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Information central for parenting with breast cancer.

Answers to Kids’ Questions

Sample answers for common questions your children might ask

About Diagnosis

What is breast cancer?

For younger kids: Cancer comes from out-of-control cells. Cells are like very tiny Lego pieces, so tiny that you can’t even see them without special equipment. When some of the cells in the breast start to grow out of control, they can crowd out normal cells. This is called breast cancer.

For older kids: Every living thing is built out of cells. All cells are programmed by DNA, which tells them how to grow, when to stop growing, when to divide into more cells, and when to die. When the DNA in a cell is damaged, the cell begins to behave abnormally. It can divide too fast and not die off. The abnormal cells can grow out of control, crowding out normal cells. When this happens in the breast, the cancer cells form a mass of tissue that’s called a tumor. Breast cancer most often starts in one of the milk ducts-the tiny tubes that carry milk to the nipple. Eventually the cancer cells will break through the walls of the milk ducts and continue growing into the breast.

What causes breast cancer?

For younger kids: We don’t know exactly why some people get breast cancer. We do know that nothing I did and nothing you did (or thought) caused it.

For older kids: We don’t know exactly why some people get breast cancer. We know that certain things (called risk factors) make some people more likely than others to get it. Here are some risk factors for breast cancer: being female, getting older, starting menstruation at an early age, many pregnancies, pregnancies later in life, family members with breast cancer, exposure to hormones, excess body weight, and lack of physical activity. Even people with all of these risk factors are not guaranteed to get breast cancer. We can’t be sure who will get it.

Are all tumors cancer?

No. Cancerous (or malignant) tumors can spread to other parts of the body. Non-cancerous (or benign) tumors do not spread to other places.

Did you get sick because of me?

No, I did not get sick because of you. Scientists have figured out some of the things that cause breast cancer, and they’re trying to learn more. One thing we all know for sure is that I could not get breast cancer from you or from anything you did.

Can I catch breast cancer from you?

No, breast cancer is not like a cold. You can’t catch it from someone else.

What’s going to happen to us?

Nothing bad is going to happen to you. Things will be different while I’m being treated for cancer, but I’ll let you know what to expect. I’ll tell you if someone else will drive you to soccer practice or pick you up from school. There are lots of people who will help me take care of you if I’m feeling sick. When I’m finished with my cancer treatment, things will get back to normal.

Who is going to take care of us?

I’m going to take care of you except during the times that I might feel too sick. When that happens, Daddy and Grandma and Grandpa and our friends are going to help out.

Can you still make our food?

You can’t catch breast cancer like you catch a cold. So I can still make your food (and hug you and kiss you, too!). Sometimes I might feel too tired or sick to cook, but we have friends who will cook meals for us.

How long is this going to last?

My doctors are going to get rid of my cancer and do everything they can to make sure it doesn’t come back. We can’t be sure exactly how long this will take, but I should be getting back to normal around [springtime, the start of school, Christmas, etc.].

About Surgery

What’s going to happen?

For lumpectomy: I’m going to the hospital to have the tumor removed from my breast. A doctor (called an anesthesiologist) will give me some medicine so I fall asleep and stay asleep during the surgery. While I’m sleeping, another doctor (called a surgeon) will use special tools to make an opening in my breast, remove the cancer, close up the opening, and cover it with a bandage. Then the anesthesiologist will stop giving me the sleeping medicine so I’ll wake up. He’ll also give me pain medicine so I will be comfortable after the operation. I’ll come home and rest for a couple of days. I’ll be sore, but I’ll feel better soon. (illustration)

For mastectomy: I’m having an operation to remove the parts of my breast that have-or can develop-cancer. At the hospital, a doctor (called an anesthesiologist) will give me some medicine so I fall asleep and stay asleep during the surgery. While I’m sleeping, another doctor (a surgeon) will use special tools to open my breast, remove the breast tissue, and close up the opening. He’ll wrap a special bandage around my chest. Then the anesthesiologist will stop giving me the sleeping medicine so I’ll wake up. He’ll also give me pain medicine so I will be comfortable after the operation. I’ll come home and rest for a couple of days. I’ll be sore, but I’ll feel better soon. (illustration)

Will it hurt?

Before the operation starts, the doctor will give me medicine that will make me fall asleep. Since I won’t be awake, I won’t be scared, and I won’t feel any pain. The doctor will stop giving me the medicine when the surgery is over, and then I’ll wake up. Before, during, and after the surgery I’ll get medicine that will help control pain. I’ll probably still feel some pain, but it won’t be too bad. It will get better as I begin to heal.

What will happen when you come home?

When I come home from surgery, I will be very tired and sore. I’ll probably stay in bed or on the sofa sleeping or resting for a day or two. I’ll have a big bandage wrapped around my chest. I won’t be able to give you tight hugs during the first couple of days because my chest will be sore. I’ll feel better every day, and eventually I will be back to normal.

Will you be alright?

The doctors will take very good care of me. They have done this same surgery many, many times. I chose them because they are excellent at what they do. I’ll be sore for awhile, but I will okay. So will you!

Will you look different?

For lumpectomy: I’ll have a scar on my breast where the doctors opened me up, took out the cancer, and closed me up again. The scar will look red and sore at first, but it will fade with time. My breast may also be a little smaller or have a small dent where the lump used to be. (illustration)

For mastectomy without reconstruction: My chest will be flat and maybe a little bit uneven where my breasts used to be. I’ll also have a scar where the doctor opened me up and took out my breast tissue. The scar will look red and sore at first, but it will fade with time.

For mastectomy with flap reconstruction: After the doctor removes the breast tissue from my body, he will recreate the shape of breasts by taking tissue from another part of my body. I’ll have scars on that part of my body and also on my chest. The scars will look red and sore at first, but they will fade with time. Also, I won’t have a nipple and areola. The doctor removes these along with the rest of my breast because they often contain cancer cells. The doctor can create a new nipple and areola at another time. I can explain this to you if you want to know more about it.

For mastectomy with tissue expanders: I’ll have a scar on my breast where the doctors opened me up, took out the breast tissue, and closed me up again. The scar will look red and sore at first, but it will fade with time. My chest may be a little flatter than before my surgery. Eventually I will have the shape of breasts again, but it takes awhile. I can tell you more about that if you’re interested. Also, I won’t have a nipple and areola. The doctor removes these along with the rest of my breast because they often contain cancer cells. The doctor can create a new nipple and areola at another time. I can explain this to you if you want to know more about it.

How does the doctor make a new nipple?

The doctor will make small cuts on my skin where the nipple is supposed to go. Then he will sew the skin into the shape of a nipple. It will be the same color as my skin, not reddish like my old nipple. After the new nipple heals, I can have it colored reddish by getting a tattoo. An expert in this special kind of tattoo will create a reddish color on the nipple and in the space where the areola used to be.

How do tissue expanders work?

Surgeons can create the shape of a breast by putting an implant under my chest muscle. The implant is a special sac that’s filled with soft material like my own breasts. Before the surgeon can put this implant in place, he has to create space for it beneath my chest muscle. He does this by putting a temporary implant, also called a tissue expander, under the muscle. At first my chest will still look pretty flat. Over time, the surgeon will add liquid to the tissue expander so it gradually gets bigger, slowly stretching out the chest muscle so a permanent implant can be placed there. The doctor adds liquid to the tissue expander with a needle in his office. It feels like getting a shot. The stretching does not hurt because it happens so gradually. Later I will have another short operation to take out the tissue expanders and replace them with the permanent implants. (illustration)

About Chemotherapy

What is chemotherapy?

Chemotherapy is special medicine that kills cancer cells. Cancer is like a dandelion. The wind blows the seeds loose from the flower, and they travel to other locations. Then they can grow into new dandelions wherever they land. Tiny cancer cells can leave the tumor in my breast and travel through my blood and lymph system to other parts of my body. Over time they can grow into new tumors. Chemotherapy will kill any tiny cells that have travelled to other locations.

Why is your hair falling out?

Chemotherapy is very strong medicine. It targets cells that grow quickly, like breast cancer cells. Unfortunately, it also kills other fast-growing cells like those in my hair, in the lining of my stomach, and in my blood. That’s why my hair is falling out. After I finish chemo, my healthy cells (including my hair) will begin to grow normally again.

Why are you sick to your stomach?

I feel sick to my stomach because of the medicine I take to kill cancer cells. The medicine makes my brain send messages making me feel sick to my stomach. Sometimes my brain even sends signals that make me vomit. There are different medicines and other treatments that can help me feel better.

Why are you so tired?

Chemotherapy is very strong medicine. It targets cells that grow quickly, like breast cancer cells. Unfortunately, it also kills other fast-growing cells like those in my hair, in the lining of my stomach, and in my blood. Red blood cells carry oxygen to the other cells in my body. When chemo limits the number of red blood cells, it limits the amount of oxygen that’s delivered to the rest of my body. My body doesn’t work as efficiently, and I get tired very easily.

Why do you have to get chemo so many times?

Chemotherapy is very strong medicine. It affects normal cells while it’s killing the cancer cells. My doctor gives me breaks in between chemo treatments so my normal cells have time to recover.

About Radiation

What is radiation?

Radiation is the use of x-rays to kill cancer cells. Radiation can come from a machine, and it can come from special material that’s placed inside my breast near the cancer.

Why are you so tired?

Doctors aren’t sure why radiation often makes people tired. As I finish my treatment, I’ll gradually get my energy back.

Why do you have to go so often?

Radiation works best and causes fewer problems when it’s given in small amounts over a period of time.

Does it hurt?

No. In fact, I can’t feel it at all.

What’s wrong with your skin?

Radiation can cause changes in the skin, like redness or roughness or blistering. This happens because radiation goes through the skin to get to the cancer in my breast. The redness/roughness/blistering should go away over time.

About Recovery

When will you feel better?

I will start feeling better when I’m finished with [chemotherapy, radiation, etc.]. My last treatment will be [after school starts, around Easter, etc.]. It will happen slowly, and some days will be better than other days. But before we know it, I’ll be back to normal.

About The Future

Are you going to die?

Everyone is going to die sometime. Everything that’s alive-flowers, bugs, leaves-all die. We never know when a person is going to die. But I plan to live a very long time. My doctors and I are doing everything we can to make sure that I live a very long life.

Am I going to get breast cancer?

There’s no way to know whether or not someone will get breast cancer. You should know that kids don’t get breast cancer. It’s a disease that usually affects older women. So even if you were to get breast cancer, it wouldn’t happen for a very long time. Breast cancer is one of the most researched and studied diseases, and every year doctors and scientists come up with new ways to treat it. Things will be very different by the time you reach the age when developing breast cancer is even a possibility.

What can I do so I don’t get breast cancer?

For younger kids: We can’t control whether or not we get breast cancer. Taking really good care of your body will make you less likely to get breast cancer and other diseases. You can take care of your body by eating a healthy diet, getting lots of exercise, and staying at a normal weight for your body.

For older kids: Most of the risk factors for breast cancer are out of your control. The risk factors are getting older, a family history of breast cancer, and changes in hormone levels during your lifetime. Hormone levels are affected by the age when you begin menstruating, your age at menopause, and the number of pregnancies you have. Even if you could control these factors, it’s unclear how much it would affect your risk of getting breast cancer.

You can control some of the risk factors for breast cancer. You can do this by taking good care of your body. You should eat a healthy diet with lots of fruits, vegetables, whole grains, and healthy fats. You should also get a lot of physical activity, stay at a normal weight for your body, and avoid drinking alcohol to excess. You can find more information about living a healthy life at www.mypyramid.gov.

Can breast cancer be inherited?

Some people can inherit a higher chance of getting breast cancer from their parents. But having a higher chance does not guarantee that you’ll get breast cancer. Nearly all cases of breast cancer are NOT related to family history.

Will breast cancer come back?

It’s possible that breast cancer can come back, but my doctors and I are doing everything possible to make sure that won’t happen.

What will happen if breast cancer comes back?

If breast cancer comes back, my doctors and I will do everything we can to fight it. We’ll try different medicine and other treatments that can keep the cancer from getting worse.

Can breast cancer turn into another kind of cancer?

No, breast cancer cannot turn into another kind of cancer. Sometimes breast cancer can spread to other parts of the body like the liver, bones, lungs, or brain. If breast cancer cells grow in these other locations, it’s still called breast cancer.

Is everything going to be alright?

Everything will be alright. My doctors and I are going to do everything we can to get rid of my cancer and make sure it never comes back. Things will be different for awhile, but it will only be temporary. We’ll get through it together.

Other Questions

Why are you in a clinical trial? Isn’t that dangerous?

The drugs used in clinical trials are studied and tested and reviewed very carefully before they are given to patients like me. I’ll be helping improve breast cancer treatment for other people who get the disease. And, I may do better with this treatment than I would without it.

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