Talking to Family and Friends

Honesty and openness can help a lot

Having cancer can change your life and the lives of people close to you. Your "family" might include a spouse and children or it may look entirely different. Your family might not live with you or even live nearby, but they can still help.

Just like you, the people who care about you and rely on you (for love, support, guidance, income, meals, friendship, or wisdom) may have strong feelings about the changes that come with cancer and its treatment. Let these feelings come out and face them together.

Here are some things to plan for and talk about:

Household routines may have to change because of doctor visits or treatment side effects.
Roles and responsibilities may change - others may have to fill in for some things that you cannot do during treatment.
Relationships can get stronger, or they may have setbacks.
People around you may feel anger, sadness, or fear.
Sometimes, living arrangements have to change for a while - perhaps you will go to live with someone else, or someone may move in to help care for you.

Experts suggest that people should be open and honest about cancer and the feelings that come up.

Share information with your spouse or life partner - or perhaps an adult child who lives with you or is very involved in your life. Include him or her in:

visits to the doctor
learning about the cancer and treatment
decision-making

When you talk to friends and people outside your immediate family, help them by letting them know:

when and if you want visits
what specific things they can do to help (offer a list of needs such as meals, chores, rides to the doctor, shopping, or visits and company)
that you don't expect them to say "exactly the right thing"

Learn about many helpful resources, including Web sites that let you set up your own online support system.

Talking to Children

Honesty is especially important when talking to children, even toddlers. The truth, told with love and hope, is much better than leaving a child to imagine the very worst.

Speak at the level right for your child's age group and use simple words that your child can understand:
   doctor not oncologist
   medicine not interferons
   sickness or skin cancer not melanoma or malignancy

Encourage children to talk about their feelings and ask questions. Even if a child asks the most difficult question of all - "Are you going to die?" - you can say honestly: "The doctors are doing all they can to help me. Many people live a very long time with cancer. I'm going to do everything I can to get better. Someone will always take care of you."

Young children are especially concerned about how their needs will be met. Who will make them meals? Take them to school? Help with homework? You can reassure your child by making a plan and explaining how their daily routines and needs will be looked after. Also explain how things may change, so children are not surprised, confused, or disappointed.

Talk about the facts with love and hopefulness, especially when dealing with children and teens.

Be sure that children understand:

Nothing the child did, thought about, or said caused the cancer.
Cancer is not contagious; it does not spread from one family member to others.
Many people with cancer live a long time.
Doctors have many new ways to treat cancer.
Any upset, angry, or scared feelings about the cancer are OK to have and OK to talk about.
Things in the family may change during the year of treatment and grownups may act differently because they are worried.
Good things for children to do include:

going to school, sports, and other regular activities
helping around the house
drawing pictures
talking to grownups they like and trust (such as scout leaders, teachers, favorite family members, and spiritual advisors)

Children may "act out" (misbehaving, fighting with siblings, letting grades slip at school) in response to their feelings about your illness. If this happens, try to encourage the child to talk about their feelings. Look for ways to spend time with children and continue fun activities during your treatment.

Ask the hospital social worker or nurse on your health care team if they have books and other resources to help children deal with their feelings about cancer in the family. If problems continue, think about getting some outside help. Talk to the child's teacher, the pediatrician, or a spiritual advisor you know. You can also look for a social worker, child psychologist, or psychiatrist.

Glossary

Cancer: A general term for more than 100 different diseases that involve the uncontrolled increase of abnormal new cells. These cells form tumors that can destroy surrounding tissue and spread throughout the body.
Interferons: Proteins produced naturally by white blood cells that stimulate the growth of certain disease-fighting blood cells in the immune system. Manufactured forms of interferons are used in cancer immunotherapy to improve the body's natural response to disease.
Malignant: Cancerous; cells that can invade and destroy nearby tissue and spread to other parts of the body.
Melanoma: A highly malignant type of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole.
Oncologist: A physician who specializes in treating cancer.
Psychiatrist: A medical doctor who specializes in the prevention, diagnosis, and treatment of mental, emotional, and behavioral disorders.
Psychologist: A specialist who can talk with patients and their families about emotional and personal matters, and can help them make decisions.