They have to be among the four most dreaded words a man can hear from his wife: "I've got breast cancer."
While it is the woman who becomes the prime focus -- her anxiety, how she endures treatment and the lingering fear of recurrence -- husbands go through their own form of emotional hell when faced with the diagnosis.
How they cope can differ substantially from women whose husbands deliver similar news about their own cancer threat, said Wendy Duggleby, a professor of nursing at the University of Alberta, who studies the role of hope in men's ability to support their wives through cancer.
"We were surprised at the huge impact that their wives' diagnosis of breast cancer had on them," Duggleby said from Edmonton.
"Some even called it the worst thing that had ever happened in their lives," she said. "You often think about being diagnosed with cancer yourself, but they were saying this was worse."
Warren Tasker, an Edmonton-based writer and editor, vividly remembers the day in March 2007 when his fiancée, Gwen Borowski, told him a lump in her left breast was malignant.
"We sat in a little café here in Edmonton, she told me, and we both wept and we were scared," Tasker, 52, recalled. "I was devastated. I was racked with emotion, just like anybody else would be."
But the couple put their emotional energies into making a plan to tackle the enemy -- one day at a time, side by side.
They focused on getting proper rest, eating healthy food, exercising and educating themselves about the treatment of breast cancer and the disease itself, which, in Borowski's case, turned out to be an aggressive form that meant removal of her breast.
"It was getting a plan and talking things through -- this is what we can do, this is what we can't do. And the rest is up to nature or God, or whatever you want to call it," Tasker said. "And that grounded us."
Focusing on a plan of action can be a coping mechanism for many men, who can only stand by as their spouse goes through tests, surgery, chemo, radiation and more, Duggleby's research suggests.
In a study recently published in the journal Oncology Nursing Forum, Duggleby's team interviewed
11 men whose wives had breast cancer, asking how they handled their loved one's battle with the potentially fatal disease -- both for their own well-being and to help them care for their spouse.
Participants described feeling out of control. One confided: "I was entirely powerless. They say it's a guy thing or a man thing, you want to fix things, you want to put things right. And, of course, you couldn't do that."
Duggleby added: "The first thing they said was: 'We don't like to go to support groups.' They said no to support groups because that's not the way they deal with situations. They don't feel comfortable in them. It doesn't also fit with what they're trying to do."
The men said talking about all their problems could make them feel worse, she said, and they needed to take a break from the emotional roller-coaster of their partner's cancer by exercising, listening to music or going out with male friends to sporting or other events.
Donna Czukar, senior director of support programs for the Canadian Cancer Society's Ontario division, agreed that men in general are less inclined than woman to go to support groups.
"I think there's many ways that people access support and it may or may not be a group," she said from Hamilton.
The society provides information on its website for patients and their loved ones about cancers of all kinds, including breast cancer, which can be more complicated because of intimacy issues.
The organization's One-to-One program can connect a man seeking support with a volunteer who has been through a similar experience, Czukar said.
Tasker said he never considered a spousal support group because he was too caught up in taking care of Borowski.
"I continued to run and go to the gym, and I took up boxing as a way to relieve pressure," he said. "You need a release valve, you really do.
"And boxing was good for me because I would go in some days and I would work out with these guys. And I would go on the heavy bag and I would pound the heavy bag until I couldn't lift my arms, until I felt I couldn't breathe.
"It kept me in shape. It kept me alert."
Tasker, who was raised in a strict Baptist household, also relied on his faith to get him through the emotional upheaval of his fiancée's illness and to bolster his strength so he could be a rock for her to lean on.
"My mission was Gwen and that was it," he said of his 53-year-old partner.
"This is essentially a love story. I love her to death. She's the most important thing in the world to me, and I'm not going to lose that."
Tasker advises men faced with a similar health crisis with their spouse to not become overwhelmed by fear, anger and all the other swirling emotions that erupt with the diagnosis.
"Be strong. It's time to be heroic -- heroic in the sense that you put your life to the side, you're completely selfless and you get on with helping your partner. But if you abandon, if you leave, you're a failure and you should hide in shame."
