A friend of mine started dating a man six months after he was diagnosed with cancer. At the beginning of their relationship, he was open about his health issues. And then cancer showed up stronger, and he walled himself off.

“He won’t let me give him any hands-on care,” my friend said. “And he doesn’t want me to be there emotionally for him.”

The couple split a few months later because the guy wasn’t willing to let my friend into his pain. Which means he turned away an amazing gift of love and support.

When my husband, Gary, was diagnosed with late stage prostate cancer, the treatment of choice was hormone therapy, designed to kill testosterone-which meant he would be going through menopause. Hot flashes, softened muscles, emotional ups and downs.

“I think it’s great we’re going through menopause together,” I said, probably a little too perky.He didn’t find that humorous.

He once cried while meeting with our insurance agent, which was excruciatingly humiliating for my strong, steady, left-brained, data-analyzing husband. Add to that the most devastating side effect — loss of libido — and you can see how his maleness was being threatened. Gary withdrew. He simply shut down his words and affections. Paired with tight finances from recent unemployment when the company he worked for was sold, and the care for my live-in mother slipping into dementia, it was a heavy, hard, bleak season. And then my brother offered to fly Mom — who had been living with us for 2 years – to Florida for a visit. For the first time in the long months since his diagnosis, Gary and I were free to talk in the public places of our home. More than once, as I started dinner after work, he walked in the front door, headed into the kitchen, and began a conversation that couldn’t wait.

“Men tend to measure their level of success by their jobs, possessions, and sexual performance,” he explained. Men are so shallow.”  Sigh.This invited me to voice my thoughts over the loss of affection.

“A woman wants to be pursued by the man she loves, which involves a dozen thoughtful little things.” Sex is part of that, of course, but … “suggest a date out; bring me hot tea; hold me for no particular reason other than you love to hold me.”

So what keeps men from opening up to the people who care about them? Based on my experience — and speaking in generalities — here are 4 insights:

1. It’s not always easy for men to express feelings
It wasn’t just the disease, but also the fall-out that left Gary distressed. His diagnosis came during his lay-off period. Among other things, he worried about who would want to employ someone with terminal cancer; he worried about how I would survive financially after he died. His emotions ran from fearfulness, to depression, to discouragement, to hopefulness … back to hopelessness. In time, Gary admitted the more he talked about cancer and its domino effect, the easier it became.
2. Men don’t do vulnerability well
“When a man starts to lose his sexual desire, it’s distressing,” Gary explained in one of our kitchen conversations. “And it’s awkward to discuss it with your wife.” Saying words like these out loud leaves a man vulnerable; it’s easier to keep it in. But it was clarifying for me to know what was going on in my husband’s head. And it helped distribute the weight he was bearing alone; this was something I could help him carry.
3. Men fear losing the people they love
“You might not want to care for me if I become a burden,” Gary said in one conversation. “I need your heart to belong to me until the end.” I cried. This was the man who loved and cared for me and our children, who kept me laughing all these years. I was all in – for better, for worse, in sickness, in health. How beneficial for the wife or girlfriend to know what the man is feeling so she can reassure him — in multiple ways — of her love.
4. Men have their own definition of success
(An incorrect definition, but still …) Gary once sent an email to steer clear of a discussion that might produce tears: “It seems to bother me more when I see successful people and they talk about their jobs, houses and vacations. It’s not that I want what they have. It just causes me to feel that I’ve failed. And it’s feeling that I have brought you down with me.” His words fractured my heart. None of our recent setbacks were a result of anything Gary had done or not done.
This thought from Ralph Waldo Emerson:
“To laugh often and much; to win the respect of intelligent people and the affection of children … to know even one life has breathed easier because you have lived. This is to have succeeded.”
Gary was a highly successful man, and I wasn’t the only one who thought so. Now that I knew what was going on in his head, I could help him combat these fears that were aggravated by the side effects of cancer treatment. Gary and I made a new commitment to openness. We held each other more frequently, established a standing Friday date night, and he redoubled his efforts at romantic attention. As for my heart, it wasn’t going anywhere.

Marlys Johnson is a blogger, speaker, author, and coach. She is also a cancer widow. Married to the same witty, courageous, wry-humored, kind man until November 2014. “We fought the good fight together for several years longer than he was supposed to live.”