As you work with your doctors to choose a treatment plan, you
will face a number of challenges. You may be overwhelmed by the prospect of treatment at the same time as raising
your children, managing your household and getting on with the rest of your life at the same time.
When you think about discussing your treatment plan with your
children, you can use many of the same principles that guided you
when you decided how you would share the news of your
As you consider various treatment options, you may feel as
though you are on an emotional roller coaster ride.
If you feel worried and stressed, take time with your partner, a
member of your health care team, or a friend to reflect on your
reactions to your diagnosis and to your treatment options. Talking
through your thoughts and feelings may help you understand why you
are anxious or feeling out of control. In turn, this discussion may
help you determine the timing for when to share your treatment plan
with your children. You also may be more able to focus on their concerns and questions if and when you
If you have younger kids, you might consider sharing the
specifics of treatment only after you've made a final decision
among all your options. You might tell them, for example, that you
and your doctors are discussing different kinds of medicine to try
to get rid of the cancer and to keep it from coming back. Reassure
them that you'll tell them more once you've made a choice.
These explanations, while frequently creative, can also be incorrect. Children pay close attention to
their parents' moods and appearances. When they notice your hair loss or decreased appetite, but
don't understand the underlying reasons, they may conclude that you
are far sicker than you really are, or that something else is going
on that you don't want to tell them.
Even if you did not share any information when you were first
diagnosed, consider talking with your kids now that you
have a treatment plan and are aware of its potential impact on your
health and physical appearance, as well as the family's usual
You might also mention that you don't know exactly how
you will feel during treatment, and that you may react to your
treatment in different ways at different times. As always, let your
children know that you will keep them updated on how you are doing,
and give them frequent opportunities to ask questions and express
You may assume that your kids won't be able to understand
anything you say about your treatment, or don't even remember that you are sick. You may
conclude that you have nothing to lose by keeping silent about your treatment.
Potentially, however, you have a lot to gain by sharing this
information. Although the start of treatment is challenging, many
patients and their families feel a sense of relief once there's
plan in place and treatment begins.
If your children
already know about your diagnosis, they'll be
relieved to hear you're taking steps to get better. Your relationship with them may be strengthened by your
willingness to confide in and trust them with this information.
Kids in this age group tend to think in concrete terms, so try to explain your treatment plan using very simple
words. The attention span of preschoolers is short, so keep
conversations brief. For example, you might describe chemotherapy
as a "good medicine" that will fight bad cells or "make mom's
sickness go away."
Because preschoolers are very aware of their physical
surroundings, help them prepare for any possible changes in your
appearance or in the set-up of the household. For example, explain
that grandma will be coming for a long visit to help out, or that
the medicine that gets rid of bad cells also makes your hair fall out.
Preschoolers have a different sense of time than grown-ups, and
are much more creatures of the moment. So while you may decide to give them information well in
advance of a change in your appearance, treatment, or routine, be
prepared to repeat the information much closer to the time it will
Games and pretend play are important ways that kids of this age
process information. Drawing pictures with them, making a stuffed
animal hospital together, or encouraging them to try on your wig
are examples of activities that may help your young children to
absorb this news.
At this age, children are learning about how the human body
works, and may be able to handle more details about your
They still do better with simple, clear, brief discussions, but
school-aged children can usually understand more complicated
Children of this age need to hear that you are getting
treatment to help you fight the cancer. But they also will be
concerned with concrete, specific details about how it will affect
you and them. If possible, be matter-of-fact about side effects,
such as hair loss or low energy.
Your children's experience with medicine may be quite different from what they see as you
undergo chemotherapy or radiation. Kids usually take medicine for
brief periods until their symptoms go away. You may want to explain
that your taking medicine over many months (or having treatments
for many weeks) does not mean that you still have cancer; the
treatment helps to keep the cancer from coming back.
Be specific about when and why you need your children's cooperation. You might say that while germs don't cause cancer, the
treatments you get may make it easier for you to catch a cold or
get an infection, so they will need to wash their
hands more often than usual. Explain that there might be times when
you may not be able to kiss them, but only for a while until you
School-age children can develop a basic understanding
of the potential danger of low blood counts, and may be more
supportive when you let them know that your counts are low.
After hearing your updates, your kids may simply go off to
school or play, and may ask questions or bring up their concerns at
some later time. Try to remember this, and follow up on your
conversations several hours or days later by asking, for example,
"Do you remember what we talked about? Do you have any more
Your children may also react to these conversations through
their behavior rather than (or in addition to) words. Be on the
alert for any signs that they are pulling back from others, are
unusually clingy, or are more likely to start fights with siblings
As children get older, they usually develop a better sense of
time. Perhaps you can hang up a calendar, and use it to show how
long your treatment will last. Refer to familiar milestones, such
as, "Just before July 4, I'll be all done."
At this age, your children are trying to become grown-ups.
Respect this by asking what they want and need to know, and then
providing straightforward, honest answers. As in other situations,
try to take direction from your teens, giving as much or as
little information as they seem to want. Don't expect to cover
everything in one conversation, and be ready to come back to important
information as many times as necessary.
Brief updates on your treatment and how you are doing are also helpful. Some kids with
cancer in the family say they don't need to know everything, but do
want to know what is going on and not be left out. Others say they
want all the details or they will worry about what is being kept
Teenagers may also want more direct involvement with your
treatment. They might want to meet your doctor or go with you to
one of your chemotherapy or radiation sessions. If you are
comfortable with these requests, honor them as much as
Although teens are more able to understand abstract and
complicated ideas, they still need specific concrete details of how
treatment will affect both them and you. As with school-aged
children, use a calendar when you give information. For example,
you might say, "Surgery will be next Tuesday. Then I'll be
recovering for the next three weeks," or "Chemotherapy is every
Thursday for the next six weeks, until spring vacation starts."
Because adolescents often rely on the Internet or their
peers for information, recognize that you may not be their primary
source of knowledge.
If your teen-age son or daughter
seeks information online, you might want to caution them
that medicine changes rapidly, and that what they read on websites
might not be relevant to you and your illness. Encourage your
children to share what they find with you.
Try to keep the door open to conversation about your diagnosis and treatment, and
let them know that you would appreciate it if they would let you
know when they are confused or upset by something they read or hear
Even if your kids seem unconcerned about your diagnosis and
treatment, remember that they will have many reactions that remain
invisible to you (and perhaps even to them). When a parent is
diagnosed with cancer, it is the rare child who never wonders,
"What if my parent dies?"
Children can tend to push away these worries by "forgetting" about the illness, acting out (for
example, misbehaving and drawing attention to themselves about
other issues), or keeping silent to protect their parents from what
they believe would be the burden of their anxiety.
Directly acknowledge this possibility. If you need to have
surgery, for instance, begin by explaining what will happen in a
clear, brief and general way. ("The surgery will take the cancer
out of my breast.") Then ask if they have any questions and respond
as honestly as possible.
Don't be afraid to say you don't have all
the answers. It is often enough to reassure them that their
anxieties are normal, and that you understand. You might even say
that you are a bit nervous as well, because this situation is new
to you, too.
If you can, identify the
specific ways in which your kids will be affected. For example, you
might let them know if you won't be able to drive them to school
for a while. If you are starting chemotherapy or radiation, tell
them that sometimes you may be so tired that you
won't be able to help them with homework or read to them at
bedtime. Whenever possible, talk with your children about who will
help out when you are not available. Ask them for their ideas and
preferences, and act on these when you can.
Adapt your language to the age of your child. You might tell a younger child that,
"Mommy's medicine will make her feel very tired, so she will take
lots of naps today and tomorrow." You might say to an older child
or a teen that you will be sleeping a lot for two or three days
after each chemotherapy appointment because you'll be
Be sure to mention, however, that your reactions to the
medicine may change from treatment to treatment, sometimes in
unpredictable ways. Let your children know that you will keep them
informed about how you are tolerating your medicine as time goes
After you start your treatment, your kids may come up with new
concerns. They may worry that you are getting sicker or that you
will die, especially as your appearance or behavior changes.
Address these concerns as directly as possible.
Your children probably will have questions as your treatment
progresses. Be aware that they may pick up information from other
sources such as television and radio news, the Internet, and
stories of friends or family. Some of this information may be
accurate and may apply to your situation; some may not. Point out
that while you want your kids to get information and support from
many sources, you would like them to come to you with their
questions. And when they do, try as much as possible to be
available and open.
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