Objectives Contextual self‐concealment in the psychooncology literature has been found to be associated with elevated distress. The current study aimed to understand the dyadic relationships of an individual's perception of spousal support and dispositional perspective‐taking with own and partner's levels of self‐concealment behavior, among couples coping with cancer. Methods A subsample of 61 heterosexual couples coping with cancer was taken from a large‐scale cross‐sectional study. Patients and their spouses independently completed measures of perceived spousal support, perspective‐taking, and contextual self‐concealment. Dyadic data were analyzed by using the actor‐partner interdependence model both for couples in which the woman was the patient and also for couples in which the man was the patient. Results Perceived spousal support negatively predicted contextual self‐concealment, regardless of gender and role. Implications of perspective‐taking for concealment behavior were dependent on role and gender. A female patient's perspective‐taking was associated with a reduction in her own and her spouse's concealment behavior. A male spouse's perspective‐taking was associated with an increase in his own and his spouse's concealment behavior. A female spouse's perspective‐taking negatively predicted patient's concealment behavior, but not her own. Conclusions Findings stress the important roles played by spousal support and perspective‐taking in communication patterns between couples affected by cancer. Although the perception of support from one's spouse seems to reduce the need to conceal cancer‐related issues, interventions that focus on couples' communication should address the differential implications of perspective‐taking, as they can lead to either more or less self‐concealment among couples, depending on role and gender.