Cancer victims may lose more than their health - a report out today suggests many see their relationships come under strain or break down completely. Paul Moss reports:
By Paul Moss
BBC World Tonight reporter
Cancer can change relationships, the charity says
It's hard to believe Sarah's cheerful demeanour. She sits in a pub in Buckinghamshire and tells me the story of how her marriage broke down - not as a result of infidelity, or a relationship that just ran out of steam.
Her husband left her after she fell ill with cancer.
"The consultant gave us the diagnosis, that I had breast cancer.
He said to my husband: 'Give her a hug, she needs a hug.' He just moved his chair away.
"It was as if I had leprosy, and he was scared he was going to catch it. He wouldn't go near me after that."
Sarah insists her husband had been an affectionate partner until then, her "soul-mate".
But as she began chemotherapy, she lost her hair and put on weight. Her husband's response was to suggest she eat less, and he also complained that her hair was falling out all over their bed.
"One day he just said 'I don't love you any more and I'm leaving.'"
Sarah is not alone. According to a report from the charity Cancer Backup, two thirds of cancer sufferers say the disease has had an impact on their relationship.
Nearly half said they could not even discuss the illness with their partner.
'Sex is affected'
Derryn Borley, a spokeswoman for the charity, said the results were "no surprise".
"Cancer is a 'dread disease. Fear is a common reaction when you're diagnosed, and so is shock from your partner."
It is this fear which she believes provokes negative behaviour from partners of cancer sufferers.
But cancer also causes particular problems with relationships, because of the ordeal involved in curing it.
The hair-loss may leave people with low self-esteem, but even people physically-unaffected by cancer report feeling unattractive, and not worthy of their partners.
"Two thirds of people who responded to the survey said cancer had affected their sexual relationship.
"But people can't always talk to their doctor about it, or they think the nurse is too busy."
In fact, the NHS is aware of the need for emotional counselling of cancer patients.
Back in 2004, the National Institute for health and Clinical Excellence (NICE) recommended it be available at all cancer centres.
'Talk about it'
But there is still not enough provision, according to Maggie Watson, a clinical psychologist who works at the Royal Marsden Hospital.
Derryn Borley of Cancer Backup says fear can harm relationships
The Marsden led the way in this field, opening Britain's first 'psycho-oncology unit," back in 1986, specifically to provide support to cancer patients.
"We encourage people to talk to their partners," Dr Watson says, "to discuss the disease, and the possibility that they might die. They are given support in a professional environment. Cancer is a family problem."
She emphasises the importance of this work, and wishes all hospitals could provide similar facilities: "There is evidence that patients who are not emotionally coping with the disease react worse to the treatment they get."
If there were a model for how to handle cancer well, then Debbie Wasden might provide it.
A library assistant from Sheffield, she was found to have a tumour on her breast just two months ago.
She is now looking at a long period of chemotherapy and surgery as well. But Debbie shows signs of a more positive phenomenon, that today's survey also remarks on: that couples may develop more closeness and intimacy following a cancer diagnosis.
"My husband and I had been together for 30 years," she says, "We had really come to take each other for granted. But now, I think we realise how much we mean to each other.
"He hasn't changed, I don't really want him to change.
"But we do more things together now. And I am not going to let this beat me. We are going to fight the disease together."
This report will be broadcast on The World Tonight on Thursday March 27.