To the mourners at her father's funeral, Lynn Barlow was a wonder.
Although she had lost both her father and her breast to cancer in a span of three months, she was bearing up without any signs of strain.
Her doctor had told her husband, Rich, that the stoicism might crack. But as the months wore on, there was no sign of it.
"I was beginning to be confident we weren't going to have a low low--a bottom out," he said. "But when it hit, it was like a bomb went off."
Rich came home one day, eight months after Lynn's mastectomy in 1986, to what looked like ground zero. Lynn had emptied her closet and strewn her clothes throughout the house. She was huddled on their bed, sobbing uncontrollably. It took a tranquilizer to calm her enough so she could speak, he said.
"She said: 'I'm not a whole person. How can you love me? Why do you love me?' "
In the months that followed, the Barlows, who live in the new Orange County development Aliso Viejo, struggled to keep their marriage intact. Like other couples, they came to realize that breast cancer not only invades a woman's body and endangers her life. The disease also can destroy a woman's self-image and her confidence. And it can strain a relationship to the breakup point.
Although it is the woman who has cancer, her partner also faces some of its effects. He is afraid she will die. He's unsure how to respond to her range of emotions as she copes with her illness. He feels compelled to be stalwart and rock-ribbed, even when he is terrified. And, finally, he has to confront his feelings about the woman's body, transformed by surgery and chemotherapy.
"It's hell for her, but him too," said Ron Pepin, 65, of Anaheim. His wife, Ginny, 65, had a mastectomy in 1988 and reconstructive surgery a year later. "So many things happen to a woman where the guy doesn't understand what the hell to do. It's confusion, frustration and fear. It's a lack of knowledge and understanding. All that together, you've got a big problem."
That big problem led to the formation of a men's support group at the Breast Care Center in Orange, one in a growing number of facilities dedicated to helping couples. Two men whose wives had been treated there saw the benefits of the patient support group and asked if one could be started for men, said Barbara Scott, the center's patient educator.
The groups began getting together in the fall of 1992. Once a week, for a month or so, women whose cancer has been diagnosed in the past six months come to the center with their partners. The couples talk together for about a half-hour, then split into men's and women's sessions for an hour or more. Then the couples gather again to summarize the evening's discussions. When the formal sessions have concluded, couples can exchange phone numbers and continue to meet if they wish, Scott said.
"The thing I see most is a fear of saying what you're feeling to that other person," Scott said. "The woman is so busy saying, 'I'm fine, fine, I'm going to be fine,' that she doesn't get to say, 'I'm really scared.'
"And the man is so busy saying, 'You'll be fine,' that he doesn't have the opportunity to say he's scared, too. Here they can come to a safe place and say their deepest feelings in a supportive environment."
Dr. John West, surgical director of the center, said he urges men to go to the meetings.
"If they don't do it, I lean on them a little bit," he said. "I'm now convinced it's part of the healing. The males do better, the relationship does better, and maybe there's a survival-rate improvement."
Although men are not known for pouring out their feelings to strangers, the group setting does work, said Craig Nattkemper, a psychologist who leads the men's sessions. Even if a man doesn't talk, he at least learns that other couples face the same difficulties.
Men such as Pete Wesselink, 48, of Orange attend sessions to tell the group what they and their wives went through. Susan Wesselink, 47, had a bilateral mastectomy, rigorous chemotherapy and reconstructive surgery in 1990.
"It's so valuable for the guys," he said. "It gives them the chance to see how other people have dealt with this thing. If a guy asks, 'What did you do when her hair fell out?' or "How was your love life and did it bother you that your wife didn't have a breast?' you give them the benefit of your experience. That's been comforting to people."
The groups nearly always talk about what it means for a couple when a woman loses her breast to cancer. Women and men who have participated in the groups and talked to couples individually agree: It's more often the women who think losing a breast makes them less desirable.
"It's almost a universal response, that when the woman asks about what the loss of a breast means, the man says, 'Hey, it doesn't matter,' " Ron Pepin said. "Most women don't buy it."
Pete Wesselink said he understands why that might be.