ACS :: For Spouses, Family, and Friends

Sometimes family members are the first to learn of a loved one's cancer diagnosis. How does a family decide if they should or when they should tell the person who has the cancer? Are some people too emotionally fragile, too young, or too old to know? Most people can handle the news that they have cancer, but each person needs time to adjust and figure out what the diagnosis means to them.

If you are a family member trying to decide if you should tell a loved one they have cancer, consider this: you may think you are sparing them bad news, but they probably will sense something is wrong, especially if they start having a lot of tests done and/or don't feel well. The person with cancer may resent it when they find out family members kept the diagnosis a secret. Although you may think you are protecting them, that person might see this as dishonest.

When people with cancer are not told about their diagnosis, they are unable to make important decisions about their treatment and their life. There may be things they want to do, personal matters they want to take care of, or legal papers that may need to be updated. Even when a person has a cancer with a good outlook, families still need to discuss decisions about end-of-life care, including advance directives (living will and durable power of attorney for health care).

People usually need time to sort out feelings before they can be expressed and shared in the way they want. During this time, friends and family members may be the targets of their loved one's strong, overwhelming feelings that are being vented. If you are the target of anger and frustration, remember you are not the cause of this anger--you are a trusted person on whom the anger can be let out. Your loved one is angry about the cancer and how it has affected her or his life. Even though family members and friends usually try to respond with love and friendship, it is natural for them to feel their own anger and frustration, and sometimes express it, too.

Friends and families may also have a hard time adjusting to the cancer diagnosis They may have to cope with increased responsibilities while trying to manage many different emotions. On top of this, they want to try to be sensitive to the needs of their loved one who has cancer. If you are close to the person with cancer, simply saying something like, "I'm here when you are ready to talk" will keep the lines of communication open and offer your loved one the chance to share this experience with you. Your presence is also a way to show your support for the person with cancer. Don't be afraid to share your fears and worries with your loved one with cancer. Being honest about these feelings can allow everyone to work through difficult times together.

You may struggle to find the right words to say to someone who has been diagnosed with cancer. Know that there is no right way to act or perfect words to say. Just listening to the person with cancer is often more helpful than anything you can say. Reassuring them of your love and support is one of the most important things you can do. Most people with cancer do not want to face the experience alone and will need support from their family and friends. "I'm here for you" may be the best thing you can say to show your support for someone with cancer.

Keep in mind that not everyone with cancer wants to talk about his or her feelings. They may have other ways to express their emotions, such as writing in a journal, music, art, or yoga. Some people just prefer to keep their feelings private. People with cancer might just want you to help them maintain their normal routine, as much as possible. Just be yourself and continue to do things with them as you would if they didn't have cancer.

A diagnosis of cancer changes a family forever. Figuring out what's for dinner or what your plans are for the weekend is suddenly less important. Family and personal values are questioned and priorities are tested and changed. Unsettled feelings and arguments may resurface during a family's struggle with cancer. Often a family must sort out and revisit old, unresolved feelings before they can start to battle cancer together, as a family unit.

Cancer can cause role changes in the family, too. The head of the household may now be more dependent on other family members. Others may need to work outside the home or work different hours. When family members take on new roles, the way they interact within the family can change. New responsibilities may overwhelm some family members.

Parents might look to their children for support. If the children are old enough, they may be asked to take on more responsibilities within the household. These requests often come when children themselves need support. The behavior of younger children might regress in response to the stress on the family. This may be their way of dealing with cancer and how it has changed their family. Adolescents, who are often rebelling and spending more time with friends, may instead cling to their families for support.

As a friend or family member helping to take care of the patient, you also have needs. Taking care of yourself will allow you to care for others. When your needs are met the patient will also benefit. Overdoing is different from doing. Know your limits and rest when you need to. This rule applies to both caregivers and patients.

Often families find themselves treating the person with cancer like an invalid, even when the person is fully capable of doing for him- or herself. Sometimes people will not want you to help them with things like bathing and dressing. These wishes should be respected if at all possible.

Although the person with cancer may not want to get outside help, friends and family members should look at their own limits and get any help needed. Certified nursing assistants, home health aides, and other resources can help care for the patient. Local churches may be able to help with cooking, shopping, transportation, and general housekeeping. Professional services may also be helpful, but there usually is a fee involved and this is rarely covered by health insurance.

How a family handles cancer is depends a lot on how the family has dealt with problems in the past. Those who are used to communicating openly and sharing feelings are usually able to talk about how cancer is affecting them. Families who solve their problems as individuals instead of a team might have more trouble coping with cancer.

Cancer treatment includes care for the patient and the family, not just the cancer. A mental health professional may already be a part of the cancer care team. If not, talk with the doctor or nurse to learn about other resources that can help you and your family cope with cancer.

People with cancer often say that lack of communication in their families is a problem. Changes in responsibilities can cause resentment and anxiety. Some family members may not feel comfortable openly discussing their feelings. Other family members may avoid the person with cancer because they feel as if they have nothing to offer, don't know how to act, or feel they can do nothing to help make the situation better. These factors can all make families more distant at a time when they need to pull together. Many families may need help with this. Through family counseling, members can be helped to learn to deal with changes within the family and discuss their feelings more comfortably.

Family and friends can find ways to relieve their stress by taking part in activities outside the home. Resources outside the home, such as individual counseling or support groups, can serve as outlets for the frustrations you may be facing within your family.

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