Michal Braun

Women with advanced breast cancer and their spouses: diversity of support and psychological distress.

Objective: The current study examines the effect of perceived support from different agents (spouse, family, friends, religion—spirituality) on psychological distress experienced by women with advanced breast cancer and their male spouses.

Couples facing advanced cancer: examination of an interdependent relational system

The relational impact of advanced cancer on both patients and spouse caregivers has rarely been examined simultaneously. This study describes a framework for understanding distress in each partner as a consequence of psychosocial characteristics, burden of disease or of caregiving, and the distress of the other person. A model focusing on the protective value of social relatedness was tested to illustrate the interdependence of patients and spouses in their mutual adaptation to disease.

Agents of support: psychometric properties of the Cancer Perceived Agents of Social Support (CPASS) questionnaire

Objective: The current study presents the development and the evaluation of the psychometric properties of the Cancer Perceived Agents of Social Support (CPASS). The CPASS is a new self‐rating instrument devised in order to enable both cancer patients and their spouses to report on the level of perceived social support they get. The CPASS evaluates the support given by different agents of support (spouse, family, friends and spiritual or religious beliefs) in several dimensions (emotional, cognitive and instrumental).

Souvenir Children: Death and Rebirth

Miriam was a 28-year-old woman who came to my office (M.B.) in the psycho-oncology unit, seeking advice and support. Her husband, Jonathan, had died of cancer 2 months earlier in a nearby hospital. I thought that this would be another case of bereavement counseling, with her loss at such a young age. However, I had no idea how this woman was about to challenge my worldview and to raise significant ethical, philosophical, and psychological quandaries. One year and 3 months before their wedding, Jonathan had been diagnosed with angiosarcoma of the heart. The prognosis was clear to both of them. However, Miriam did not think that her husband’s life expectancy would be so short. Jonathan commenced chemotherapy; and, except for the hair loss, he tolerated the treatment well. After hearing the diagnosis, he talked with Miriam about canceling their wedding. She refused, and they were married duringthesameperiodthathewasundergoingchemotherapy. They had been friends for 2 years before deciding to marry, and she described their relationship as “two lonely wolves who had found one another.” They loved each other very much, had created a small, insulated world for themselves, and both had difficulty with external social interactions. Miriam revealed that during her husband’s illness, they had been undergoing invitro fertilization (IVF) to try to have a baby. When Jonathan died, she was in the middle of an IVF cycle and actually had completed it at the time of the Shiva (Jewish ritual of mourning during the first week after the death of an immediate family member). Miriam was the only one who knew about it, besides Jonathan and the medical team. She still had his frozen sperm, and it was clear that she would use it in order to become pregnant with Jonathan’s baby. Miriam and her husband had never talked about this possibility. In retrospect, she felt that Jonathan would have opposed it. While listening to Miriam’s story, I questioned the inequitable paradox of going through fertility treatments while facing death and the offer to bank sperm to newly diagnosed cancer patients with a poor prognosis. THE PARADOX OF FERTILITY AND ADVANCED CANCER