The First 48 Hours: Breaking the News to Your Children

Patient Expert

It's one of the first challenges you'll encounter. Expert Patient Beth Brophy shares tips on talking to your kids about breast cancer.

The only thing harder than learning you have cancer is having to tell your kids about it. My daughters were 5 and 8 when I was diagnosed, and I agonized over what to tell them. Learning you have breast cancer is a terrifying experience--you want to try not to pass that sense of overwhelming anxiety to them.

Unfortunately, you do have to tell your children. Even if it were possible to hide it, doing so would forever erode their trust in you. As you and your family anticipate your treatment regimen, telling your children the truth about your illness can alleviate their anxiety and fear.

While you may want to delay sharing the bad news, especially if school is about to start or there's another important event coming up in your children's lives, don't wait more than a few days. They are likely to pick up that something is wrong, or overhear the alarming news from someone else, which will be a lot worse for them.

When you sit down with your partner and your children, the adults should convey calm and optimism, no matter how scared you and your partner may feel. In fact, I made it a rule to never break down in front of my children (and consequently spent a lot of time behind the locked bathroom door with the water running).

Don't use euphemisms for the word "cancer." The sooner we all got used to hearing and saying the terrifying word "cancer," the sooner it lost its mystifiying power. Even if you avoid the word "cancer," your children are sure to hear it from someone else at some point.

Be truthful and don't over-promise. Cancer treatments may bring some unpleasant surprises and may result in changes to the family's routines. Schedules may have to be rearranged and family trips postponed or cancelled. But, for the most part, do everything humanly possible to let the kids keep to their routines. On weekends, for example, my husband was responsible for the kids and getting them where they needed to go. This is a good time to realize that your friends and family want to help. When friends offer to take your kids for sleepovers, or drive extra carpools, or buy groceries, you'll do yourself a huge favor by learning to say, "Yes, thanks."

No matter how pessimistic you feel, reassure the kids that you are taking care of your illness and doing everything possible to get better. Stress the positive---that you have every reason to believe you will be OK after the treatment ends. And if that situation changes, you will let them know.

Naturally, how much information you give your kids depends on their ages. Here are some age-appropriate guidelines:

Under 3 years: Generally, children under 3 are not going to understand what cancer is, but they--and their older siblings--will be disturbed if you are going to be away for several days at the hospital, or if their daily routine is disrupted. Their father, grandparents, other relatives, friends and caregivers should pitch in to give them extra attention and reassurance.

Ages 3 to 7: Explain your illness in simple terms, such as "good" cells and "bad" cells; that cancer is not contagious and that it's not their fault. Children, being the self-centered creatures that they are, may think they are responsible for your cancer, unless you explicitly tell them otherwise.

Explain how your treatments will affect their routines--and the measures you have taken so that others will take care of them. For example, "Dad will drive you to school in the mornings now, and Rachel's mom will take you to soccer on Saturday."

Warn them about the side effects you will have. For instance, you may be too tired for awhile to play with them as much, and your medicine will make your hair fall out. Explain that your hair will grow back. In the meantime, tell them that you will wear a wig or hat. Your kids might not want their friends to see you without hair. I promised to always wear a wig when their friends were around or when I was at their school or out in public. My daughters did not want to see me bald, and they never did. I even slept with a turban.

Ages 8 to 12: They can understand more than their younger siblings, but don't overwhelm them with information. They may be afraid to ask what is really on their minds, so check in with them often about how they are feeling and ask if they have any questions. Notify their teachers about what is going on at home so that they can alert you to any behavioral changes, such as failure to do their work. As much as you can, give your children extra support--even an afternoon with you at the movies can restore some sense of normalcy for your kids.

Teenagers: They can understand pretty much everything about your illness and treatments and may want lots of details. Teenagers may react with anger or they may distance themselves. Then again, generally that's how they react to everything. If they don't want to discuss their feelings with you, suggest that they speak with another family member or a friend. If your kids are likely to do their own research about cancer on the Internet, ask them to show you what they find, as there's a lot of misinformation and crazy stuff out there that does not apply to your particular case.

There are several books that help kids cope with a parent's cancer, and you may want to bring some home for your kids to read, or for you to read aloud to your younger kids. Here are some books that may help you, but browse your local bookstore or Amazon.com as well:

When A Parent Has Cancer: A Guide to Caring for Your Children by Wendy Harpham, $26, Harper Collins. Writtten by a doctor and mother of three who had non-Hodgkins lymphoma.

The Paper Chain by Claire Blake, Eliza Blanchard, Kathy Parkinson, $8.95, Health Press, a picture book for school-age children about a family where the mother gets breast cancer.

Above all, focus on keeping the paths of communication open with your children, regardless of their ages. Your own health is a main priority, but your kids still need you.

The First 48 Hours | Questions for Your Doctor | Breaking the News to Your Children | Telling Your Friends and Co-Workers | Ten Common Myths