As you may recall, since the time of my diagnosis, I have talked openly with many adults and children about my breast cancer diagnosis and treatment. While the personal nature of this circumstance made the conversations emotionally challenging, my professional experience as an adult and a special educator for children have given me both the tools and confidence to ensure that I inform people of all ages, especially children with the developmentally appropriate answers.
When I was home and recovering, I often revisited a lot of the original questions as well as some new ones. For example, my friend’s daughter asked, “Do you think that your cancer will come back?” GULP.
So, I thought I’d take this opportunity to share with you her questions and my answers. These questions tend to be typical of most children affected by a cancer diagnosis.
· What is cancer?
· The body is made up of cells. Cells make our bodies work. They are so tiny that you need a microscope to see them.
· Cancer cells don’t look or act like normal cells. They don’t allow our normal, healthy cells to work properly. They can grow very fast and spread. Cancer cells may group together to form a tumor.
· There are many different types of cancer. Cancer can grow anywhere in the body.
· My friend’s daughter wanted to know if a person could get cancer in their eyes, on their skin and in their legs.
· There is an iPad application called 3D4medical that has an image of a breast cancer cell. It is an ominous looking beast of a cell. This was really helpful for children to envision what was in my body and to then understand the sense of urgency (& drastic measures!) to get it out.
· Is cancer contagious?
· Cancer is not something that you can catch from someone else like you can a cold or the flu.
· You can be close to the person who has cancer and not worry about catching it.
· Did I cause cancer?
· No. Nothing that anyone does, says or thinks can cause cancer in someone else. Ever.
· Though they will rarely ask the question out loud, YES, children wonder whether they caused cancer. It’s sad, but true. If this question isn’t addressed, children can carry this fear (that they had some hand in causing cancer) with them into adulthood.
· Why do people get cancer?
· Most of the time, no one knows why someone gets cancer. It’s hard to not have all of the answers, but the truth is we don’t.
· What causes cancer?
· There is still a lot we don’t know about how cancer begins and what causes it.
· Sometimes cancer can be caused by some chemicals, air pollution (smoke), certain viruses and other things inside and outside the body.
· Do children get cancer?
· Yes, unfortunately children do get cancer. It is rare for children to get cancer. More adults get cancer than children.
· How is cancer treated?
· Different people have different treatments for cancer.
· Sometimes people have an operation to take the cancer out of the body.
· Sometimes people take medicine called chemotherapy. It uses special kinds of chemicals to destroy cancer cells. It is usually given through a needle inserted into a vein.
· Sometimes people have radiation therapy to help get rid of cancer cells. It is done with a special machine that is made just for cancer treatment. The radiation is given only to the area of the body where the cancer is.
· I happened to need all three of these treatments.
· What are “side effects”?
· Side effects of cancer treatment happen because the chemotherapy damages healthy cells as well as killing the cancer cells.
· You will be able to see some of the side effects such as: my hair falling out, scars from my surgery, mouth sores and weight loss.
· Other side effects can’t be seen such as: feeling tired, feeling sick to my stomach, wanting to rest more, not being able to play.
· After I’m done with all of my treatments, these things will go away.
· Are you going to die?
· We are all going to die sometime. I am working very hard with my doctors to make sure that I don’t die from breast cancer.
· Children’s questions and concerns about dying may come up any time after they hear the news about their parent’s cancer diagnosis.
· All children, except very young ones, wonder if cancer means you are going to die, even if they don’t ask the question out loud. They may be afraid to ask you about death and dying if you haven’t been able to talk about it.
· If adults change the subject, or answer them with silence, they will sense that it is not acceptable to talk with you about death and therefore internalize the issue and come up with inaccurate answers on their own. Remember: a child’s imagination about cancer (& its treatment) is worse than the reality.
· When will you feel better?
· Feeling better will take a long time because I have been very sick. I’ll still be tired, but little by little I’ll be able to do more and more. In fact, every day I feel a little better, which is a Shining Moment. I will feel back to my old self in a few months.
· Will the breast cancer come back?
· I hope that it won’t. I am working very hard with my doctors to make sure that the cancer does not come back.
I feel compelled to reiterate how important it is to be honest with children. Having difficult discussions with them builds a sense of trust and inclusion that children so desperately need when someone in the family is diagnosed with and treated for cancer.
By the way, children are likely to find out anyway because they often hear adults talking about subjects not meant for them even when the child is busy and doesn’t seem to be listening. When children overhear these conversations, it confirms that adults are keeping things from them. This can fuel the potential for thinking that they’ve done or not done something to cause the cancer.
Another reason to process information about cancer with parents is that children learn about cancer from other sources, e.g., school, television, the Internet, their classmates, and listening to other people talk. Some of this information is correct but a lot of it is not. Not knowing what is really going on or how to cope with information about cancer can be terrifying to a child.
So, doesn’t it just make more sense to hear the information at home?
Talking about cancer does not have to be traumatic. If anything, NOT talking about it is ultimately more traumatic. In the past, misplaced embarrassment about cancer has allowed misunderstandings and fears about the illness to grow. Remember: there are always professionals who are willing and able to help when parents feel overwhelmed by talking with children (Shining Moment). Engaging professional help when coping with breast cancer or any kind of cancer for that matter is a sign of strength and resourcefulness.