How Do Families Deal With Uncertainty?

Dealing with the unknown can be the hardest part of cancer and its treatment. Your natural desire is to tell your children that everything will be fine. But you really can’t do that until some time has passed. Because cancer can recur (come back) or grow in another part of the body (metastasize), you may have to wait quite a while after treatment to know what to expect in the future. Young children might not understand this. Children tend to see things just as they are. If your treatment is finished and you look good again, they will probably think that the illness is over.

You may find that you have trouble relaxing and moving on after treatment. You may feel as if you need to wait until you know for sure that the cancer is most likely gone for good. Everyone hopes that the end of treatment will be the end of cancer. And you probably want everyone to feel hopeful and get on with life. Be honest about your feelings and tell your kids positive things that are true. For instance, tell your children that you are relieved to have treatment behind you, or you’re anxious for your hair to grow back, or you’re glad that you won’t have to be away from them as much now that treatment is done. You can let them know that if the cancer does come back, treatment will start again, but for now you’d just like try to enjoy the present. If you would like to learn more about dealing with your uncertainty after treatment, please see Living With Uncertainty: The Fear of Cancer Recurrence.

For most young children, this kind of open, positive talk is all they need to begin putting the cancer behind them, especially when you are looking and feeling better. Still, some children worry more than others and may need more talks with you. If you think your child is worrying a lot or seems to be afraid a lot, you might want to talk with a mental health expert who works with children. Teens can be very challenging, since they may avoid talking openly about their fears or concerns. Just as parents try to protect their children, children may not talk about what frightens them because they don’t want to upset the parent. Sometimes it’s easier for your children to discuss their fears with someone outside the family.

Children fear the worst and want to be prepared for it.

Even though they may not ask, children will wonder who’ll take care of them if a parent dies. But people newly diagnosed with cancer may not have a plan in place for what will happen to the kids if they should die. It’s important to make those arrangements and let your children know about them.

If you don’t have relatives or friends who are logical choices as caregivers, there are social service agencies that can help find possible caregivers. This is a painful issue to think about when you learn you have cancer, but it’s something that must be done. It’s one way you can be sure that your children will always be cared for. If your children are older, tell them that they may have some input about who would become their caregiver.

After you have a plan, you may want help to come up with a way to bring this up with your younger children, and decide if they are old enough to understand it. Your child’s treatment team usually has someone who can help you plan this talk. Most school age children (6 or 7 years and older) are able to understand that a having a back-up plan means that you are thinking of their well-being. Talking to your child about this is even more crucial if the child has only one parent. The child knows that you provide all or most of their care, and may not know who would do it if you weren’t around. Again, what the child imagines may be much worse than reality.

This is a tough talk to have with your child, and you may have to rehearse a bit before you can do it without getting very emotional yourself. When you are ready, give yourself some uninterrupted quiet time with your child. You can open the subject by saying that you know that children often worry about what would happen to them if a parent couldn’t take care of them, or if their parent died. This lets the child know that you won’t be shocked or upset with them if they ask questions. You can see how the child responds to this statement before you explain your back-up plans.

In a divorced family, if the parent who left the home is the one who is ill, the child may feel less connected to that parent, and unable to be as involved with the sick parent. Everyone should still make an effort to keep the child involved with the parent who is ill, for both the child’s and parent’s sake.

Is it harder for teens to deal with a parent’s cancer?

Teenagers can be challenging to their families even when parents are healthy. The task for this age group is to separate from parents and begin to define themselves as individuals. Watching teens develop can be a process tinged with worry as they test adult ideas and behaviors. They often move back and forth between the security of childhood and the world of adults. When cancer comes up in the middle of this, family routines change and teens feel that life no longer revolves around them and their activities.

Cancer means that, at least for a period of time, you will be less available to your children and have less time with them. Other people may be helping out and you may not feel as connected to your kids as you were before. Your energy is divided among your family, your job (if you’re still working), and the physical and emotional demands of cancer treatment.

Teens can help a lot during these times because they are grown up enough to take on some of the household tasks. But it’s hard to decide what they can do and balance what you need from them with their school and social life. Try to gauge how much you are depending on your child and recognize when this begins to feel like a burden or starts to overwhelm your teen. Because teenagers can clam up and try to protect you from worry, they might not tell you if things are becoming too stressful. They may feel resentful, angry, and confused about what’s happening. They may also be afraid that the treatment will not work.

Teens still need to invest time and energy in their schoolwork and maintain their relationships with friends. Staying in contact with friends may not seem like a priority in light of what the parent is going through, but these relationships are very important and can offer your child a much-needed outlet. Ask your teens how their friends reacted to your diagnosis. Unless they’ve had cancer in their families, their friends may not know what to say or do. Teens may describe the same sort of withdrawal by their friends that you have felt with some of your friends. Your teen’s friends may ask questions that are hard to answer. If this is the case, you might be able to suggest ways that your child can handle these situations, so that he or she can maintain peer relationships without too much attention to your illness.

Because teens are so aware of their own bodies, they may worry that they might get sick too. They may worry about catching cancer—like catching a cold—or inheriting the cancer. Teenage daughters of women with breast cancer may especially worry about having breast cancer. It’s a good idea to discuss these concerns with your oncologist so you can give your teenager accurate information.

If your teenagers seem worried or unable to share their concerns with you, check with your hospital about a group for teens whose parents are in treatment. Or there may be a counselor with special expertise in helping adolescents deal with illness in their families. Try to find your teen the help they need to get through this time.

Last Medical Review: 08/07/2012
Last Revised: 08/07/2012
Source: American Cancer Society