By Dhara Thakar Meghani
“I just say, it is something to be sick when you are alone, but something else when you have children. Then it is awful.” —Mother with breast cancer¹
It’s not just a nightmare; it’s a tragic reality when your cancer diagnosis has been confirmed. If you are a parent with cancer, you must summon the strength to manage the physical pain and discomfort, and are also confronted with the unimaginable burden of breaking the news to your children. You may be tempted to procrastinate, praying furiously or relying on a medical miracle that “it” will go away before you have to tell your children.
You might think twice before telling family members about your illness due to superstitions touted in your community that “cancer is contagious,” or because it’s taboo to even utter the word “cancer” as has been reported by several South Asian women diagnosed with breast cancer in the UK². In this study, South Asian mothers also said they worried they would hurt their children’s eventual chances of getting married if word was out that the child’s mother had cancer.
While it might be desirable to avoid bringing up this topic with family members, especially children, hiding this information can be more stressful for parents, children, and their relationship. Certainly you would not want your child to find out through another channel; children who learned about their mother’s diagnosis of breast cancer from someone else felt angry, confused, and left out by the parent who did not tell them the truth from the onset³. You might wonder what the implications are for children whose parents do talk with them about their diagnosis – it’s easy to imagine the news would be devastating for children to hear and perhaps even have long-term effects in their functioning.
You wouldn’t be off the mark in assuming children do express negative emotions and sometimes experience changes in their behavior –who wouldn’t be?—when hearing that a parent has been diagnosed with a life-threatening illness. However, research indicates these reactions are not necessarily as off-the-charts as could be expected; and time seems to help: adolescents reported reduced levels of uncertainty and helplessness one year following their parent’s cancer diagnosis4, which may have been due to having more knowledge of prognosis by then, and also because a more consistent and predictable routine was established in the household after the initial tumult following diagnosis.
Not all children will react to a parent’s cancer diagnosis the same way. Here are some differences in emotional expression and behavior that have been shown through several studies:
Developmental stage of child matters.
• Children aged 3-5 who are already susceptible to normal fears of being separated from or about losing a parent may experience greater anxiety. These fears may also show up through reluctance to be away from the parent, or “clinginess” when the child had not previously exhibited these behaviors. By contrast, younger children may make less of the knowledge that “mommy is sick” than older siblings as they do not yet have a very clear grasp of illness and death.
• Children aged 6-12 may demonstrate their worries through behavior at school, where teachers may notice they are acting out or making unusual comments about sickness and/or death. Additionally, they may withdraw from peers, feeling that others do not understand what they are going through.
• Adolescents aged 13-17 who are in the midst of defining themselves and often times using parents as role models may be upset or accuse parents of letting them down, insinuating in some way that cancer is the parent’s fault (e.g., “how could you…?”). They may simultaneously experience anger at feeling abandoned by their healthy parent and anxiety about being catapulted into a life of increased responsibilities due to an ill or dying parent.
Regardless of the age of your child, it is important to be in touch with teachers to keep them aware of the reasons your child may be behaving differently; staying in touch with the school can also keep you informed of new developments in your child that aren’t being expressed at home (i.e., acting out, withdrawing, etc.)
Gender matters.
• Daughters may be more likely to experience emotional ups and downs than sons; this may be due to daughters feeling more responsible for taking care of a sick parent but feeling helpless against cancer. Additionally, girls in most cultures tend to be more likely to express their emotions openly, whereas boys are often discouraged from being emotionally transparent. What are your familial and cultural expectations when it comes to emotional expression, and will they be upheld in the context of a cancer diagnosis?
Positive outcomes may also emerge.
• Parental cancer does not prevent children from experiencing positive emotions; many children continue to function well and are incredibly resilient despite the challenging circumstances. Open communication, attempts at retaining routines and fun traditions that were practiced prior to diagnosis can all contribute to a child’s well being during this trying time.
• Bonds may become closer and tighter between family members. The cancer journey isn’t just an individual phenomenon, but a collective one for families who have been through the peaks and valleys of diagnosis, treatment, remission, and relapse.
However old your children, and however progressed your cancer diagnosis, social support in the form of trusted friends, accepting family members, and sensitive healthcare providers is crucial. Parents rely on help even in the best of situations, and in the case when cancer makes its appearance, these supports can tremendously buoy parents in the context of concrete matters (e.g., school pick-ups and dinner drop-offs) and certainly with the philosophical and emotional ones too.
Dhara Thakar Meghani reminds you there are no taboos or stigmas against asking for a little more help. Contact her anytime at gethelp@southasianparent.com and in the meantime, here are some excellent suggestions on how to start the conversation with a child about your diagnosis
Notes:
¹Billhult, A. & Segesten, K. (2003). Strength of motherhood: Nonrecurrent breast cancer as experienced by mothers with dependent children. Scandinavian Journal of Caring Sciences, 17, 122-128.
²Karbani, G. et al. (2011). Culture, attitude, and knowledge about breast cancer and preventative measures: A qualitative study of South Asian breast cancer patients in the UK. Asian Pacific Journal of Cancer Prevention, 12, 1619-1626.
³Davey, M.P., Tubbs, C.Y., Kissil, K. & Nino, A. (2011). ‘We are survivors too’: African American youths’ experiences of coping with parental breast cancer. Psycho-Oncology, 20, 77-87.
4Gazendam-Donofrio, S.M. et al (2011). Adolescents’ emotional reactions to parental cancer: Effect on emotional and behavioral problems. Journal of Pediatric Psychology, 36(3), 346-359.
Image from My Mum has Breast Cancer
