Question: How can I tell my children about my breast cancer and the changes that will be occurring with my treatment, are there different strategies for each age?
Answer: Women who are diagnosed as having breast cancer may have children of very different ages. A woman who has children who are toddlers, infants or toddlers, likely will go through her breast cancer treatment without her children having any recollection that she had an illness or was away from home for some time for her treatment.
The child who's five or six or seven, we usually ask women to describe her breast cancer and need for treatment in age-appropriate or developmentally appropriate terms. So many patients tell their children Mom has a boo-boo; Mom has a little bump; Mom's going to the doctor, and she's going to get good medicine, and she's going to feel just fine. The small child actually needs nothing more than that kind of information. A child who is seven, eight, preadolescent child, will require somewhat more information.
Some families prefer not to use the word cancer. Some families are really quite direct and say Mom has cancer but there's good news -- the doctors know what to do; I only have to be away from home a couple of days, and then I'm going to be seeing the doctor every week or every three weeks, but the doctor's going to give me medicine to make me well.
The woman who has teenage girls, adolescent or teenage girls, has a different consideration. A girl who is starting to develop sexually, who's starting to develop breasts, may express -- or have and not express -- real concerns about herself. The girl who's thinking I'm getting breasts right now, isn't this wonderful, may be very frightened when Mother comes home and says I need to have a breast removed. Those girls often do very well if they have a chance to see the doctors who are taking care of Mother or often girls of that age like to have a chance at some point to sit down and talk with a nurse or a mental health professional, social worker, psychiatrist, psychologist, about what Mom's going through. We're aware of the fears that girls who are preadolescent and teenage have. They may not always express them, and we just ask parents to be very aware that some of the stress a child may be exhibiting at home is related to concerns about breast cancer, Mother's being very sick from treatments, and perhaps dying. But some of those children may not be able to express their concerns the way adults would.