Dating and Cancer History: To Disclose or Not to Disclose?

I wanted to start off this post with a video where Nick Ross, an AYA cancer survivor, talks about dating and disclosing his cancer history: 

“Cancer is my heaviest baggage. It’s my crazy ex-girlfriend that tried to kill me, and I would hate it if she ever came back, but she’s crazy, so she might. And I feel that I have to tell you at some point, so when’s the right time?… If I tell you right away, it might scare you off…but if I like you, I want you to know everything about me, and cancer is a big part of who I am. So, there it is. How to navigate when the right time is? It’s complicated.”

Like Nick, many AYA (adolescent and young adult) cancer survivors struggle with whether and/or how to disclose their cancer history to new dating partners—so if you are feeling this way too, know that you are not alone! In fact, in addition to fear of rejection after disclosure, concerns about when, how, and how much to tell dating partners about their experience with cancer are among the most common in AYA cancer survivors.¹ Sharing about the impact of cancer on one’s life has the potential to shape AYA cancer survivor’s development after treatment², so, in the context of dating, the question becomes: to disclose, or not to disclose? And if the former is chosen: when should one disclose about their cancer history? 

Self-disclosure is the act of revealing personal thoughts, feelings, and experiences to another person.³  Self-disclosure is integral to the development of intimate relationships⁴—like Nick said, “if I like you, I want you to know everything about me”—and there are many benefits associated with self-disclosure (for example, it can promote identity development, feelings of self-worth, greater social support, etc.).^5,6,7 Disclosure may also enable AYA cancer survivors to integrate cancer into their sense of self.² There are, however, negative implications also associated with self-disclosure (for example, the recipient of the information may reject the discloser)⁸, so it makes sense that it can also seem scary.

Fears Associated with Disclosing

In fact, fear of rejection is a concern that many AYA cancer survivors mention when they think about what scares them about disclosing their cancer history to a dating partner.⁹ A recent study featuring 18 survivors of childhood cancer ages 18-25 illuminated other reasons why AYA cancer survivors fear disclosing their cancer history with others.¹⁰ In this study, survivors spoke about multiple challenges related to disclosing their cancer history (see below for a table of these fears and what a few AYA cancer survivors had to say about them). 

Fear	AYA Quote
Experiencing strong emotions related to the impact of cancer on their lives	“I’m very open to that stuff, like talking about the basics—what I had, what I went through, like I lost my hair—like that I don’t mind. It’s just when it comes to questions like ‘well how’d it make you feel back then?’, any of those questions, I’m like, I don’t know, less comfortable with.”
Concerns about the nature and extent of people’s reactions	“I feel like there are so few guys to pick from, that are attracted to me that I’m attracted to, that it’s like, this could easily be the deal-breaker that scares them away. My mom warned me about that, watch that information ‘cause that’s scary to some people.”
Preference not to appear vulnerable as a result of the cancer experience	“I just don’t think it’s that big of a deal. It’s just something my life threw at me that I had to deal with and I don’t want people to feel bad for me ‘cause that happened and I don’t want them to look at me different.”

Whether AYA Cancer Survivors Choose to Disclose 

Given the various concerns associated with disclosing a cancer history, determining whether to disclose is (as Nick mentioned) complicated. In another study featuring 26 AYA cancer survivors, researchers found that when deciding whether or not to disclose their cancer experience with someone, the most common answer was “it depends”.² These survivors expressed that if not prompted by others, their cancer experience was typically not introduced into conversation. Additionally, they were more likely to disclose if they had a shared experience with the potential recipient or if the survivor felt that the relationship had the potential for quality and depth. When the survivors did choose to disclose and the recipient reacted positively, survivors mentioned that the disclosure was helpful, positive, and comforting. 

When to Disclose: The Recipient’s Perspective 

So, let’s say that you really do like the person, and you see the potential for a high-quality and deep relationship with them, so you decide to disclose your cancer history. Now the question becomes, when is the best time to disclose this? The first date? The third date? Well, in a study featuring dating website members and college students, researchers set out to determine when people think the best time for a potential dating partner to disclose their cancer history would be.¹¹ Of the 593 people surveyed, they found that most people wanted to hear about the cancer diagnosis after a few dates and that a very small percentage (2-5%) wanted to hear about it before the first date took place. 

So…I want an answer already! Should I disclose or not? And if I do, when should I disclose?

If it doesn’t feel like the research is providing a clear-cut, formulaic answer regarding 1) whether or not to disclose a cancer diagnosis to a new dating partner and 2) when to disclose this diagnosis, your intuition is correct. Like the researchers mentioned previously, the right answer to these two questions might be: it depends. If you really like the person and see the potential for a relationship with them that is characterized by quality and depth, then maybe you should consider disclosing this to your dating partner, perhaps after a few dates, as self-disclosure is key to the development of close relationships⁴, and is associated with various other positive outcomes.⁷

These relational dynamics are complicated and also largely understudied in the research¹², and future research may help to further illuminate the experience of self-disclosure in AYA cancer survivor’s romantic relationship. 

I am going to leave you with the following interview featuring Dr. Sage Bolte, a sexual health and oncology counselor, as I feel she has some helpful insights (that also appear to be backed by the research mentioned above) that may help AYA cancer survivors to navigate self-disclosure in a dating relationship. 

“Yes, disclose, but choose the timing of which you disclose…usually about 3-4 dates in you kinda decide ‘I really like this person—I’d like a fifth date’ and before you get too emotionally or intimately involved, giving them the opportunity to know and respond…and gives you the opportunity to respond to either evade being hurt or to [give them the opportunity to] participate in healing and survivorship with you.”

“I really encourage people to disclose earlier rather than later just because there are people who may not be able to handle the fact that you’re a survivor and that’s not because they’re a bad person it’s just because they’re not the right person and they don’t have the capacity to manage it. I’ll often say if they don’t have the capacity to manage that, they’re probably not going to have the capacity to manage other crises that are bound to happen in a lifetime. So, move on to the next who can.”

References 

1. Zebrack, B. (2011). Psychological, social, and behavioral issues for young adults with cancer. Cancer, 117(S10), 2289-2294.
2. Barnett, M., Shuk, E., Conway, F., & Ford, J. (2014). Cancer-Related Disclosure Among Adolescent and Young Adult Cancer Survivors: A Qualitative Study. Journal Of Adolescent And Young Adult Oncology, 3(3), 123-129. 
3. Collins, N., & Miller, L. (1994). Self-disclosure and liking: A meta-analytic review. Psychological Bulletin, 116(3), 457-475.
4. Altman, I., & Taylor, D. A. (1973}. Social penetration: The development of interpersonal relationships. New York: Holt, Rinehart, & Winston.
5. Derlega, V. J., & Grzelak, J. (1979). Appropriateness of self-disclosure. In G. J. Chelune (Ed.), Self-disclosure: Origi,ns, patterns, and implications of openness in interpersonal relationships (pp. 151-176). San Francisco: Jossey-Bass.
6. Reis, H. T., & Patrick, B. C. (1996). Attachment and intimacy: Component processes. In E.T. Higgins & A. W. Kruglanski (Eds.), Social psychology: Handbook of basic principles (pp.523 -563). New York: Guilford Press.
7. Knapp, M. L. (1984). Interpersonal communication and human relationships. Boston: Allyn and Bacon. 
8. Kelly, A. E. (2002). The psychology of secrets. NewYork: Kluwer Academic/Plenum.
9.  Foster, R., & Stern, M. (2014). Peer and Romantic Relationships among Adolescent and Young Adult Survivors of Childhood Hematological Cancer: A Review of Challenges and Positive Outcomes. Acta Haematologica, 132(3-4), 375-382.
10. Thompson, A., Long, K., & Marsland, A. (2013). Impact of Childhood Cancer on Emerging Adult Survivors’ Romantic Relationships: A Qualitative Account. The Journal Of Sexual Medicine, 10, 65-73. 
11. Tuinman, M., Lehmann, V., & Hagedoorn, M. (2018). Do single people want to date a cancer survivor? A vignette study. PLOS ONE, 13(3), e0194277.
12. Kent, E., Smith, A., Keegan, T., Lynch, C., Wu, X., & Hamilton, A. et al. (2013). Talking About Cancer and Meeting Peer Survivors: Social Information Needs of Adolescents and Young Adults Diagnosed with Cancer. Journal Of Adolescent And Young Adult Oncology, 2(2), 44-52.