The population in the western world has been aging while the cancer survival rates have been systematically increasing. Knowledge is lacking about psychological processes and effects of gender difference among middle-aged cancer patients and their healthy spouses. This study assesses psychological distress, coping and social support among middle-aged couples, where one of the partners was diagnosed with colon cancer. A repeated-measure MANOVA and Pearson's correlation coefficient were used to assess the relationships between the variables. Levels of social support were found to be negatively correlated to levels of psychological distress among all of the participants. Surprisingly, men (healthy or sick) were found to be more distressed than their wives (p<0.0001). Men also reported receiving more support from their wives than did the female spouses (p<0.0005). The gender differences found in our study imply that men (healthy or sick) tend to receive more support than they give to their wives. It also implies that men do not use the support they receive as effectively as their wives. Thus, although men report higher levels of support from their spouses, they also report higher levels of psychological distress. Practical implications are discussed.