Breaking the "I Have Cancer" News: 10 Strategies for Communication

Patient Expert

Just been diagnosed with breast cancer? At some point, you'll need to share the news - with family, friends, and work colleagues. Here are 10 things to remember when telling people - from your 5-year-old son to your college roommate - that you have cancer.

  1. First and foremost, think hard before you pick up the phone, type an email, or just blurt out the news that you have cancer. This is HUGE; and you feel like you have to tell someone - anyone After all, a burden shared is a burden halved. But take a deep breath, sit down, and plan a quick communication strategy before you act.

Decide who should know right away. Your closest adult family members, of course; you'll need their support immediately. But do your aging parents need to know right now, before you even understand what your treatment will be? Do your young children need to be told today - or can you spend some time internalizing the news yourself, before sharing it with them? You may need or want to share the news at work - or you may not.

Think about who needs to know, and when; then give yourself some time to plan how and what you'll say. There's no rush - this is going to be a long journey.

Once you've decided whom to tell, the following are some hints on how to do it.

  1. Your spouse/partner. If you're married and/or in a loving, stable relationship, your partner is probably the first person you should share this devastating news with. If s/he wasn't with you at the time of diagnosis, give yourself time to pull yourself together before pulling out your phone and speed-dialing.

Is your partner in a place where s/he can receive this difficult call privately? If not, be prepared to say, "Honey, I've been to the doctor and we need to have a private discussion ASAP. Could you call me back?" S/he'll know it's bad news, and will have the chance to make the necessary arrangements to talk to you without worrying about who's listening in.

  1. Younger, healthier parents. Be straightforward; tell them you've just found out you have breast cancer. They'll be shocked, of course; but luckily, they have each other to lean on. They'll want details; if you have them, share. If you don't, tell them you'll let them know as soon as you know anything further.

  2. Single parents. Same strategy as above. But understand a single parent might secretly (or not so secretly) be counting on you for all sorts of future help, both emotional and financial.

Assure your mom or dad that whatever happens, you'll be there. Period. No need to think about death right now; find out your complete prognosis before deciding who's going to weed Mom's flowerbeds after you're gone!

  1. Challenged parents. Perhaps your parents are very old and frail. Maybe one has early Alzheimer's, and the other is struggling to provide care. In this case, it might be better to find out more about your treatment before you share the news.

Older people fear and dislike change, as well as anything unfamiliar. Besides feeling awful about you and your health, they're going to be frightened about how your treatment might change their lives. Will you still be able to do Mom's grocery shopping? Take Dad to his doctor's appointments? Take the time to find out just how your cancer might affect your parents before sharing your news.

One key point: to older people, cancer = death. Reassure them that millions of women survive breast cancer, and it's simply not the automatic death sentence it seemed to be when they were young.

  1. Children and teens. Beth Brophy, a blogger on this site, had to tell her 5- and 8-year-old daughters that she had cancer. Read her strategies for telling your kids you have cancer: from 3-years-old and under, up through the teenage years.
  1. Adult children. (Such an oxymoron, isn't it?) Whether your kids are 6 or 46, in your heart they're still rosy-cheeked toddlers. But remember, they're (hopefully) fully functioning adults. They can handle this news in a mature way. Sure, they'll be blown away: scared, sad, angry. But they'll quickly get over it, and hopefully rally to your aid.

A friend told me she called her children scattered around the country, and asked that they come visit her individually, before she started chemo. She was thrilled when each came and spent time with her, one on one. That way, she was able to deal with each one personally, giving each the tools she knew they needed to cope.

Think about your adult children as individuals, and deliver the message to each in the way it'll best be received. And remember to ask that they let you be the one to deliver the news - no letting the bossy older brother call the bratty younger sister!

  1. Other family members. Siblings, cousins, aunts, grandmothers" If your family functions fairly normally, everyone will eventually know. YOU should be the one who controls how they find out.

If you're close to your siblings, tell them as you did your parents: straight out. As for timing, it depends just how close you are. If your sister is your best friend, call her right away. Not only will you need her support, she'll want to give it. And remember, this changes her health status, too (as it does your mom's, and your adult daughter); their known risk of breast cancer has just gone up.

For siblings you're not in contact with regularly, treat them as you would aging parents. It might be best to learn a bit more about your treatment before breaking the news.

For others, if your parents are in a position to share the news with their generation, enlist their help. Rather than you tell your aunt - let your mom do it. They've watched you grow up; they have a bond around you that'll come in handy now. And let your aunts and other extended family, in turn, tell your cousins and other family members.

In short, develop a communication tree. You tell Mom; she tells her mom (your grandma), and Aunt Sally; Sally tells her kids, your cousins Mike and Marie. Trust me, the word will spread quickly; expect phone calls and emails, and be ready to deal with them.

  1. Close friends. You'll probably want to tell your very best friends right away; they'll be a huge resource to you as you try to absorb the fact that you have cancer. In person, on the phone, via email - you know the communication vehicle that works best for each individual.

There's really no need to wait for a treatment plan before telling your closest friends; no matter how close you may be, you're still not their mom, sis, or daughter; the family baggage/ties, good and bad, just aren't there.

Don't be surprised if someone you consider a close friend suddenly disappears; I've seen this happen again and again. Some people simply can't deal with the level of emotion that comes with cancer. Or, for whatever reason, they're scared to death of cancer, and can't be close to it. If they don't return calls or emails, write them out of your life for awhile (or maybe even permanently); it's best for you, and for them.

  1. Other friends and work colleagues. Some women feel comfortable telling their work colleagues; some don't want anyone at work to know. And some strike a balance, telling their HR department, but not the workplace as a whole. Decide which camp you fall in.

If you're afraid your job will be jeopardized by treatment; or if you simply don't want ANYONE at work to know, it's possible you don't have to share the news - though problematic. It'll be impossible if you have chemo and you lose your hair; and it'll be tough if you have radiation, and need to be out of work every day for a certain amount of time.

My advice is, tell your HR department, and your direct supervisor, if possible. HR's job is to help you deal with this while still fulfilling your job function enough to retain your position. Your HR department can actually be quite helpful, as they explain the company's short- and long-term disability benefits; and possibly help you deal with your insurance carrier.

Once you've met with HR, and you've decided others have to know - for instance, if you're going to do chemo - tell those with whom you work most closely. You might choose to tell your closest friend at work, and have her help spread the word (and believe me, it'll spread like wildfire... that's the nature of workplaces). Or, if you don't have a particularly close friend, share the news in a department meeting, or via email to your immediate team or department.

Be direct; try to be low-key and positive. Tell folks that breast cancer isn't the death sentence they might believe it to be, and that the vast majority of women recover and go on to live long and healthy lives.

Don't feel obliged to answer personal questions ("Will you be having a mastectomy?"). Politely say that you'd prefer to keep details of your treatment private. That way, you can hopefully head off a slew of questions, and share only the information you want to, when you want to share it.

And maybe you'll avoid the following situation.

One of my colleagues at work, "Bob," heard via the grapevine that I had cancer, and was starting chemotherapy. He sat down next to me, looked me in the eye with great sympathy, and said, "I have two friends who've done chemotherapy. It was the worst experience of their life." He shook his head sadly, and walked away.

Uh, thanks for sharing, Bob"

Rule #1 for friends and family communicating with someone starting cancer treatment: DO NOT share horror stories.

But that's another post - coming next month!