One of the most difficult things about a cancer diagnosis is telling your family. This post contains practical tips for approaching these conversations…
by Hilly Janes
In the past the “c word” was spoken about in hushed tones, if it was mentioned at all. But thanks to medical progress, we understand that cancer is not necessarily a death sentence – survival rates for many types have improved dramatically. And times have changed too, so talking openly about cancer is no longer taboo.
And there is so much to talk about when someone receives a cancer diagnosis. It can trigger a cascade of emotions from shock and anxiety to anger and fear, or even numbness. Plans will be up in the air and while you will become the centre of attention, family members may also experience these feelings. Bottling them up won’t make them go away, while letting them out can reassure and relax everyone.
There is no right or wrong way to talk about cancer and these days families come in all shapes and sizes, but you know your family better than anyone. As well as having cancer, you have a new role – choosing how to keep them informed.
‘Information needs to be managed and organised – who do you tell, what do you tell and when? And your emotions need to be understood and lived with, they too need to be managed and you must work out what are the best ways of getting the emotional support you need’. Live Better With community member (recovering from breast cancer)
Where to start?
If you hear your diagnosis alone, the first person to tell is your partner, closest family member or friend. Make sure you have the facts straight in your head – keeping notes at consultations helps with this. Choose a calm moment and quiet place when you can be alone together and prepare yourself for their reaction. They may be very upset, while you might be thinking ‘Whaaat? Want to try swapping places with me?’ You will need their support however, so try and keep the lines of communication open.
‘I think that we men sometimes struggle with things we can’t control and we tend to try to keep our emotions bottled up, which is very hard to do.’ Community member with prostate cancer
Talking to children
If you have adult children with partners, break the news when they are together – it will save your sons or daughters having to pass on the news, and they will be able to support each other. If they have children of their own, ask them to explain about granny or grandpa.
Adolescents and teenagers
This age group often know more than they let on and won’t thank you for pretending nothing is wrong. They may just want to hear the facts and seek reassurance. Don’t be surprised if they don’t want to talk about it, even if you want to, or if they need to let their hair down more than usual. You may want to tell them before younger siblings or tell your children all at the same time. Boys may find it easier to hear news about mum from their dad or a trusted male relative.
Try to use simple language they will understand, perhaps explaining that you have some lumps and bumps that need to be taken out, but that these aren’t catching and it’s not their fault. Very young children won’t understand, just try and keep their usual routine going.
Macmillan Cancer Cupport has helpful short articles about talking to children here.
Talking to your parents
Telling your own mum and dad that you have cancer will be especially hard. They will want to make everything alright for you as they did when you were a child, but they can’t. Accepting some TLC at the family home may help you all – what one woman with cancer describes as ‘Hotel Parents’.
Extended family: keep some distance
It may be easier to tell extended family members through a group email to conserve your energy, and if you can’t face it yourself, ask your partner or someone close to take this on and manage replies. You can keep everyone updated easily this way, or once they know, you could set up a private WhatsApp or Facebook group. Not sure how to do this? Ask a teenager!
During Treatment: Asking for help
Cancer treatment can leave you feeling unwell, exhausted and depressed. Your loved ones can only watch this happen. ‘What can I do to help?’ will be a common reaction. Explain that you just don’t have the energy to do everything you used to. If you have ‘chemo brain’ and are getting forgetful, ask for help with making shopping lists or reminders. Think of this as a win-win situation.You are getting help and your nearest and dearest will feel less helpless. There’s even an app for that! Jointly, created by Carers UK, lets chosen people share the load, such as:
- Cooking healthy meals
- Dealing with finances
- Child and pet care
- Fielding phone calls
- Arranging visits from friends and family
- Keeping track of your medication
- Keeping track of/chasing up appointments
- Coming to appointments and keeping notes
Don’t push people into roles they aren’t comfortable with. A rubbish cook preparing meals isn’t going to make you feel better!
Saying ‘the wrong thing’
Family members may not be able to deal with bad news and be relentlessly upbeat, trying to shut you down or not tell you things that they think might upset you, when you would rather they had been honest. Remember they may be be nursing you one week, or waving you off to work the next – that’s challenging.
Phsyical changes caused by treatments can really lower your self confidence. If your partner saying you still look great makes you want to thump them, that’s normal! It can a year to recover from treatment, so be kind to yourself. (If you worry about how cancer might affect your sex life, our guide can help.)
‘The truth is . . . I consistently feel flat, no energy and still struggle to be amongst people, despite putting on a brave face.’ Live Better with Cancer Community member, post treatment
Getting outside support
If talking to family members is unbearable – or vice versa – consider talking to someone else. You should have access to a specialist cancer nurse, and there are many support groups and helplines (see below).
‘My wife is a volunteer at Hospice and they have weekly get togethers with coffee, cake and discussion groups which are very enjoyable.’ Live Better community member.
‘How long have you got?’
If the answer is not long, your family will be devastated. Perhaps the best you can do is to find someone to talk to openly about practicalities like instructions for your funeral, what to do with your possessions, taking children shopping for clothes… Nominate a charity they could support through a joint fundraising activity to help them feel positive, after you have gone.
- Macmillan Cancer Support has some helpful information about talking to families. Helpline 0808 808 00 00
- Marie Curie supports people with terminal cancer and has helpful information for families. Helpline 0800 090 2309
- Teeange Cancer Trust Facebook page has short videos where teenagers talk about cancer.
- Near you: find support groups in your area through an internet search, or try Cancer Support UK for telephone groups
- You, Me and the Big C is a BBC podcast in which three women who have had cancer talk openly. Download any of the 30 episodes from BBC iPlayer or the BBC Sounds app.