How do families deal with uncertainty after treatment?

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

You might have trouble relaxing and moving on after treatment. You might feel as if you need to wait until you know that the cancer is most likely gone for good. Everyone hopes that the end of treatment will be the end of cancer – it’s normal to want to put it behind you and get on with life. Be honest about your feelings and only tell your kids things that you know are true. For instance, tell them that you’re 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, please see Living With Uncertainty: The Fear of Cancer Recurrence.

For most young children, talking about the end of treatment is all they need to begin putting the cancer behind them, especially when you’re looking and feeling better. Still, some children worry more than others and might need more support. 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 a lot of parents don’t plan for what will happen to their kids if they 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 very painful issue to deal with on top of the 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 – no matter what happens. If your children are older, you might want to get their input on who would become their caregiver.

After you have a plan, you may want help finding a way to bring this up with your younger children. 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 simply means that you’re thinking of their well-being. Talking to your child about this is even more crucial if the child has only one parent. Your child knows that you provide all or most of their care, and might not know who would do it if you weren’t around. Again, what the child imagines might happen could be much worse than reality.

This is a tough talk to have, and you may have to rehearse a bit before you can do it without getting very emotional yourself. When you’re 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.

Helping teens deal with a parent’s cancer

Teens can be challenging even when parents are healthy. The key task for this age group is to separate from parents and begin to define themselves as individuals. Teens develop by testing 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 may struggle with the stark reality that life doesn’t revolve around them and their activities.

Cancer means that you’ll be less available to your children and have less time with them, at least while you’re getting treatment. Other people may be helping out more, and you may not feel as connected to your kids as you were before. Your energy is divided among your family, your job (in some cases), 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 often hard to decide what they should do, and balance what you need from them with their school and social life. Try to gauge how much you’re depending on your child so that you can recognize when this begins to feel like a burden or starts to overwhelm your teen. Because teenagers may try to protect you from worry, they might not tell you if things are becoming too stressful. But at the same time, they may feel resentful, angry, and confused about what’s happening. They may also be afraid that your treatment won’t 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 for your teen to handle these situations, so that they can maintain peer relationships without too much focus your illness.

Because teens are so aware of their own bodies, they might worry that they could 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 teens seem worried or unable to share their concerns with you, see if your hospital has a group for teens whose parents are in treatment. Or there may be a counselor with special skills in helping adolescents deal with illness in their families. Try to find your teen the help they need to get through this time.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Revised: April 27, 2015

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