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Dealing with Diagnosis

154815783_8If you have children, at some point you will likely tell them about your diagnosis. This can be difficult because a parent never wants to cause a child fear and pain. As adults, we have some general ideas about what cancer is and what treatment it may involve. But a child or teenager may have little concept of what it means or what to expect.1 Family matters. Taking Time: Support for People with Cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/takingtime/page3#B4. A teen probably does know enough about the “C-word” to be scared that you might die or understand that things are about to get much more difficult at home. You will still need to explain a great deal to help your children understand what is going on and what to expect in the coming weeks and months.

Don’t pretend that everything is okay. Children know when something is wrong, and they respond better to honesty. If you don’t tell them what is going on, they may imagine the worst.2 Rosenheim E,Reicher R. Informing children about a parent's terminal illness. J Child Psychol Psychiatry.1985 Nov;26(6):995-998. Research shows that children’s anxiety level is higher if they are not told about a parent’s cancer diagnosis than if they are.2 Rosenheim E,Reicher R. Informing children about a parent's terminal illness. J Child Psychol Psychiatry.1985 Nov;26(6):995-998. This is true from young children to teens.

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Young children

The younger the child, the more important it is to be very intentional in how you discuss a head and neck cancer diagnosis. You should allow yourself ample time to come to terms with your own feelings. You might seek out expert help, such as an oncology social worker, to assist you in framing the matter in a forthright way, yet not overwhelming to a child. Use words the child can better understand, such as “medicine” instead of “chemotherapy” or “spread” instead of “metastasis.”1 Family matters. Taking Time: Support for People with Cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/takingtime/page3#B4.

Give your young child information in small chunks and speak with a gentle, honest and open approach.3 Talking with your child about cancer. National Cancer Institute. 1986 Jan. http://www.eric.ed.gov/ERICWebPortal/contentdelivery/servlet/ERICServlet?accno=ED273867. Start by explaining what cancer is in very simple terms. (Cancer is a disease of unhealthy cells. Our bodies are made up of cells so tiny you need a microscope to see them. Cancer cells don’t look or act like normal cells, and they don’t allow our normal cells to work properly. There are many different types of cancer, and it can grow anywhere in the body.) If your child’s attention span is long enough, you can go on to explain that cancer is not contagious and that it can take a long time and a lot of hard work to get rid of it. Assure your child that you and your doctors will be working very hard to make you better.

When young children begin to understand what cancer is and what it means, they may:

  • Become very needy and not want to be left alone
  • Throw tantrums or act out angrily, maybe even blame you
  • Show signs of regression, which is acting younger than their age
  • Abruptly change how they socialize and play with others
  • Feel guilty and think they caused you to be sick
  • Look to you for the first clues of how to cope with a diagnosis—are you calm, or behaving anxiously?
  • Quickly forget or misunderstand the information you provide—repeat often and in simple terms1 Family matters. Taking Time: Support for People with Cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/takingtime/page3#B4.

Lots of affection, soothing words and songs, and companionship are vital to help your child cope with the news. It can be really difficult to give your full attention once you or your spouse has been diagnosed because there is so much to deal with before treatment begins. Look for help from family and friends during this difficult time.

Adolescents and teens

Teens are already prone to volatile emotions. A cancer diagnosis can set off even more emotional behavior in an adolescent’s life. Teens also like to portray themselves as more mature and confident than they really are, making it difficult to discuss matters that make them feel vulnerable or scared. They might cut off the conversation or seem to ignore you if they get too uncomfortable. Conversely, teens who have a parent with cancer also often complain that they are not given enough information and feel ignored with all the attention on the sick parent.2 Rosenheim E,Reicher R. Informing children about a parent's terminal illness. J Child Psychol Psychiatry.1985 Nov;26(6):995-998. Contradictory and rapidly changing reactions are not unusual for children in this age group.

Here are some tips to help you talk to your adolescent or teen child about your head and neck cancer diagnosis:

  • Find out what your teen already knows about cancer. Correct misconceptions if necessary and then present your diagnosis in straightforward terms. You might have a diagram ready to show your teen where the cancer is in your head or neck.
  • Include your teen in family discussions as appropriate from now on and provide as much information as possible.
  • Encourage your teen to be involved in your treatment and to ask questions.
  • Assure your teen that the cancer is no one’s fault.
  • Be honest about how the cancer diagnosis is likely to affect your teen’s social life, activities and household responsibilities.
  • Allow space and time for your teen to process what your diagnosis means and come to terms with his or her emotions.
  • Urge your teen to talk to friends or mentors if he or she isn’t comfortable talking to you or a therapist. Each member of your family needs emotional support and a safe place to talk during this time.
  • If your teen is in crisis, take him or her to a professional therapist or a support group of other teens struggling with cancer in their families.4 Tips for talking with children of different ages. National Cancer Institute. 2012 Jan 1. http://www.cancer.gov/cancertopics/coping/when-someone-you-love-is-treated/page6 - d4.
It happened, and we lived through it. We got through it together. Our kids are stronger for it, and we’re stronger for it.Bonnie S. (wife of a tonsil cancer survivor)

References

1 Family matters. Taking Time: Support for People with Cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/takingtime/page3#B4.

2 Rosenheim E,Reicher R. Informing children about a parent's terminal illness. J Child Psychol Psychiatry.1985 Nov;26(6):995-998.

3 Talking with your child about cancer. National Cancer Institute. 1986 Jan. http://www.eric.ed.gov/ERICWebPortal/contentdelivery/servlet/ERICServlet?accno=ED273867.

4 Tips for talking with children of different ages. National Cancer Institute. 2012 Jan 1. http://www.cancer.gov/cancertopics/coping/when-someone-you-love-is-treated/page6 - d4.