If a patient receives a cancer diagnosis, this usually changes their life drastically – but family members can also be massively affected.

In Germany there are around half a million new cases each year, which are associated with considerable mental stress.

The problems are often just as big for relatives as for the patients, sometimes even bigger, says Jochen Ernst from the Leipzig University Hospital, where he heads the psycho-oncology research department.

While depressive symptoms, fear and traumatic stress predominate in patients, it is often a matter of burnout for relatives, says Ernst.

They are often only asked how their partner is doing, but not themselves.

Hinnerk Feldwisch-Drentrup

Editor in the department "Nature and Science".

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A typical behavior is to protect the sick and to want to buffer them from problems - even if you are completely overwhelmed yourself.

They can often still do and decide a lot.

Other people tend to get business as usual and ignore cancer.

Both behaviors could lead to similarly severe stress, says Ernst.

Men rarely take advantage of counseling services

The problems of relatives have only been more widely recognized for around 15 years.

"For a long time, the relatives in the hospital were seen as a disruptive factor." Now there are offers for them at many clinics, and all patients at his clinic would be informed about this.

However, not every person who is under greater stress seeks help, many try to solve the problems within their social system: According to a survey by Ernst in 2015, more than two out of three emotionally stressed cancer patients treated as outpatients did not want any psycho-oncological support - while others did very much accept offers.

“Most of the women go to these advice centers, there are hardly any men,” says Ernst.

Women make up around 80 percent of the patients and relatives seeking help – traditional masculine role models are often the decisive reason why men stay away.

The sociologist has studied how patients and their partners behave after a cancer diagnosis and how the other perceives this.

In some cases there is broad agreement here, but in other cases the perception differs considerably.

This is relevant, for example, in discussions with the doctor, in which reports are often made about the other person, and the question of how reliable these descriptions are.

"Ask instead of guessing"

"We know from the psycho-oncological support that the relatives are under a lot of stress," says Martina Prinz-Zaiss, who works as a resident psycho-oncologist in Freiburg.

At the same time, she is Vice-President of the German Working Group for Psychosocial Oncology, which has the motto “Cancer in the Family – Systemic Aspects in Psycho-Oncology” for its annual conference next year.

She herself sometimes only looks after relatives, for example when the patients do not need to be accompanied.

She also clarifies the clinical picture, medical details are often misunderstood, which can trigger fears.

When it comes to topics such as palliative care and death, there are major taboos that cancer patients and their relatives often do not talk about - this usually relieves it a lot,

It is also sometimes very helpful for the patients if they know that their family members are asking for help.

She gives one sentence to all clients, namely: "Ask instead of guessing" - to ask what the other person needs instead of giving advice that is often very stressful.