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Information central for parenting with breast cancer.

Communicating with Your Children

Breaking The News

When mom breaks the news that she has cancer, she has an opportunity to set the emotional stage for how her child will experience her illness. This will be the first of many discussions about breast cancer, so it doesn’t have to be perfect. It’s just the start of a journey for both you and your kids.

Timing

Ideally, you should break the news when you have all of the information you need-after your diagnosis is confirmed and after you have a treatment plan-and when you have had a chance to think through what you want to say.

You might find that an opportunity to tell the kids arises without notice. You could be sitting at the dinner table, for example, and one of your kids says that he’s learning about cells in science class. This could be a good time to bring up the idea of cancer because it fits naturally into the conversation, because the family is already together, and because everyone is paying attention.

Kids’ Early Questions

You may need to talk to your kids before you’re armed with all of this information. Children often know that something is wrong before a parent tells them. Kids are remarkably perceptive, and even the youngest child can notice changes in mood and activity. Here are suggestions for answering your child’s early questions.

  • Be honest. This is an opportunity for you to build up (or chip away at) trust with your kids. If you say, “Nothing’s wrong,” they know you’re not telling the truth. It’s clear to them that something IS wrong. By denying it, you break their trust. You also make them feel more anxious because they think, “It must be something so terrible that Mommy won’t even talk to me about it.”
  • Limit the information you share. Too much information can overwhelm kids, making them feel more fearful, not less. You don’t want your child to take on adult worries, especially about something that might not even occur. Be prepared for your child to push you for more information. This sometimes makes parents blurt out things they would prefer not to say in a way they would prefer not to say it.
  • Reassure them. Your child needs to know that whatever happens, he will be okay. Your goal is not to make him think that everything is normal. Your goal is to reassure him that even if something is wrong, he will be okay. No matter what the doctor says, you’ll make a plan, and you’ll handle it together. This sets the stage for trust and communication if it turns out to be cancer.
  • Acknowledge possibilities. Older kids might ask, “Could it be cancer?” You can acknowledge that cancer is a possibility, but only a possibility. You can tell your child some of the other less scary possibilities, too. Then you can say, “Let’s not get ahead of ourselves. We don’t know what it is yet.”
  • Ask and listen. When your child asks a question, you can say, “What do you think about it?” This allows your child to work through what he’s thinking and feeling.

Click here for some examples of how you might respond to early questions.

Preparing to Break the News

  • Decide if you will talk to your kids separately. If there’s a gap in the ages of your kids, you might want to talk to them separately. Even if they are similar in age, you might want to talk to them separately if they have different temperaments or abilities to understand the information.
  • Decide what information you want to share. What exactly do you want to tell them? You probably want to tell your kids 1) that you have cancer, 2) what cancer means, and 3) that you will all be okay. You might want to tell older kids about your treatment plan. This will likely be too much information for younger kids to absorb in one sitting.
  • Write it down. Write down what you want to say and what words you want to use. You don’t have to use the written information when you talk to your kids. The act of writing will help you remember.
  • Have another adult with you. You might want to have your partner, a grandparent, or a friend with you when you talk to your kids. This adult will be reassuring to your children and supportive to you. If you become overwhelmed or forget what you want to say, this other adult will be there to help. Be sure to share the information-and how you plan to say it-with this adult before you have the talk.
  • Be matter-of-fact but emotionally honest. Your kids might not know anything about cancer. As far as they’re concerned, cancer may be as commonplace, and as benign, as strep throat. There’s no reason this has to change. Facts are facts. They do not come with emotions already attached.While you may hope to be matter-of-fact, you should still be honest about your feelings. You can tell your kids if you’re worried or angry. They probably already see it. Remember, just because you’re worried or angry, they don’t have to be. Your feelings need not be contagious.How do you do this? You acknowledge your feelings, but reassure your kids. Let them know you will get through this together.

What You Can Say

  • Use accurate words even if they’re scary. Your children will hear words like “tumor” and “cancer.” By using these words yourself, you take the opportunity to define them for your kids. This is always better than letting another child, or a random adult, define them. Also, using scary words demystifies them. Leaving the words unstated makes them all the more frightening.
  • Acknowledge the seriousness of the illness. You don’t have to tell your kids that cancer is serious. But if they ask questions, be honest.
  • Tell your child that this is temporary. Knowing that something is temporary will help your kids get through it.
  • Tell your kids that they (and you) will be okay. Your kids need reassurance. It helps them accept the scary things you tell them. It’s particularly important to tell younger kids that lumps are almost always normal. Kids who play hard are constantly developing bumps and bruises. You don’t want them to be worried that their lumps are cancer too.
  • Use concrete examples. Cancer is abstract for kids. Comparing it to other situations can help them make sense of it. Be sure to pick examples that have minimal potential for frightening the kids. And pick examples where the outcomes are positive. Click here for an example.
  • You don’t have to tell them everything at once. Pay attention to your kids’ reactions. If they look overwhelmed or bored, stop talking for now.
  • Reassure younger kids. Younger kids may believe they caused your cancer. Be sure to tell them this is not the case. They may also think your illness is contagious. Be sure they know it’s not.

Click here for examples of how to break the news.

Other Suggestions

  • Get their attention. Talk to your kids in a quiet place. Have older children put down their homework and their i-pods. Sit with them in a casual place-on their bed or in the back yard. For younger kids, get to their eye level, perhaps by sitting on the floor with them. Look them in the eye when you speak, and be sure they’re listening.
  • Listen. Pay attention to what your child says and does when you break the news-and after. Be sure she understands what you said. If not, you can go back and clarify, correct, and build on her understanding. Your child may have a completely different perception of what you just told her.
  • Be flexible. Watch your child’s reaction, and don’t be too set on your plans for the talk. You may realize that your child is overwhelmed and can’t digest all of the information you wanted to tell her.
  • Communicate despite your own fear. You may be surprised that this conversation will be easier than you had imagined.

If “the Talk” Doesn’t Go as Planned

  • Forgive yourself ahead of time for being imperfect. You will forget things, say things you didn’t mean to say, use words you hadn’t planned to use. You might start crying and forget what you wanted to say altogether.
  • This is a process. Communication-and cancer treatment-are processes. This is the start of many conversations that you’ll have with your child about cancer. Expect to talk about your illness, your feelings, and your kids’ feelings over and over again.
  • Kids are resilient. Whatever you say, you’re not going to hurt your child. Your kids’ feelings will come out in their play or in their behavior. They will give you opportunities to talk. You can help your child reorganize the information. Even therapists are not perfect when they communicate with children. They, too, have to reorganize, delete, repeat, and then repeat some more.

Click here for a tool that can help you prepare for breaking the news to your kids.

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