Suppose we were having a cup of coffee in my office, and I asked you, "Can you think of something really good about having bladder cancer?" You would probably look at me as if I had a screw loose.

Well, the response I've received from couples who read our recent article We've Survived Bladder Cancer, But Live With the Effects of Surgery. Tough Love Isn't What We Need is proof that something indeed very good can result despite the tragedy of experiencing this life-altering disease.

Within hours of the article being online, emails and phone calls arrived from people affected by bladder cancer, including the spouses of attorneys (lots of attorneys), business executives, retired military, law enforcement — people used to being in charge — who had the same message:

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Having bladder cancer made them — or me, depending on who reached out — a better spouse. The readers talked about how their spouse stopped being their work self at home, arguing over little, stupid, petty things. They were more appreciative of their spouse than they had been in years.

"Mr. Beaver," one woman said, "bladder cancer brought us closer, and we both had a lot to learn. Would you please address these important issues?"

So I spoke with Dr. Patricia Pedreira, a postdoctoral associate at Duke University School of Medicine specializing in psycho-oncology. She works with cancer patients and their families, navigating the psychological impact of diagnosis, treatment and survivorship. This is a summary of our interview. (Have a box of Kleenex nearby. I'm glad that I did.)

Bringing couples closer together

The daily realities of living with a urostomy can either drive couples apart or bring them closer together. The difference often comes down to how the partner responds in their spouse's most vulnerable moments.

High-achieving spouses frequently tell me the same thing: I realized my behavior was hurting my spouse at a time when that was the last thing I wanted to do.

How small things suddenly matter

Bladder cancer recalibrates what's considered worthy conflict. Couples describe how arguments that used to dominate their relationship (finances, household tasks, who said what) suddenly feel absurdly trivial.

When you're dealing with the daily reality of an ostomy, who forgot to take out the trash doesn't register anymore.

Also, small kindnesses become massive. Such as when a spouse keeps extra supplies stocked without being asked. Or warms the bathroom before a pouch change in winter. Or doesn't wrinkle their nose or look away.

These gestures communicate acceptance and love more powerfully than any words.

Partners also notice what you don't do. Such as not complaining about middle-of-the-night accidents. Not making a big deal about canceled plans because of not feeling well. What a spouse doesn't say speaks volumes.

Identity and dignity

Losing bladder function strips away dignity in a way that's hard to describe if you haven't experienced it. The person may feel like less of an adult, less of a partner, less attractive, less capable. These feelings are real and valid.

As their spouse, it's not your job to talk them out of these feelings. It's to show them through your actions that you still see them as your partner, not a patient. You still find them attractive. You still respect them. You still want to build a life with them.

This means maintaining aspects of your relationship that have nothing to do with cancer or the ostomy.

• Keep watching your show together
• Keep your Sunday morning coffee ritual
• Keep planning for the future

Don't let "bladder cancer patient" become their entire identity in your eyes or in the relationship.

How bladder cancer can strengthen a marriage

Shared vulnerability creates connection. When your spouse responds with compassion instead of disgust at your most vulnerable moments, you realize they aren't going anywhere. That acceptance builds trust that many couples never experience.

Trivial conflicts disappear. Arguments about money or household tasks feel absurd when you're dealing with real problems. This clarity leads to less conflict and more appreciation.

You become a team. Managing ostomy care together as a shared challenge creates a genuinely collaborative partnership.

Crisis reveals character. Watching your spouse show up for accidents and breakdowns without resentment shows you who they really are. Many people fall in love all over again.

You stop taking each other for granted. Facing mortality makes couples more present, more grateful and less interested in grudges. When time feels finite, you stop wasting it on pettiness.

The challenges are real and brutal. But many couples find the "bladder cancer experience" strengthened their marriage. They become more honest, more compassionate and more certain of each other.

When to seek professional support

For the person with bladder cancer, watch for signs that your grief and adjustment have shifted into clinical depression or anxiety:

• Persistent sadness that doesn't lift even briefly
• Loss of interest in things that used to bring comfort
• Pervasive hopelessness
• Significant changes in sleep or appetite beyond what treatment explains
• Constant intrusive worry about the ostomy failing or people noticing
• Thoughts of self-harm

For partners, watch for the following in yourself:

• Resentment that won't go away
• Constant irritation with your spouse
• Avoiding physical closeness
• Feeling trapped or overwhelmed by caregiver responsibilities

These are signs that you need support.

Mental health care is part of comprehensive cancer care, not a luxury or admission of weakness. Most cancer centers have psycho-oncology services or social workers who can refer you to therapists experienced in helping people adjust to life with an ostomy.

Both patients and caregivers benefit from this support.

Therapy gives you tools to process the grief, anger, fear and adjustment challenges that you can't get from well-meaning friends or support groups alone.

It's a space to be honest about how hard the situation is without worrying about burdening anyone.

What I tell couples

You don't have to be inspirational. Some days, you'll cope well with the ostomy. Other days, you won't. Both are okay.

Practice self-compassion. Treat yourself with the same kindness you'd offer a friend navigating this. Don't beat yourself up for feeling grief, frustration or anger about losing normal bladder function.

These feelings don't mean you're weak or ungrateful to be alive. They mean you're human.

For partners: Don't beat yourself up for finding the situation difficult. Watching someone you love struggle is painful. Having your life disrupted by middle-of-the-night accidents and medical complications is legitimately difficult. Acknowledging that doesn't make you selfish.

Find small moments of normalcy and connection even in the hardest stretches:

• A conversation that has nothing to do with cancer
• A meal you both enjoy
• A moment of laughter

Something that reminds you you're still you, still a couple, still capable of joy even in the middle of something that's hard to deal with.

If you're struggling, ask for help. You don't have to figure this out alone.

Readers can contact Dr. Pedreira at This email address is being protected from spambots. You need JavaScript enabled to view it..

Dennis Beaver practices law in Bakersfield, Calif., and welcomes comments and questions from readers, which may be faxed to (661) 323-7993, or e-mailed to This email address is being protected from spambots. You need JavaScript enabled to view it.. And be sure to visit dennisbeaver.com.

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