ACS :: Telling Your Family and Friends

People who have been told they have cancer may wonder who to tell and how they should tell them. They often feel pressured to share their diagnosis, but most people are able to wait until they are ready. There is no set time when people begin to feel comfortable enough to discuss their cancer with others. It is different for each person.

Delores, cancer survivor: "Telling friends and family was really hard. Since my mother had died from breast cancer it felt like I was saying, 'Here we go again.' My sister-in-law had died from lung cancer the same month I was diagnosed with breast cancer. This made it hard to tell my husband's family that cancer had struck again. I was sad for my husband."

If you have been diagnosed with cancer, only you know the right time and the right words to use to tell your family and friends. You may find that sharing the news of what you are facing leads you to people who become key sources of support and encouragement. Sharing this experience with loved ones gives them a chance to offer their support. Your honesty and openness can help open new lines of communication and make relationships stronger and better.

It's very hard to hide a diagnosis of cancer. Friends and family might suspect you have cancer when they become aware of symptoms or different types of tests you have had. Often when people do not know what's going on, they imagine the worst possible situation. But when you do share the news, they may still be stunned and not know how to react or what to say.

Before you talk to others about your illness, think about your own feelings, your reasons for telling others, and what you expect of them. Be ready for a wide range of reactions. When you share information about your diagnosis, your family and friends will have many different feelings, too. They also need support at this time. They might be able to express their feelings to you, or they may try to hide them.

Delores, cancer survivor: "The first time you say, 'I have cancer' out loud is the most difficult. The more you say it, the easier it gets to say the words. The more I talked about my diagnosis of breast cancer, the easier it was for me to accept what I was going through. Sometimes I thought it was ironic that I felt like I was the one who was cheering up the recipients of my news."

Each person reacts and copes differently when they learn someone they care about has been diagnosed with cancer. You may find that family members and friends are ready to talk about the cancer before you are. But no one should rush you. Simply thank them for their concern, and tell them you are not ready to talk about it yet.

Some family members or friends may feel uncomfortable talking about cancer. You may notice changes in how people act around you after you tell them the news. People may feel uncomfortable because they do not know what to say or how to act. This is new for you and for them, too. Not everyone has faced cancer before, and even those who have might not know anything about the kind of cancer you have or its treatment. Some friends may act awkward and distant, while others will continue to be themselves. Some may even seem to be too nosey or overly helpful. It will take time for all of you to adjust to cancer and get more comfortable talking about it. With time most people are able to share understanding, compassion, and friendship. Giving your loved ones information and a chance to ask questions can be helpful as you work through this time together.

If someone's reaction disturbs you, try to talk with them about it. Explain exactly what type of response is most helpful to you. Don't be afraid to tell people about what's happening with you. Teach them. Explain what kind of cancer you have and the treatments you'll need. Tell them that cancer is not a death sentence, nor is it something they can "catch." The best thing you can do for each other is to be honest about your feelings. People often have fears about the future. Once these feelings are shared, most people find it easier to talk about hopes and plans for the future.

Cheng, cancer survivor: "I simply told my family this was not going to be a deathbed watch. I was in this for the fight no matter what and expected their full support and understanding. I feel their active involvement and full inclusion in what was going on was what helped my family cope with the experience."

After sharing the news of your diagnosis, family and friends may offer practical help such as helping out with household chores, cooking, child care, or shopping. Friends might call to see how you are and ask that you let them know if there is anything they can do to help. Try to take them up on these offers if you could use some help--they are asking for a job to do, and for direction. But they need to know how best to help. Some patients keep a list of things they need help with by the telephone. Then when someone offers, they can tell them exactly what they need.

If you enjoyed walking or hobbies with friends before your cancer diagnosis, remind your friends that you still enjoy those activities. But don't be afraid to tell them at times when you don't feel up to talking or other activities. If you want them to ask again later, tell them that, and ask them to keep inviting you. A lot of people will be happy to do that for you. Let them know it feels good to be asked -- even on the days you’re not up to it.

Marisol, cancer survivor: "I was in a daze a lot of the time. Just dealing with the possibility of my own death was a lot, so I relied on friends to give people updates and concentrated on my immediate family."

Judith, caregiver: "I wish I had been more open with my children instead of trying to protect them. I think I could have prevented some of the acting out behaviors that I saw. I think they needed to be more involved to help both themselves and me."

Children and teens need to understand and be involved based on their age and coping skills. Therefore talking with them about cancer is very important. By doing so, children learn that their families are there for support and they can count on their families to be honest with them. Children should be encouraged to talk about their feelings. Some parents who tried to spare their children from knowing the truth later regretted not discussing things more openly during the course of the illness.

When families choose to hide information about a cancer diagnosis, children may still pick up on the tension and stress. As a result, they may suspect something is being hidden from them. Children may listen in on adult conversations to get information. Or they may just hear bits and pieces, or things that they were not intended to hear. They may not understand what they hear, and just know that something is wrong.

Wendy experienced cancer in the family as a child: "My dad did not want to tell my older sister or me that he had cancer. Even though I didn't know he had cancer, I definitely noticed the changes in our house. I remember he had blue and purple marks on his neck and chest (for radiation treatments) and a catheter in his chest. His skin was pale, his hair fell out, and his usual round belly disappeared. My mom and I made a lot of trips to our local pharmacy and it seemed like he was always taking medicine."

It is normal for children to see the world only as it relates to them. And it is common for children to think something they said or did caused the cancer. Be aware of this and talk about it with the child when he or she learns about cancer in a loved one.

Cancer is usually not something children understand or have experienced. They tend to understand concrete information and make broad generalizations. So children may not realize there are many types of cancer, that each person's cancer is different, and that having cancer does not mean the person will soon die. They get information and ideas from other children and what they see in everyday life, including what they see on television. Without the right information, children may fill the gaps with their imagination. Many times what they imagine is far worse than reality.

Parents often struggle with what to tell their children when they are diagnosed with cancer. How much they need to know and can handle depend on the child's age and maturity level. Give children a small amount of information at a time, in words they can understand. Then give them time to take in the information and a chance to ask questions. Ask them if they have heard any words that they don't understand or find scary. Listen to their concerns. Help them express their feelings and reassure them of your love. It is often easier for children to show their feelings using activities, such as puppets or painting. Older children might prefer writing poetry or drawing.

Peter, caregiver for his wife: "Telling your children is the hardest part. It is important that you think through what you're going to say--the words and emotions will have a significant impact on how they'll react. The calmer you are, the less frightened they will be. My wife and I told our kids (our son was 15 and our daughter was 11) at the end of a Christmas ski vacation.

By that time, we had made arrangements to get a second opinion at a top cancer center, had dealt with necessary legal papers, and had talked with our closest friends. We calmly told the kids, in easy to understand words, what the first doctors had told us and that in a few days we were going to Texas for more tests. As calm as we were, the revelation of cancer was a huge shock to our kids and was met with fear and tears. It is essential that kids are reassured that their parents are going to do everything possible in the way of treatment, that they are still deeply loved and always will be, and if necessary, assured none of this is their fault."

Adults can tell children what's going on in just a few sentences. "My doctor told me I am sick with cancer. The doctor is going to do what he/she can to make me better. I'll have to go to the doctor a lot to get a special kind of medicine so I might not be able to spend as much time with you. Sometimes the medicine might make me feel bad so I might not feel like playing much, but I'll still be here. I want you to know how much I love you." If the person with cancer does not feel comfortable telling a child about their cancer, a close relative or friend may be able to explain things to the child. This often depends on the relationship of the person with cancer to the child (for example aunt, grandparent, or parent).

Children might have problems coping with cancer in a parent or another family member for many reasons. The person with cancer might be getting treatment at a hospital far away from home, or they may be recovering at home and be uncomfortable or look different. Children may also be asked to help out more or be on their best behavior, especially if people other than their parents are helping to care for them. They may question or even resent any loss of attention.

If friends or other family members want to help out, getting your children to school or to other activities when you can't is a great way to do so. This can help keep your children's routines as normal as possible.

Younger children may focus on death. Older children who are becoming more independent must deal with the changes taking place in their everyday life, and also the possibility of long-term separation or even the death of someone they love.

Although it is important to try and maintain a normal routine and lifestyle for children, they also need to be included as part of a family that is fighting cancer. Children may ask to see where treatment will be given and may ask questions about any changes they notice in the person.

Peter, caregiver for his wife: "My wife and I tried to help our kids by trying to keep as normal a routine as possible. When you have new information or when they ask questions, discuss the illness in language that they can understand. Frequently reassure them of your love and that they will always be loved and cared for. Involve them in helpful activities, like selecting a wig! Perhaps most important, enroll the kids in a local support group for kids whose parents have cancer. The sharing of experiences with the help of professionals worked wonders in helping our kids cope."

Many children try to act like adults so life will be easier for their parents. A support group for children might give them a safe place to air their frustrations. Hospital social workers, nurses, psychologists, clergy members, and school counselors are good resources to ask about support groups in your area.

For more information about how to talk with children about cancer and a list of suggested reading materials for parents and children, see the "Additional resources" section at the end of this document.

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