All parents seem to feel shock, disbelief, fear, guilt, sadness, and anger. But in this situation, just about any feelings could be considered normal for parents and other family members.

Shock

No one is ever prepared to hear that their child has a life-threatening illness. At first, depending on their knowledge or personal experience with cancer, they may fear that their child is going to suffer and perhaps die. At the very least, they know their family will go through major changes and upheaval. They often describe feeling numb or as if they have been hit over the head. Parents also report feeling confused or being unable to hear, remember, or think clearly when the doctor explains their child's diagnosis or treatment plan. This numbness allows them to slowly get used to the painful feelings that tear through them. It gives parents time to gradually absorb and face these painful emotions and hard decisions.

What can help parents get through the shock?

• Know that it is a normal reaction.

• Seek comfort from one another or from other family members or friends.

• Talk with the team social worker or nurse about their feelings.

• Ask a family member or friend to take notes during doctor visits.

• Record important meetings with doctors (with the doctor's permission, of course), then go back over it with others.

• Ask staff to repeat information.

• Remember that feelings of shock will pass with time.

Disbelief and denial

When parents are first told their child has cancer, it just seems too horrible to believe. Their child may not seem sick enough, or look sick enough, to have such a serious disease. They may question whether the lab could have made a mistake or if the test results are really those of another child. They may wish to check on the reputation of the staff or medical center.

If a diagnosis is hard to make, they may wonder if the medical staff knows as much as they should. They may decide to get a second opinion. The disbelief or denial that strikes at first can help buffer painful feelings. It is also a way for parents to gain time to adjust to the reality of their child's diagnosis and to be sure that their child will get the best treatment. Denial is not a problem unless it gets in the way of timely treatment.

What can help parents get through the disbelief stage?

• Get answers to all your questions and resolve your doubts.

• Call the American Cancer Society or other information resources for more information about diagnosis and treatment.

• Check on the reputation of the medical center and qualifications of the treatment team.

• Ask for help in getting a second opinion.

Fear and anxiety

It is normal to feel anxious and fearful when facing unfamiliar events and outcomes that are out of our control. And nearly everyone has a fear of cancer. A family's only close encounter with cancer may have been with an older family member (when it might have seemed easier to accept or understand). There may be stories about the problems other family members or friends had with chemotherapy or radiation treatments, or beliefs that having cancer is a death sentence. If a child is diagnosed in a major medical center, parents may believe rumors they have heard that doctors in big hospitals "experiment" on patients.

Since doctors cannot guarantee exactly how each person will respond to cancer treatment, fear of the death of a child or teen is real. Trusting the knowledge and skill of others to protect the life of a much-loved child is frightening. Protecting the child is the normally the parent's job. Now a parent must trust others to take care of their children. That's hard to do. Also, facing major changes in daily life is upsetting, and parents worry that they may not be up to all the tasks that will be asked of them. They may also be worried about their child getting through all the needed treatment. They may be concerned about how treatment will affect their child's body and self-esteem. Fear of intensive treatment, of an uncertain future, and of the unknown are all normal.

What can help parents cope with fear?

• Get accurate information.

• Develop trust in treatment team members.

• Openly discuss fear and anxiety and get help from cancer treatment team members.

• Use or learn strategies to reduce anxiety or tension.

• Listen to how other patients and parents have coped.

• Take as much control as possible of everyday events and decisions.

• Accept that some things cannot be controlled.

• Finding strength in religious beliefs and personal spirituality.

Guilt

Questions of guilt come up soon after parents accept that their child really does have cancer. Parents have the major task of protecting their child from danger. They may question what they might have done to contribute to their child having this life-threatening disease. Could this be "payback" for past mistakes or the result of drug or alcohol abuse? Has their smoking caused the cancer? Mothers sometimes wonder if something they did or failed to do during pregnancy may have made a difference. Those with cancer in their families might think that one parent or the other has "bad" genes. They may question the safety of where they live, their water supply, or wonder about toxins in the environment or in their home. They may wonder whether something related to their job might have caused the cancer.

Parents also voice guilt about not paying enough attention to their child's symptoms. They worry that they did not get to the doctor quickly enough, or that they did not demand a specialist see their child when the symptoms didn't go away. Although it is normal to try to understand the causes of a problem, the fact is that right now no one knows exactly what causes most cancers. Parents are not at fault for their child's cancer. Most children are diagnosed and begin treatment quickly. If you feel guilty, talk to someone on the cancer treatment team about your concerns. It is important not to let guilty feelings distract you from the many tasks you face when your child has cancer.

What can help parents deal with guilt?

• Talk with the child's cancer treatment team about feelings of guilt.

• Get answers to your questions about the causes of cancer.

• Make changes to create a healthier home environment if this is a concern.

• Talk with other parents whose children have diagnoses like their child, but who have different backgrounds and experiences.

• Accept that there may never be an answer to the question of what caused the child's cancer.

• Realize that finding a reason for something isn't going to change the fact that it has happened.

Feeling of sadness and depression

Of course you will feel sad when your child is diagnosed with cancer. Every parent has hopes and dreams that their children's lives will be healthy, happy, and carefree. Cancer and its treatment change that dream. Parents will grieve for the loss of some of those hopes. In grieving, they may feel hopeless about their child's recovery. They are also sad when they think about the hard days of treatment that lie ahead. The intensity of their feelings often matches their child's outlook for recovery, but it also reflects their own temperament and personality. One parent may be more naturally optimistic, while another may react to any life problem with more fear of bad outcomes.

Parents may find it hard to eat or sleep at first. They may not have the energy they need for routine daily tasks or for facing all they need to do now that their child has cancer. Parents often report feeling overwhelmed by their child's diagnosis. Unfortunately, parents cannot be spared these painful and unpleasant feelings and will have them at times throughout their child's illness.

But parents and families are usually able to adjust to the changes in their lives, even with these painful feelings. They work to find ways to maintain some quality of life for themselves, the rest of their family, and their sick child during this battle with cancer.

What can help parents deal with sadness and depression?

Parents can:

• Find ways to express feelings, such as talking or crying.

• Ask for support from each other, family, or friends.

• Use support from social workers, counselors, nurses, psychologists, doctors.

• Seek spiritual support, get guidance from pastors, rabbis, or other clergy; use prayer and other spiritual practices.

• Take care of themselves: eat right, get rest, and care about appearance.

• Attend to any personal needs for medicines or help with mental or physical health.

Anger

The fact that cancer threatens the life of an innocent child often makes parents angry at the cruel and random injustice of life. When someone we love is attacked, even by illness, it is easy to want to blame someone, or ask "Why me?" or "Why us?" This anger is sometimes directed at the doctors who made the diagnosis or who explained the difficult treatment. For others, God is the object of rage as parents question a world in which children become ill and suffer and die. Parents also feel upset at the experiences they know their child will face, including the diagnostic tests and invasive procedures.

The daily frustrations of dealing with a large and complex health care system, strange places, and many different care providers can also be sources of anger. Parents may resent one another over past or current issues that now affect their child's treatment. Anger also may be directed at family or friends who make thoughtless remarks or who are too busy to provide support.

Parents are sometimes surprised and guilt-ridden to notice that they are even angry with the child whose illness is causing so many problems for the family or who is not cooperating with the doctors and nurses. Some parents hide their anger or even deny that they feel that way since they believe that such feelings are "not nice". Others express their anger in explosive and hostile ways and take it out on other people. Sometimes other children in the family become convenient targets for that anger. Since parents and the care providers must work together to help the child or teen deal with the cancer and its treatment, it is important to find healthy ways to express anger at the unfairness of it all. It is also important to find healthy ways to resolve valid complaints.

What can help parents deal with anger?

Parents can:

• Accept that anger is a normal part of this process.

• Understand the root of the anger in each situation.

• Express anger effectively.

• Find solutions when anger is justified.

• Use psychosocial support staff to discuss angry feelings.

• Seek physical release of tension (walking, exercising, or sports).

• Find private space to vent feelings by shouting, screaming, or crying.

• Express feelings by keeping a journal or writing a letter (to keep, not to send).

• Talk with other parents who have dealt with feelings like this.

• Let anger go, accept that there may be no one to blame, and find ways to use the energy to help themselves, the child, and their family.

Go back to Children Diagnosed with Cancer: Dealing with Diagnosis.

Last Medical Review: 06/02/2009
Last Revised: 06/02/2009