Talking with Children About a Breast Cancer Diagnosis

Having to tell children about a breast cancer diagnosis is rotten. I mean, really, as if having breast cancer isn’t hard enough. However (based on my professional experience as a nurse and my personal experience as a patient), I know that including children in the process — from the time of a diagnosis — is the most important thing that we adults can do for them.

Children deserve open lines of truthful communication. Truthfulness is the best (and only!) way to establish and maintain a bond of trust with anyone, but especially with children. Discussing illness honestly and openly will teach children that parents are trustworthy and that honesty is a core family value.

As much as I wish that my experience only happened to me and that I could have shielded my husband and children from the pain, the reality is that cancer happens within the ecosystem of family, friends, and community. It just does. The Silver Lining is that there are indeed tools to help parents talk with children.

Here are some practical suggestions for how and when to talk with children:

  • Talk with them at the time of the diagnosis.
  • Talk frequently and briefly, letting their questions guide you.
  • Base conversation on the child’s age and sense of understanding.
  • Begin with the basics.
  • Practice what you are going to say.
  • Consider having another adult present.
  • Use clear, specific words that the child can understand.
  • Be honest. If you don’t know the answer, say so, but reassure them you’ll find out.
  • Look for clues they may be confused, angry, sad, or withdrawn.
  • Get support. Inform your child’s teachers/counselors/coaches.

When talking with children, it is helpful to become familiar with the typical beliefs that children hold about a cancer diagnosis and how to respond to these beliefs.

  • Children often feel guilty (often silently) because they think they caused cancer in the family — by misbehaving, thinking angry thoughts, etc.
    • Reassure them that no one is to blame for the cancer.
  • Cancer isn’t contagious, but children may think it is.
    • Let them know that this isn’t an illness like a cold or the flu, and that it is NOT contagious.
  • When a parent is ill, children may feel worried about being alone and abandoned.
    • They need to know that they will always be taken care of. Identify the person who will take care of them when you are unable.
  • Children may equate cancer with death, even if the prognosis is good.
    • Be honest about what you know. Do not make false promises, but stress that doctors and nurses will do everything they can to get rid of the cancer.

While we cannot protect all of the world’s children from the big and little “lumps” (pun intended) of life, the manner in which the experience is handled lays the foundation for how children will handle the inevitable future “lumps” in the road.

The Silver Lining is that children are wonderfully resilient and can survive a family’s cancer diagnosis, treatment, and recovery. My husband and I had two choices about how we were going to handle this wretched diagnosis: from a position of fear or from one of love, from a place of denial or truth. We chose love and truth. As a result, our children mirrored our words, actions, and emotions. It was emotional. It was honest. It was hard, but we were all in it together.

Hollye began writing as a way to discuss her journey with breast cancer. She believes that breast cancer happens within the ecosystem of family, friends, and community. Consequently, she decided to take the holistic approach and write about breast cancer with style, humor, and silver linings. Hollye writes from the uniquely candid perspective of both her personal and professional experiences. She is a pediatric and adult palliative care nurse and social worker with graduate degrees in bioethics and child development. Hollye has worked as an educator, clinician, trainer, and consultant at the City of Hope National Medical Center, the University of Chicago Children’s Hospital, the University of Chicago Pritzker School of Medicine, and Northwestern Memorial Hospital. She speaks nationally about bioethics, grief and bereavement, and a family-centered approach to facing life-threatening illnesses. You can follow her blog at The Silver Pen, email her at hollye@TheSilverPen, or follow her on Twitter @hollyejacobs.

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