What do you say? What do they say? What do you want them to say?
When do you break the news? How often do you bring it up?
Talking about a cancer diagnosis – or any health crisis – can be challenging, uncomfortable and emotional. In this blog, we tackle how to talk to your family about your cancer diagnosis.
Where to begin
If you have children, it’s important to tell them as well. What and how you tell them will depend on their age — we discuss some strategies in the next section. You’ll want to tell close family members in person, or over the phone if they live too far away. Extended family can be informed by another family member, via letter or email. While telling family might be considered a courtesy, it is also an opening. You may want and need their help and support during treatment.
What to say
How much you want to disclose about your condition — e.g. “I have breast cancer” or “I have triple-negative metaplastic carcinoma breast cancer. It has a 40% survival rate. I am terrified and not sure I can handle the treatment” — is something you’ll need to consider.
If you don’t typically share personal information with family members, you may choose to keep your discussion brief. However, you might find that keeping them involved and informed about your illness helps ease your burden.
Tell the people close to you how you’re feeling. It’s healthy to share your sadness, anxiety, anger, or other emotional distress. If you don’t feel comfortable doing this, you may want to find a support group or a mental health counselor to help you. Some people prefer workshops, peer groups, or religious support.
It can get tiring telling a lot of people details about your illness over and over again. You might suggest that they visit our website to learn more about your cancer for themselves. Websites like Caringbridge were designed specifically to help cancer patients share their health stories and updates with a large number of people. You may want to ask someone close to you to help with this.
Change the conversation when necessary
Sometimes, even close friends or family members will say the wrong thing. They may ask about something you’re not comfortable with or ready to talk about. They may bring religion into the conversation in a way you don’t agree with. Plan a response for these uncomfortable moments to change the topic. Something like, “I’d rather not talk about cancer anymore. Let’s talk about something else,” or “My emotions are pretty raw today. Can we discuss this another time?”
On occasion, a family member may even make a thoughtless statement, like telling you to “cheer up,” when you’re talking about your sadness, anxiety or fears. While some people (even family members) may not be comfortable with your feelings, it’s important for your mental health that you find someone you can talk to. Ask them gently if they could just listen, without passing judgment or giving advice, when you need to express yourself. Explain that it would be a great help to you.
Talking with kids about cancer
With children, age is an important factor in determining how much to tell them about your cancer diagnosis. The most important issue for children of any age is their own sense of security and safety. Children depend on their parents for their basic physical and emotional needs.
At this age, they understand illness or not feeling well. You can tell them that “Mommy or Daddy is sick and needs to go to the hospital to get better.” Stick to your child’s routine as much as possible and reassure them with the physical contact they are accustomed to getting from you.
Explain what cancer is in simple terms, using picture books, dolls, or stuffed animals to help. You may need to repeat information. You may use words like, “I have an illness called cancer. The doctor is giving me some medicine to help me get better. The medicine might make me feel sick or tired some days, but on other days I may be fine.” Explain disruptions in the routine and how things may be different, but they will be taken care.
This aged child can typically understand more complex explanations of cancer, including the name of the cancer, the part of the body where the cancer is, how it will be treated, and how their own lives will be affected. Hearsay at this age, from other kids and the Internet, can cause confusion, so try to keep the lines of communication open. An explanation may sound like, “I have an illness called breast cancer. It means some lumps are growing inside my body that shouldn’t be there. I am going to have an operation in the hospital to have the lumps taken out. Then I’ll have some more treatment to make sure they don’t grow back.”
Teenagers have a much deeper understanding of a parent’s illness and will be much more perceptive of your feelings and fears. Help them learn more about your illness if they are interested or show concern. Remember, understanding the facts can help him or her feel less afraid. Encourage them to talk about their feelings, but keep in mind that they may find it easier to confide in friends, teachers, or other people they trust. Your talk may go something like, “You know that I’ve been pretty sick lately. The doctors told us today that the tests show I have cancer. The good news is we have a plan to beat it.”
Choose a time and place when you can talk uninterrupted. If you have more than one child, you may want to talk to each one individually, enabling you to tailor your discussion and pay close attention to how they’re responding to what you’re telling them. The child may also be more willing to ask questions when alone with you.
Older children may be able to understand a more complex discussion and may want to “Google” your condition and learn on their own. Any kid may be too overwhelmed to have questions at first, but invite them to talk to you whenever questions or concerns come to them.
Don’t promise them everything is going to be OK
While it can sometimes be reassuring to tell your child, “Everything will be fine,” it’s not a fair response to cancer. No one really knows how treatment will go and whether everything really will, in fact, be OK. You need to maintain your child's trust and also comfort them. You can reassure your children that no matter what, they will always be cared for, that others will fill-in to help their family get through this tough time. Some children may want to participate in some way (like attending chemo appointments). If this is something they are interested in, let them.
Correct misinformation early
It is well documented that young children often feel guilty or responsible for their parent getting cancer. They believe they are the center of the world and can make all kinds of things happen. So, if they were naughty or angry with you, they may feel they caused your cancer. Mitigate that potential feeling of guilt by saying something like, “The doctors have told us that no one can cause someone else to get cancer—none of us made this happen.”
You cannot catch cancer. As adults, we know this, but many children think it is a sickness, like a cold or flu and therefore contagious. Based on their experience, they may also believe that everyone dies form cancer. Correct these ideas before the child has a chance to worry.
Talking about cancer is rough stuff. But having a group of informed, supportive family members around you can have a profoundly positive impact on your cancer experience. Help others help you by setting the tone and setting boundaries.
In future blogs, we’ll discuss how to talk to friends and co-workers about your diagnosis.