PHOENIX - Did you know about 1 in 8 women in the United States will develop invasive breast cancer over the course of her lifetime, according to breastcancer.org ?
Scottsdale resident Carol Bailin knows that too well. Her mom and mother-in-law were both diagnosed with breast cancer. She said she found it difficult to talk to her three kids about the news.
Dr. Coral Quiet, co-founder of the Arizona Breast Cancer Specialists says that's normal. We asked her the best way to handle one of the toughest situations any family could face.
SF: How should we determine what needs to be said and what doesn't?
Age is an important factor in deciding what and how much you should tell a child about a cancer diagnosis. The guiding principle should be to tell the truth in a way that children are able to understand and prepare themselves for the changes that will happen in the family. Kids thrive on routine -- it helps them feel safe. When life becomes unpredictable, they will need help adjusting to the changes.
Young children (up to 8 years old) will not need a lot of detailed information, while older children (8 to 12 years) and teens will need to know more. Teens, who are testing their independence and limits, will have very different concerns from a 5-year-old who needs parents for basic caregiving.
All children need the following basic information:
The name of the cancer, such as breast cancer The part of the body where the cancer is How it will be treated How their own lives will be affected
SF: Should a parent expect his/her child to be upset?
Some children may become very upset when learning about a new cancer diagnosis, while others may act as if nothing is wrong. The goal is to give the child a balanced point of view. The child should realize that cancer is a serious -- but not hopeless -- illness.
A child's emotional reaction to this news will depend on many things, including how the information is given to them and the child's experience with illness. It is important for parents to choose a time when they are feeling fairly calm to talk to their children.
In a two-parent household, it's a good idea for parents to talk to their children together.
For single parents, it may help to ask an adult relative or friend who is a stable, consistent influence in the child's life to be with them if they're feeling a bit shaky about the talk.
If you're feeling upset or unsure about what to say, it might be better to wait until their emotions are a bit more under control. That is not to say that parents need to pretend that there is nothing to worry about. It is OK if their kids see them crying sometimes. Parents can admit that this is an upsetting time, that cancer is a scary disease and that it's OK to have strong feelings about it. But that doesn't mean that the family won't be able to handle it.
SF: Are there certain responses that I should expect?
Every child is different. Children can't always tell you, but may show you how they feel. A child may act less mature when upset. Children blame themselves. The child's level of trust will show up in their behavior.
SF: What if my child asks if I am going to die?
The question, "Are you going to die?" does need to be answered -- even if it's not asked. Whether you openly talk about it or not, you can be sure that your loved ones are worrying and thinking about death. Here are some samples of how to address this with children:
Sometimes people do die from cancer. I'm not expecting that to happen because the doctors have told me they have very good treatments these days, and my type of cancer usually does go away with treatment. The doctors have told me that my chances of being cured are very good. I'm going to believe that until I have reason to believe something else. I hope you can believe that too. I'll tell you if I find out anything new or different. There is no way to know right now what's going to happen. I'll know more after the first treatments are finished. When I know more, I'll be sure to tell you. Right now there's not a lot known about the kind of cancer I have. But I'm going to give it my best shot and do everything I can to get well. My cancer is a hard one to treat but I'm going to do everything I can to get better. No one can know right now what will happen down the road. What you can be sure of is that I'll be honest with you about what is going on. If you can't stop worrying, please tell me so that we can work on that together.
SF: How will I know if my child needs extra help?
Professional help may be needed if a child:
Is unable to handle the feelings of sadness Feels sad all the time Cannot be comforted Admits to thinking of suicide or of hurting herself or himself Feels extra irritable Becomes very angry very quickly Has changing grades Withdraws or isolates himself or herself Acts very different than usual Has appetite changes Has low energy Shows less interest in activities Has trouble concentrating