- Question from MIL: I was diagnosed with DCIS. This may not sound like much, but my husband doesn't want to tell my daughter about it. I think it's important for her to know, but he says it'll just upset her. Any advice welcome. Thanks.
- Answers —Tamara Shulman, Ph.D., F.A.A.C.P.: DCIS is breast cancer. You are clearly feeling that you want your daughter to be aware of it in some way, not to upset her, but to inform her. You don't mention her age, and what children need to know varies enormously by their age. Give her a clear label for the disease: breast cancer, along with a reassuring explanation that this is a very treatable breast cancer and that Mom will have some treatment and in all probability will be fine. I think you are being very caring and concerned that your daughter hear what's going on directly from you. Dad isn't comfortable talking about it, and that's important because children pick up on the emotional tone of the home. While your husband may want to protect your daughter from this diagnosis, she will still sense that her parents are anxious and something is afoot, whether it's phone calls or whispering. What children imagine is going on is often more distressing than a simple age-appropriate explanation of what is actually going on. It may initially seem more stressful and difficult, but is ultimately more reassuring for the child, not only for the immediate situation, but also so they know that they can trust their parents.
- Paula Rauch, M.D.: It's not uncommon for parents to disagree about how much or how little to tell a child. I encourage parents to approach talking about breast cancer as part of the family value of being honest, of hopefully making it a model in the family for sharing even difficult news with each other. I've learned from some families that when parents withhold difficult truths from their children, when their children are teenagers they feel they've been given permission not to share difficult truths with their parents, i.e., that there was no parent home at a party or that alcohol or drugs were involved. It's a complicated message in a family to say, "If this is too hard to hear, we cannot share this piece of information." If this is an unusual situation between you and your husband in terms of the approach that each of you would like to take about communicating this, even one visit with one of the social workers or psychologists or psychiatrists at the cancer center where you're being treated can help put the two of you on the same page. If this is an ongoing difference, the parents may benefit from ongoing support from a professional. It's so important to work hard on the communication between parents when there's the stress of illness in the family, and you and your children deserve the extra help.
On Wednesday, May 17, 2006, our Ask-the-Expert Online Conference was called Talking with Kids about Breast Cancer. Paula Rauch, M.D. and Tamara Shulman, Ph.D., F.A.A.C.P. answered your questions about specific ways to support your kids while you undergo treatment, and different communication strategies for helping your kids to feel secure during a time of uncertainty.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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Paula K. Rauch, M.D. is a child psychiatrist on the Harvard Medical School faculty and practices at the Massachusetts General Hospital. She founded and directs the Massachusetts General Hospital Cancer Center parenting program known as Parenting At a Challenging Time (PACT).
Tamara Shulman, Ph.D., F.A.A.C.P. is a clinical psychologist based in the New York City area who works with adults, adolescents, and children deal with the crisis of serious illness.
