Dr. Molly O'Shea, who survived breast cancer, relaxes at home with sons, Conall, left, 12, and Declan, 14. Daughter Mairen is away at U-M. (Brandy Baker / The Detroit News)
It may be the hardest conversation you’ll ever have. October is breast cancer awareness month, and 1 in 8 women will be diagnosed with breast cancer at some point in their lives. Many women will face this scary reality and have to break the news not just to their adult friends and family, but to their children, too, which is a daunting prospect.
I had to do this last year, and I hope you never have to put the following advice to use.
Whether your children are barely old enough to understand what it means to be sick or are adults themselves, telling them that you have cancer is not easy.
The reality of it all is fresh and raw for you, and yet as a parent, you feel a need to be strong for your kids and shore them up as you share the scary news. The balance can be difficult to achieve.
Being honest and open and willing to share what you know and how you feel can help your children absorb the information, ask questions and share their feelings when you tell them and for the weeks and months to come.
I have three children, and when I felt I had enough information to talk to them and answer their questions, the four of us sat down in the living room so I could break the news. Here are some suggestions from my experience as a mom, and as a pediatrician, to help you navigate these turbulent waters if you have to:
Talk to your children together if you can, even if they vary in age. By sharing the news with everyone at the same time, they can support each other and hear each other’s questions.
Try not to quash your children’s emotions, but help them express them in a controlled way and work through them. There is no right or wrong way to feel when your mom has cancer. It’s likely that each child will respond differently to the news.
When I told my kids I had breast cancer, Declan, who was 13 at the time, was so angry he stormed out of the house and “ran away” for about a half hour before coming back home. The other two were very upset with him and felt he was selfish and immature, making it all about him. I commented that I didn’t blame him for being angry. I was super angry, too, and that by blowing off steam walking around on his own, it may help him come back and ask what he needed to know to feel less mad.
A few weeks later, Conall, who was 11 then, was sad and anxious as my surgery approached and was clearly angry that his sixth-grade year was going to have to start out with my surgery on the agenda. I reminded him how mad his brother was and that it was OK to be mad and he vented it and felt better. It didn’t change the fact of my surgery timing or the reality of my cancer, but giving them permission to express these real, negative feelings allowed them to manage them more effectively.
Remember that as overwhelmed as you feel about this, they are even less experienced at managing their emotions — so let them express them.
Answer all of their questions as completely as you can. Encourage them to ask anything they want. With very young kids, be less specific and use examples they are familiar with, saying things like, “I have breast cancer, so I’m going to be going to the doctor a lot right now and won’t be feeling well. I might be more tired than usual and need to take more naps.”
For kids younger than 5, that may be all you need to say at first, unless they have questions. When chemo starts, you’ll have to explain that the medicine you’re taking makes you super tired and causes you to lose your hair, so you’ll need their help to pick out some hats/scarves/etc. until it grows back.
Otherwise, though, young kids probably won’t need as much in the way of talking, but they will definitely feel the stress in the household and may express their own anxiety and have behavior issues as a result.
For older kids, the questions can vary a lot. My kids asked if I would die from breast cancer, a good question. I had planned to tell them the answer even if they hadn’t asked. Be prepared for this one.
Also, Declan was worried about the BRCA gene (we didn’t know at that time I didn’t carry it), which is inherited from either parent and significantly increases the risk of breast and ovarian cancer. In his young mind, breasts were private parts and boys didn’t have breasts but did have other private parts. So Declan thought maybe if he had the BRCA gene, he might get cancer in his penis or testicles. I was so glad he asked so I could set the record straight!
Don’t stop talking once you’ve told them the news. Every time you go to the doctor or get test results, share the information. Ask every few days how they’re feeling and if they have any new worries or questions. Conall was struggling with any time we had to spend apart. Come to find out, when I got him to talk, that he was worried I was going to die when we were apart. My daughter Mairen, 15 at the time (and a year later, a freshman at the University of Michigan), wanted every lab result and spent time looking up stats about prognosis to ease her anxiety about it all, so telling her as soon as I knew anything was important for her adjustment.
Remind your children that you are still their mom and they can lean on you even though you’ve got cancer. Your kids need to know that even though you’ve got a lot going on and fighting a battle of your own, if they need you, you’re still there for them. You may not be going to work or PTA meetings or making elaborate cakes, but you can still talk through a math problem or friendship issue with them.
Lastly, remember that your kids will be all right if you can be honest and open with them. It’s OK to be angry or scared or sad at times yourself and let them see it. It’s also important, though, that they see you answering their questions, holding their hands, and that you can help them manage their complex feelings as they wade through this morass with you.
Dr. Molly O’Shea is a Troy pediatrician. Read more, get answers to your questions and discuss children’s health issues at detroitnews.com/drmolly.