Dear Family Advisor

My sister has breast cancer, and I don't feel her husband is giving her adequate care.

Last updated: Feb 11, 2010

I've already lost my mother and another sister to this horrible disease. My husband says that treatments are better now and she's not going to die. How can he know that? There are several courses of treatment my sister and her husband aren't pursuing, and her health is really going downhill. I can't face losing another family member -- not without fighting.

My brother-in-law leaves for work all day while I drive her to chemo. He expects her to cook and do the laundry as if nothing is wrong. I do what I can, but if I do too much he won't realize how sick she really is. My sister has asked me to back off, saying that she needs her husband right now and that I'm alienating him. I'm just so frustrated -- and scared for my sister.

You have every right to feel scared and angry. Breast cancer has ravaged your family -- it's so hard to lose a loved one, much less several, to the same disease.

It's also tough to step back and allow someone we love to make choices we feel aren't in her best interest. But as much as you care about your sister, she has to be the one to decide how to live her life. All you can do is share your concerns with her and your brother-in-law -- separately -- and then respect their decisions.

I urge you to separate your feelings about your past loss and devastation from your present relationship with your sister. She has given you a clear message: Back off. If you force her to choose between you and her husband, you may not be the one she picks.

Have you been able to talk to a counselor or spiritual advisor about how you feel? It's easy to make your sister's situation a target for all of your emotions, but part of what you're feeling is a culmination of grief and shock over your mom and other sister. You may have a bit of "survivor's guilt." It's real, and it can make you feel that you have to "pay" for being the one without cancer. Talking about what cancer has done to you allows you to slowly work through all the sorrow and rage you've been living with.

You may never get your brother-in-law to see things your way, but I hope you won't try to make him the enemy. Marriages are complex and many, if not most, are dysfunctional. And yet your sister seems to want and need to keep hers intact. Her husband is no doubt far from perfect, but if he loves his wife and she loves him, you don't want to destroy that. I hope you're listening to her request not to alienate him.

He may be acting like the old-fashioned guy who expects the chores to get done, but it may not be for the reasons you think. He may be trying to keep her from getting too fearful about her own condition. Or, he may be desperately trying to hold onto the fairy tale that his life is fine, that his wife isn't seriously ill. It's difficult to face the truth that his wife is declining. Our society doesn't encourage men to talk about their feelings, and without a safe outlet, fears leak out in less-than-loving ways. We might assume a person doesn't care when in truth, he cares so much he doesn't even know where to begin.

Try to find one small way to connect with your brother-in-law. Pick up his favorite treat at the store or remember his birthday. Send him a note thanking him for loving your sister and how much that means to her. Your sister will be grateful to see that the two of you aren't at odds. He may begin to open up and consider your suggestions when he no longer feels threatened.

While it's possible that you're correct that your sister should be receiving other treatments, recognize that because you're very worried right now, it might be hard for you to keep things in perspective or accurately assess her condition. She's still a rational adult. Let her "own" her body. Have you asked her to let you review her records and discuss her options with her? Even if she refuses on this, ask to frankly talk about your impasse.

Your "job" as her sister is to love her and be her helper and her advocate where and when you can. Be her sounding board and confidante. Listen to her and ask her what she wants. You can broach the possibility that trying to avoid causing her husband any discomfort is keeping her from getting the help she needs; you can assure her you'll protect her and stand up for her if she wants you to. But ultimately you must respect her wishes. What she needs is your support, not your control.

Her marriage may be far from perfect, but you all need one another. Do all you can to pull together and strive to understand one another. Shower her with love and create as many memories as you can -- every day.