How a Cancer Diagnosis Affects the Children
Children will have a variety of reactions to the news of their parent having cancer. Some children are worriers, some are very sensitive to the fear and anxiety of the parents, and some seem not to notice. But just like their adult counterparts, they want to know what’s going on and if they aren’t told the truth, they may imagine something even worse. When families choose to hide information about a cancer diagnosis, children may pick up on tension and stress. As a result, they may suspect something is being hidden from them. Children of all ages can sense a parent's anxiety and fear so they can then become more afraid and insecure.
How Do We Tell the Kids?
So generally, it’s better to tell the kids rather than withhold important information. Telling your children can be very difficult but it’s essential that you think through what you're going to say as the words and emotions will have a significant impact on how the children will react. The calmer you are, the less frightened they will be. It’s best to provide the child with the amount of information they want or need and use language they can understand. Children and adolescents require an approach based on their age and coping skills. However, talking with them about cancer is essential. In doing so, children learn that their families are there for support and they can count on their families to be honest with them. In some families it may be necessary for the children to help more with chores, and they often receive less attention because of cancer treatments or doctor's appointments. If they don't understand why this is happening, they might feel as if they are being punished.
Parents often struggle with what to tell their children when they are diagnosed with cancer. How much they need to know and can handle depend on the children's age and level of maturity. Tell them a small amount of information at a time in words that are easy for children their age to understand. Then give them time to grasp the information and an opportunity to ask questions. Ask them if they have heard any words that they don't understand or find scary.
Children should be encouraged to talk about their feelings. Help them to express their feelings and reassure them of your love. It is easiest for children to show their feelings using activities such as puppets or painting. Older children might prefer writing poetry or drawing.
If the person with cancer does not feel comfortable telling their child about their cancer, a close relative or friend may be able to explain things to the child either in their presence or alone. The parent should still allow the children to ask questions at a later date after the emotion is defused.
Common Reactions
There are some common reactions that most children will have when dealing with their parent’s cancer. These guidelines can be reviewed so the entire family can better deal with this difficult time.
Fear
Anger
Sadness
Isolation
Fear Comes In Many Forms
Fear comes in many forms, some founded, some not. But no matter what the fear might be, it's real to your kids. Here's a breakdown of a few of the fears your children might experience and some suggestions how you might address the. Please seek professional help for other ideas.
Fear
Fear of Separation
When small children realize that their mother may be hospitalized, they experience a fear of separation. They have little sense of time and they live in the "now". A few days may be interpreted as permanent. They may also experience separation frequently when you have radiation treatments or chemotherapy as these take up a significant fraction of their day. If possible have them visit when you are in the hospital. Make their visit as entertaining and positive as possible. Show them how to adjust the bed by pushing the buttons and make you more comfortable. A TV suspended from the wall may be novel. Answer their curiosity questions about equipment simply. Have them bring in special pictures for you, including things that they have drawn or made for you. Be sure that they bring a photo of them and a photo of the whole family for you to have in your room. See if they can think of other things to bring you to make you feel better, like a small bouquet of flowers from your garden or even dandelions from the lawn. These tokens of love will make both of you feel better and important. But, be sure they keep their own security object at home, not with you; they will need it.
Fear that Cancer is Contagious
Many children think cancer is contagious, that they can catch it from you or others. After all, most of the colds and illnesses they get are from someone else. It is very important to assure children of all ages that cancer of all kinds is NOT contagious, that they and other members of the family can't catch it. Assure them that breast cancer doesn't happen to children. Their friends may also think cancer is contagious and may stop playing with your child because of the fear of catching it or spreading it to their mother. It’s ok to address these fears up front since many children aren’t able to articulate their fears and concerns.
Fear that I Caused Moms Cancer
As part of normal child development, children are egocentric, meaning they view the world only as it relates to them. Children have wonderful imaginations unfortunately they can use them in stressful situations like mom being diagnosed with cancer. Some children even think they can make their thoughts and wishes come true. If they had thought or said something mean while angry, they might think they caused the illness. They fear they caused the cancer and the impact of their wishes is now beyond their control. This can cause them to feel very guilty and afraid. Even older children or teenagers think they had something to do with you getting cancer. Teenagers who have more conflicted relationships with their mothers before they get sick tend to worry more about having caused or contributed to her illness. Be sure that your children and your teens understand that they had nothing to do with your illness or you getting cancer, and that wishes and thoughts cannot make people sick or get cancer.
Fear that My Life Will Change
Children thrive on routine, it helps them feel safe. When life becomes unpredictable, they will need help in adjusting to the changes. Because children derive a great deal of security in knowing what to expect day by day and in the future, discussing changes in routine is helpful so they know what to expect. Answer their questions simply. Don't offer explanations that are more complicated than the questions they ask. Keep it at their level. Be sure they know who will care for them when you're not there temporarily so they will understand you are still looking out for them even if you will be taking a break. Most mother-child relationships stay strong or became stronger during this time. Communications with children, young or old is the best way to keep those bonds strong.
Fear of Death
In the past our society frequently hid the diagnosis of cancer, often a child's or teens only exposure to cancer was people who have died. Therefore cancer meant death to many. Even today, this may be the first time that the possibility of death of someone close has ever become a consideration. Children may sense your fear of death. A younger child may think death is near at hand, an older child may interpret therapies as only postponing death. When talking to others children, stories of their grandma or aunt may be discussed and the ending may not be so encouraging, so this can be very scary time for all of us. But with the new technology and research advances, even a very serious diagnosis isn’t necessarily a death sentence anymore. As you learn more, you will be able to have conversations about the improvements in surgeries and treatment, age appropriate of course, that may soothe some of these fears.
Talking with other women who have gone through breast cancer and are healthy vibrant women will help you and your family understand this horrible disease and how it can be treated successfully. Hope is imperative and with the help of friends and family, including the kids, spirits can be kept high.
TopAnger
Our children feel anger just like we do; unfortunately they don’t always know how to express those feelings. They might be angry at you for getting cancer, angry at the cancer for attacking you, angry at you for getting all the attention, then feeling guilty. They may wonder how this event will affect their life now and what it might do to them in the future. This makes them anxious and angry and sometimes they take it out on you or other family members. Since anger is a normal response for you too, they may sense or see your anger and frustration. Sometimes children act out and become more demanding and unruly. They may do poorly in school or do things they would not do otherwise. There may be more conflict between siblings.
If your child seems angry, anxious or frustrated, encourage him/her to play with a toy that will allow expression of anger. Encourage them to draw pictures. Ask them to tell you about their pictures. Things that they do or say may give you clues to how they are feeling. Assure them that it’s okay to be sad or mad (if they are); you are sad and feel angry too. But, continue to be consistent in your parenting approach.
For teens being angry, argumentative and distant are common responses to being a teenager let alone when they have something to be angry about. It is important for the parent to not be punitive, but meet the adolescent's defiance with firmness and understanding. Some teenager may appear not to care; they really do, but are trying to cope by ignoring the situation. Acknowledge that cancer is difficult to deal with, offer to answer questions, and be supportive. Suggest that they might want to share their feelings with others, such as an adult relative, teacher, coach, or one of their peers. As difficult as it can be, try very hard not to use your children no matter how old they are to be your emotional crutch. Find friends or relatives to be your emotional support or contact an organization like Breast Friends for additional support.
TopSadness
Because you may cry often when you are holding your young children, they may think they are causing you to be sad. Acknowledge that you are sad because of your illness, but be sure they understand that they did not make you sad. Occasionally older children will share in your sadness or grief and openly cry with you, but often they do not. Some will try to be cheerful when around you, but express their sadness/grief when they are alone or with friends. Adolescence response is unpredictable for some the whole thing is too overwhelming and they will choose to deal with it by trying to ignore it. They may show little or no emotion and will appear to go about their activities as if nothing happened. This may be hard for you because they seem very unfeeling toward you.
Some will share your sadness openly, but others will keep their sadness to themselves or share it only with their friends or other relatives. It is important that you make plans for the future with your family. It’s important for you, but it’s also important for them to have something to look forward to. Keep an eye on your children’s school work. Stress makes it difficult to concentrate. If your child's school work is deteriorating, make the teacher aware of the situation at home so that the teacher can provide extra help and support for your children.
TopIsolation
Your children may feel left out as you are discuss your cancer diagnosis and treatment.. Your children may also feel isolated because other kids avoid them, either because they are afraid of the concept of cancer or because they think they might catch it. Small children may experience separation from you. These feelings of isolation become realities when you go to the hospital, and again each day that you have radiation treatments or chemotherapy. You may find that your children regress to more immature behavior. This is normal. When they feel secure again, they will return to more age appropriate behavior.
Frequently reassure your children of your love and that they will always be loved and cared for. Your children may need this extra attention and affection and it’s ok to allow others in their lives to help you to giving them that attention. You may want to have their favorite baby-sitter come over for the sole purpose of entertaining them and giving them extra attention. If grandparents or close relatives live nearby, they can be of great help in this respect. If your child has a special friend, try to arrange for his mother to have your child over to play during this period. Try to involve them in appropriate activities, like selecting a wig or allow them to help with chores. If there are support groups available for children whose parents have cancer, these are a great place for sharing experiences with the help of professionals.
Interrupt your children's normal routine as little as possible. Do activities together as a family. Let your children do things for you if they wish, but don't force tasks on them. If your child is in day care or school, be sure to let the teacher know about your cancer. Suggest that she/he alert you to changes in your child's behavior that are of concern.
TopDaughters and the Future Risk of Breast Cancer
As a group, daughters of women with breast cancer are at increased risk of sometime developing breast cancer. Actually, only a few daughters are at very high risk and the rest are at nearly the same risk as the general public. Risk increases if the mother developed breast cancer before menopause, had breast cancer in both breasts, and/or had the combination of ovarian cancer and breast cancer. There are several genes related to breast cancer risk; only some of these can be identified with testing. This is an area of very active research and within the next several years more extensive tests will be available.
It is important that all women including our daughters with breast development learn to correctly perform a self-breast examination. Be sure that your daughter learns it by the time she gets out of high school. Help your daughter get into the habit of performing it once a month, just after her period. Talk to your health professional for assistance for proper technique.
Childrens Books
Angel Kisses. Kelley, Ginny. 2000. ISBN: 0964043425.
A very sweet book that can comfort children who are faced with losing their mother to cancer. Using lambs as the fictional characters, the author writes for very young children about the cancer experience, including getting sick, having treatment (and the loss of hair), not getting better and later dying. Written specifically for young children about dealing with the loss of their mother.
Breast Cancer: Questions & Answers for Young Women. Vogel, Carole. Twenty-First Century Books, 2001. ISBN: 0761318550.
Written for adolescent girls, this book answers questions on breast health and breast cancer. It also offers practical guidance and comfort to teenagers whose mothers are undergoing breast cancer treatment.
Dear Mom, I am Sory That You Had To Get Brest Cancer. Jackson, Mikayla A. 2003. ISBN: 1553067045.
This book is a personal story and testimony of a young mother, as seen and told through the eyes of her 7-year-old daughter. The book shares with readers young and old the journey of a young mother, her daughter and their family as they experience what it means to live with, and survive breast cancer. The words are spelled as they sound (inventive spelling) and the text is simple and enjoyable for young readers.
Less Than Perfect. Albert, Louise. New York, Holiday House, Inc., 2003. ISBN: 0823416887.
This story of a mother’s breast cancer diagnosis and treatment is told through the eyes of a teenage daughter (15-16). Because she is struggling with her own self-conscious feelings about her changing body, she is unable to support her mother as she knows she should. This book is based on some of the author’s own experience, and she believes that love is the best medicine for health.
Mama’s Going to Heaven Soon. Copeland, Kathe Martin. 2005. ISBN: 0806651229.
This book is a compassionate story written to assist children in talking about the anticipated death of a parent. Readers will begin to process their own feelings as they listen to the children in the story talk about the confusion they feel because their mom is sick, the sadness they feel when they learn that their mom will die, and their questions about what will happen when she dies.
Mom and the Polka-Dot Boo-Boo. Sutherland, Eileen. 2005. ISBN: 1933002131.
This book is an informative and reassuring story that helps families talk about breast cancer. Lovingly written by a mother of two and illustrated by her young daughter, it gently prepares children for what lies ahead in the weeks and months following their mother’s diagnosis.
Moms Don't Get Sick. Brack, Pat. Melius Publishing, Inc., 1990. ISBN: 093760374.
Written by a mother and son, this book describes the feelings they experienced during the mother’s treatment for breast cancer.
Mrs. Biddlebox. Smith, Linda. Harper Collins Publishers, 2002. ISBN: 006-0286903.
This illustrated storybook is about having a bad day during which nothing is going right, and the magical way Mrs. Biddlebox makes it better.
Once Upon A Hopeful Night. Yaffe, Risa. Oncology Nursing Press, 1998. ISBN: 1890504106.
This book does a wonderful job of helping parents who are diagnosed with cancer discuss their illness with their children. A very good guide for establishing open communication about this sensitive subject.
One’s Own Self. Jalazo, Dori. 2003. ISBN: 0971519501.
This book is a story about finding joy and fulfillment in the brief friendships and experiences that touch our lives. The story could be read to a child who may be losing a loved one to breast cancer and needs to hear that it is OK to let that person go.
Our Family Has Cancer, Too! Clifford, Christine. Pfeifer-Hamilton: 1997. ISBN: 1570251444.
Clifford shares her personal childhood experiences about her mother's breast cancer as well as her own experiences as a mother with breast cancer.
The Hat Lady. Leonard, Jean. Illustrated by Mollie Elkin. Printing courtesy of Herbert D. Kerman, Regional Oncology Centers, Centers for Clinical Research in Cancer Care, 2004. www.halifax.org
This book enlightens a little girl about the necessity for some people to wear hats after undergoing chemotherapy. The hats are made to appeal to the personality, taste and mood of those wearing them. The story emphasizes the interest and delight of the little girl to be involved in her neighbor’s cancer experience and recovery.
The Paper Chain. Blake, C., and E. Blanchard and K. Parkinson. Health Press, 1998. ISBN: 0929173287.
This illustrated storybook for children provides a general understanding of breast cancer for younger children. The book uncovers the feelings of fear and separation children face as their mother undergoes surgery, chemotherapy and radiation.
The Year My Mother Was Bald. Speltz, Ann. Washington, DC: Magination Press, 2003. ISBN: 1557988889.
A month-by-month account of a young girl’s life while her mother battles breast cancer, with emphasis on her feelings during that time.
Tickles Tabitha's Cancer-Tankerous Mommy. Frahm, Amelia. Nutcracker Publishing Company, 2001. ISBN: 0970575203.
This book covers many serious issues like cancer treatment and its affect on the body and how even the delicate infrastructure of day-to-day family issues between husband, wife and children are changed by cancer.
When Eric's Mom Fought Cancer. Vigna, Judith. Albert Whitman & Co., 1993. ISBN: 0807588830.
This is a storybook for younger children about a mother who undergoes treatment for breast cancer.
When Mommy Had a Mastectomy. Greenfield, Nancy R. Silver Spring, Md., Bartleby Press, 2005. ISBN: 0910155607.
This book is an insightful story from a child’s perspective about her mother’s breast cancer and how it affects the special hug they share. The book gently introduces a child to breast cancer and states options after mastectomy while being candid about treatment and recovery issues. This book will help encourage discussion between mothers and their children, and thus alleviate some of the fear associated with breast surgery. It also reaches out to women and their families during an emotional and uncertain time in their lives and addresses a critical issue for women faced with breast surgery following cancer.
When Mommy is Sick. Sherkin-Langer, Ferne. Morton Grove, Ill.: Albert Whitman & Company, 1995. ISBN: 0807588946.
This book can help a child express the feelings he may have while his mother is away due to illness. The story portrays a little girl's experience while her mother is ill and hospitalized.
Where Did Mommy Go? Smith, Brenda Joyce. 2004.
This book is a spiritual tool to help children grow from grief to peace. The story in this book deals with a little girl whose mother has died. Where Did Mommy Go? was written to help children deal with the pain of losing any loved one to death. The main purpose of this book is to comfort children with God’s promise of eternal life. For more information, email: TALLMinistries@aol.com.
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