Talking with your Children
For all of us who are mothers, the very hardest part about a breast cancer diagnosis is worrying about our children. Even when our doctors reassure us that our prognosis is good and we are likely to live long lives, we are grief-stricken and terrified when we imagine the possibility of leaving our children too soon. These intense feelings begin the moment we hear the diagnosis and continue for a very long time. In this blog, I want to focus on sharing the first news with our children.
A few days ago, I met with a newly diagnosed mother of three young adult sons. I was struck that her worries about how best to speak with them were exactly the same as those I had heard expressed the day before from a newly diagnosed mother of two children under ten. No matter how old our children are, they are our "babies", and we want so much to protect them from all harm and sadness. How distressing it is to recognize that something that has happened to us, something terrible that is completely unwanted and out of our control, will bring pain to our beloved children.
Here is the quick summary: All children need honest and age-appropriate information. Here is the second part of that summary: Children are wonderful observers and terrible interpreters of what they see, and what they imagine is likely much worse than the reality.
Very quickly, your children will realize that "something is up." Even if you are trying not to cry or talk about cancer in their presence, they will sense your mood, the change in the air, and likely will overhear things. They may also hear something from another family member or friend. You need to tell them pretty quickly after you have heard the news.
Clearly, the mother of young adult sons will use different words and share more information than the mother of two young children. I suggested to the older mother that she needs to tell her sons more or less what she is telling her husband or closest friends. Grown up children need to be respected and treated as the adults that they are. They need to be allowed, even encouraged, to participate as much as they choose and can in our care. Generally, that means that young adult children may want to attend important doctors' appointments, be present at the time of surgery, or accompany you sometimes to a chemotherapy treatment. Grown up kids who live far away will want to make a visit home at some point, both to help, and to see that you are really doing pretty well.
Younger children need information that is honest and not overwhelming. Think of it along the same lines that you have talked to them about sex. You want to tell them what they need to know and open it, safely, for further discussion whenever they choose to bring it up. To give some examples: You could tell a 5 year old that you have just been diagnosed with something called breast cancer (and yes, you must use the real words), that you will be getting some medicine that makes you feel yucky and your hair fall out (and that this is NOT a medicine like any that s/he ever takes), and that you are going to be fine. Period. Don't be surprised if your small child reacts strongly ("Oh no, Mommy, not your hair!") or if s/he says "Can we go to the playground now?" You would tell a 12 year old a little more than the above. You would use the word "chemotherapy", maybe even name the specific drugs, talk a little more about the likely side effects/ways that you may feel. You would also be reassuring that you are going to be fine.
Most children in 2008 have heard about cancer. Either they have had a family member or friend who has had cancer or have seen movies or read books about it. If they have experienced a death from cancer, they are going to be even more upset. Even a very young child can understand that: "There are lots of different kinds of cancer. Mine is not like the one that Mrs. Jones (or whomever) had. I am going to be fine. It's like there are lots of ways of being sick. Sometimes you have had a cold and sometimes you have thrown up. Both are being sick, but they are really different from each other."
You may be thinking that it may not be honest to reassure your child that you are going to be fine, especially if you have just been diagnosed with a late stage or aggressive breast cancer. No one ever drops dead from breast cancer. If, God forbid, this cancer does come back and become life-threatening, there will be plenty of time then to talk to your children about it. (and I will write another blog on this topic) These long-term worries are for the adults (including adult children who can be well-informed). Children need to be told that you are getting good care and will be fine--and this is very likely exactly the truth.
It is very important to inform your children's school about the situation at home. Depending on your child's age and particular school situation, you may tell a classroom teacher, the principal, or a guidance counselor or social worker. Make sure that someone knows, however, because it is important that they are watching for any indications of special distress. Teachers will be supportive, attentive to your child's needs, and may be able to give your child opportunities to share (if s/he wishes) with our children.
For many years, I was involved with a study looking at the impact of a mother's breast cancer diagnosis on her children. Here is what we found: Children who were given honest, age-appropriate information AND whose own schedules were kept pretty normal did fine. Those are your instructions.