • Carla L. Fisher
  • Christy J. W. Ledford
Original Article



The aims of this study are (1) to identify sources of uncertainty breast cancer survivors and partners of breast cancer survivors (BCS) report as a result of sexual health changes after primary treatment and (2) to investigate the challenges they experience when attempting to communicate about sexual health-related uncertainty.


Forty BCS and 13 partners completed written reflections and participated in semi-structured interviews.


Analyses revealed five predominant sources of uncertainty for BCS and partners: perceptions of post-treatment body, worry about effects on relational partners, ethical concerns about dissatisfaction with sexual relationship (partners only), fears about future of the relationship, and apprehension about SH treatment futility. These concerns are linked to communication challenges for couples: supporting survivors’ body esteem, navigating potentially hurtful disclosures, responding to partners’obstructive behavior,” and believing communication is futile.


Findings suggest women and partners find themselves caught in a destructive cycle that reinforces uncertainty and inadvertently perpetuates silence and relational distress. To disrupt the cycle of silence, BCS and partners need to know that their interpretation of the other person’s behaviors/needs is not always accurate. Strategies are required to help women and their partners express uncomfortable thoughts and feelings in safe and supportive environments. Practitioners should be conscious of potential SH issues, be familiar with existing support resources for survivors, and be prepared to disseminate information that will empower women and their partners.


Female sexual dysfunction Breast cancer survivor Relational communication Qualitative analysis 


Compliance with ethical standards

We have full control of all primary data and we agree to allow the journal to review our data if requested.

Conflict of interest

The authors declare that they have no conflict of interests.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of CommunicationWake Forest UniversityWinston-SalemUSA
  2. 2.Department of Social Sciences & Health PolicyWake Forest University School of MedicineWinston-SalemUSA
  3. 3.Department of Advertising, UF Health Cancer Center, STEM Translational Communication Center, Center for Arts in MedicineUniversity of FloridaGainesvilleUSA
  4. 4.Department of Family MedicineUniformed Services University of the Health SciencesBethesdaUSA

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