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Telling Your Family and Friends

909704_53417903When a cancer diagnosis is received, the question arises about who to tell and when to tell. There is no absolute rule; instead it is a personal decision that involves many factors. We do know that people who share the news tend to get support from those with whom they share the information, and these people can become key sources of support and encouragement through the cancer journey.

Hiding a diagnosis of cancer can become more difficult for a patient and the few family such as a spouse or partner who may know. Energy level and physical changes may become apparent to those interacting with the patient that may make the secret harder to keep. Also, feeling the need to keep things a secret may place unwanted stress in one’s life while trying to focus on treatments. Others may express their feelings and concerns, or they may try to hide their emotions depending on the relationship. For the spouse or partner, it makes it difficult because they cannot share the concerns with others thus putting additional stressor on them.

When young children are in the family, there is sometimes a tendency to not tell them, but typically this secrecy can ultimately add to their stress levels as they tend to have good radar about when something is wrong in a family. Children can sometimes create worse fantasies about what is happening and not being shared, than the truth.

People’s reactions differ when hearing that someone they care about now has cancer. There is often a wide range of reactions to be expected. Some need time to adjust because they feel uncomfortable with not knowing what to say or how to act. Others may be too nosey or overly helpful. It takes time for everybody involved adjusting to cancer. But it is most common for people to share compassion and encouraging words after hearing about the diagnosis. That being said, many patients have a list of the 10 worst things someone said to them. Worrying what others say should not create pressure to keep the diagnosis a secret. Most people adjust better to the life altering changes that cancer can bring when they have others with whom to talk to and to share their worries, concerns and needs.

Cancer patients may find family and friends will offer practical help, such as household chores, cooking, child care, etc. Getting phone calls from people to check up on them or to ask how they can help should be expected. Some patients keep a list of tasks that they may need help with so that they are prepared to tell others exactly what needs attention at the moment. Some support networks organize friends to deliver meals, run errands and if children are involved offer play dates, sleepovers, and transportation. Many people decide to use a web-based blog such as CaringBridge.com to provide updates only to family and friends that are chosen to receive updates. This helps to manage the flow of information over time.

Children and teens can be more sensitive to the information because of their understanding of cancer. Based on their age and skills, their knowledge of living with cancer may be upsetting because of the fear of losing their parent. It is best to encourage children to talk about their feelings. If words are hard for them to express, then drawing or writing poetry may reveal concerns that need to be discussed. By sharing the situation with loved ones, cancer patients can open new lines of communication and make relationships better and stronger.

Give kids small amounts of information at a time to avoid overwhelming them. The information should be age appropriate and usually needs to include information about who will care for them when their parent is ill. Take the time to answer any questions they may have, making sure to encourage them to come back for information as needed. By having an open dialog where children and teens feel that they are being heard, you allow them to feel as though they are a part of the journey and are not being excluded. Be sure to let children know that they did nothing to cause the cancer. If speaking directly with your child is difficult, consider having a trusted relative or friend explain the situation for you.

Try to keep the child’s life as normal as possible during this time of change. Keep them involved in activities that they enjoy. Feel free to ask your family and friends for help with transportation. This will help in avoiding potential resentment for any loss of attention. They may pick up on tension and stress within the home, but there are support services for kids whose parents have cancer that are meant to provide a welcoming environment for them to discuss their feelings. Professionals can be very helpful to children whose parents have cancer.

Patients receiving their oncology care at UCLA can avail themselves of the opportunity to consult with Simms/Mann UCLA Center for Integrative Oncology trained clinical staff regarding these important concerns. Our clinicians, many of whom have expertise in working with families, can meet with patients to help them prepare to talk to their children (whether toddlers to college age). These consultations can help patients find developmentally appropriate language to answer questions and respond to their children’s needs in ways that can promote better communication throughout the course of treatment.

For more information on children and parent counseling available at the Simms/Mann UCLA Center, go to: https://www.simmsmanncenter.ucla.edu/index.php/services/children-parents/

To read the American Cancer Society’s recommendations on telling family and friends about one’s cancer diagnosis, go to: http://ow.ly/JZCyo

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