Primary malignant brain tumours, psychosocial distress and the intimate partner experience: what do we know?

From the time of diagnosis of a primary malignant brain tumour (PMBT) and throughout the illness trajectory, the patient and intimate partner face many psychosocial challenges ranging from fear and uncertainty to hope and loss (Fox & Lantz, 1998; Janda et al., 2007; Kvale, Murthy, Taylor, Lee, & Nabors, 2009). While many patients diagnosed with cancer may go on to live with cancer as a chronic illness, this may not be said of individuals diagnosed with a PMBT, in particular those diagnosed with a glioma, the most common form of brain tumour (Gupta & Sarin, 2002). Gliomas are associated with a short disease trajectory and multiple deficits (functional, cognitive and psychiatric). What makes the PMBT experience unique from other cancers is that the intimate partner must not only deal with the diagnosis of cancer in their spouse, but also the accompanying personality, functional and behavioural changes wrought by the disease, as well as grieve the loss of the person they once knew (Sherwood et al., 2004). These multi-dimensional deficits are thought to place the intimate partner, as caregiver, at greater risk for adverse psychosocial effects such as anxiety, depression and post traumatic stress (Goebel, von Harscher, & Mehdorn, 2011; Keir, Farland, Lipp, & Friedman, 2009). The following discussion will provide an overview of the extant literature on the experience of living with a PMBT from the intimate partner (spouse) perspective with a particular emphasis on how intimate partners cope. The intimate partner is considered to be the heterosexual or same-sex, married or common-law partner of the patient. Highlights from the psychotherapy practice of the author will be used to further strengthen the need for more research, education and enhanced practice to more effectively meet the unique needs of this under-researched and supported population.