• Family Connections

    For parents: After treatment ends

    When treatment is over, most people are eager for life to return to normal as quickly as possible. In fact, most families and friends expect that you and your usual routines will be right back to where they were before the cancer diagnosis. However, it usually takes a while for everyone to adjust to this change, and you and your children may be surprised by some of your reactions.

    You may continue to feel some of the physical effects of treatment for a while. That might catch all family members off guard, causing some worry or stress. But you and your family's emotional responses might be even more unexpected. Both physical and emotional recovery takes some time, and it is helpful for everyone in the family to be aware of this process.

    You probably all looked forward to the end of treatment and imagined you would feel only relief. Be aware that you might also experience a sense of loss when you no longer have frequent contact with your caregivers. In addition, you might feel more alone, now that you are spending less time among cancer professionals with whom you would usually share your worries and questions.

    Perhaps for the first time, you have a chance to reflect on your illness and how your life has changed. Your children, who tend to live in the moment, may be surprised if you respond by appearing sad or unusually quiet. They may even worry that your cancer is coming back. So, at the end of treatment, it is generally helpful when family members can be as patient as possible with each other, have some shared sense of what to expect, and talk directly together about their concerns.

    Topics discussed in this section

    After treatment ends, your family may expect that you'll immediately get back to normal

    In most cases, this is not true. Typically, cancer patients assume previous roles and responsibilities gradually. So as you are able, let your partner and family know when you are ready to get back to your regular routines. These changes may take some time for the family to get used to, even when they involve a return to previous patterns.

    For instance, if dad has been the primary parent for much of the past several months, he may have a hard time giving up the increased closeness he has enjoyed with your children. You and your family may need to talk about how to preserve this and other positive aspects of this period of time.

    Ask your doctor what you and your family can expect in the weeks and months following the end of treatment, and share this information with your family. Depending on the ages and developmental maturity of your children, you may decide to talk to them as a group, or with each child individually.

    When you talk, you might start by explaining that you have finished your treatment, that you are okay now, and that both you and the family can begin getting back to normal. Let them know that this will take time, and probably will involve changes in your family routines, just as the diagnosis and treatment did. As circumstances permit, spell out these changes as specifically as possible.

    For example, if dad has been ill, he might say, "Mom will be able to lead your Girl Scout troop now, because I won't need her at home so much," or, "I'm going to start doing homework with you again, so you won't have to meet with your tutor anymore." Let them know the limits of your strength and energy. For instance, you might explain that even though you've had your last chemotherapy appointment, you might still be very tired for the next month or two.

    The transition period may be a little bumpy, but usually the bumps work themselves out with time and effort

    However, if it gets to be more than you and your partner can comfortably handle, don't go it alone: ask for the help of your medical team. Oncologists, nurses, social workers, and other hospital staff have lots of experience assisting families through this potentially difficult time, so don't hesitate to ask for their advice and support.

    If your children, especially your teenagers, had more freedom while you were undergoing treatment 7ndash; either by choice or because you and your partner were too exhausted or pulled in too many directions to do anything else – expect some resistance to your efforts to reestablish previous limits and routines

    Use this resistance as an opportunity to rethink the rules. Get input from your children, and assess whether the old ways of doing things still apply. Many children become more responsible and mature when the family faces a serious illness. Depending on how your children coped with your diagnosis and treatment, you may or may not want to make some changes. Again, patience and good communication will help you get through this transition.

    How your children may react

    Sometimes children will try to "keep it together" if they know you are sick or that the family is stressed. Once they perceive that everything is returning to normal, they may let down their guard and express their resentment or anxiety.

    One day, you may notice that your kids are actually getting mad at you, are increasingly moody, or are presenting you with a list of their woes. Try to consider that this is a good sign that they are less worried about you and are beginning to see you as their protector again.

    While it might be useful to talk about these feelings, not all children can put their feelings into words, or even want to

    Although your kids might usually discuss difficult things with you, they may not want to now. Remember that your children will be reassured if you are able to stay relatively calm and handle their reactions with a combination of clear limits and affection. When you respond in this way, you let your kids know that "I'm back and we are going to be okay."

    Your children may overreact to any signs that you are not feeling well

    Whenever you have a headache, a stomachache, or fever, your children may worry. If appropriate, reassure them that you "just have a cold," and that the cancer is not coming back. If you are worried too, then call your doctor for reassurance. This will make it easier for you to respond calmly to your children. Work out with your health care team whom you should call with questions and concerns, so you too, don't have to sit on worries unnecessarily.

    When children are not well, they can wonder if they, too, have cancer

    This is quite natural. When you can, directly ask your children if they are concerned about being diagnosed with cancer. Reassure them that this is highly unlikely, but don't hesitate to talk to or take your kids to their doctor if they need more information or support.

    Children may also seek more sympathy than usual for minor scrapes or symptoms

    In this way, they may be indicating that they are looking for you to resume your role as caregiver and protector, and are trying to find that greater sense of security that familiar routines are falling into place again.

    If you're no longer in active treatment, your children may assume that you and the doctors are no longer "doing anything" to beat the cancer, and can come to certain conclusions about what this means

    As a result, some kids will believe that the cancer is all gone, and may act as if everything is normal again or as if nothing ever happened. They may think that your cancer has been "cured," and your family is done with cancer worries forever.

    Other kids may worry that no one is doing anything to fight the cancer. Some children may become clingy and won't leave your side, while others may withdraw from you or seem angry.

    With younger children, explain that you and the doctors hope the cancer is gone forever, but that you will have follow-up appointments on a regular basis to make sure you are okay.

    If your children are older, you might provide a few more details, perhaps saying that you and the doctor hope that the chemotherapy or radiation has gotten rid of the cancer. Explain that even so, you will continue to have regular appointments with your oncologist for blood tests and other lab work to monitor your health.

    Most children need this kind of explanation when treatment ends

    After a while, however, your kids may begin to take your good health for granted. As a result, they may not want to know about each visit.

    If you find that you get a bit anxious before these periodic visits with your doctor, explain this to your kids. Let them know that you may be a bit impatient or distracted at this time. Ask them if they would like to know when you are going to see the doctor, or if they'd just like to know that all is well once your visit is over. They may not want or need to talk about it, but could appreciate and benefit from a brief update.

    Be aware that your children will continue to work through their own reactions, worries, and concerns

    Remind them that you are available to talk with them if and when they wish, and try to listen and look for signs that they have more on their minds and could use some additional support.

    Learn more about stress warning signs in children

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