The Affair

The Affair

Anne Katz, PhD, RN, FAAN

Jul 19, 2022

Mark and Isabel* have been married for almost 25 years. They married young and have four children. Two years ago Isabel was diagnosed with breast cancer; while the diagnosis shocked her whole family, what she did next was even more shocking.

Isabel had an affair.

A man she dated briefly in college messaged her on Facebook shortly after she found out about the cancer. As she described to me in our first session, she didn’t know why she agreed to meet him at a coffee shop in a suburb far from their home. But she was intrigued by the thought of seeing him again and she dressed carefully before driving to meet him. She blushed as she told me that she had forgotten how it felt to see a man, practically a stranger, smiling at her as he sat at a table in the corner. She felt her heart beating as she walked towards him and the hour that they spent talking felt like just a couple of minutes. That initial meeting led to another, this time at an expensive steakhouse downtown. And then they dispensed with the meetings in public and spent afternoons in a hotel room, close to where the man worked. She delayed her cancer surgery twice, each time telling Mark that it was the surgeon who had postponed it.

Mark believed her; he had no reason to not trust that what she said was the truth. He only grew suspicious when the surgeon came out of the operating room to tell him that the surgery went well and commented that Isabel was lucky that the delay had not resulted in the cancer spreading. Mark was confused but he didn’t say anything to Isabel for weeks as she recovered.

The affair was over. She had not told the man about her cancer and she was angry that he had made no attempt to contact her when she disappeared. When she checked her Facebook page just days after her surgery, she saw a post from him that his wife was pregnant. She knew he was married, but he had sworn to her that his marriage was over and he no longer had sex with his wife. She felt betrayed and hurt, even though she knew she had no right to feel that way.

Something had shifted in her relationship with Mark and she did not understand why. He had been distant since her surgery but she assumed it was because he was busy at work and was driving their teenage children to school and to their extracurricular activities. After 6 months she realized that he had not touched her, not even a hug or a kiss in passing. Her initial thought was that he was afraid to initiate anything after the surgery. On their anniversary she cooked a special dinner and made sure that their children were out for the evening. Mark did not seem to notice the effort she had made, and he drank most of the bottle of wine that she had chosen to serve with dinner before the meal was over.

Isabel did not expect what happened next. He barely looked at her as he asked, his voice cold and his words clipped, why she had lied about the 2-month delay before her surgery. She was not sure how to respond and in the brief moments before she answered, Mark exploded in anger. He told her that he knew she was lying, that he had known since the day of the surgery, and if she didn’t tell him everything he was going to leave.

She was so shocked that she blurted out every little detail about the deception. She begged him to forgive her and pleaded with him to stay. She promised that she would get help for them to move past this, if only he would stay.

She called me the next day to ask for an appointment, not telling me the reason why she needed to be seen urgently. She told me all this at our first meeting the day after she called me. When I asked her if she thought it had anything to do with the diagnosis of her cancer, she said that she was not sure; she and Mark had grown apart, their lives focused on their children and their work. They hardly spoke to each other except in a superficial way about the kids and household matters. Their emotional attachment with each other had disappeared and she could not remember the last time they had sex before her surgery.

“Okay,” I responded, “but why did you have the affair? What was it about this other man that made you risk 25 years of history with Mark?”

Isabel looked at me for a moment but I remained silent.

“I guess I needed to feel wanted, to feel like was attractive before I lost my breast…”

“Have you told Mark that? Have you shared this with him so that he may understand why you did this?”

Isabel shook her head. They had not spoken since the dinner when their marriage cracked open.

“He needs to know.” I spoke softly. “That may start the beginning of repairing your relationship.”

As the brilliant Esther Perel writes in her book The State of Affairs, infidelity can be the impetus for a deeper understanding of love and relationships.1 Just as cancer changes the relationship between what we think is certain and the fallibility of our assumptions, it too can be a source of discovery. I hope that Mark and Isabel will be able to repair what has been broken and appreciate their growth. It is going to take time and a lot of work.

*Names and identifying details changed.


  1. Perel E. The State of Affairs: Rethinking Infidelity. New York, NY: Harper Collins, 2017.


The ideas and opinions expressed on the ASCO Connection Blogs do not necessarily reflect those of ASCO. None of the information posted on is intended as medical, legal, or business advice, or advice about reimbursement for health care services. The mention of any product, service, company, therapy or physician practice on does not constitute an endorsement of any kind by ASCO. ASCO assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the material contained in, posted on, or linked to this site, or any errors or omissions.

Back to Top