If the metastatic breast cancer is a recurrence, telling your loved ones that the cancer has returned may be more difficult than it was telling them about the original diagnosis. If this is a first diagnosis and it’s metastatic, telling friends and family can also be extremely challenging. You may be concerned about upsetting your family and friends or worried about how they will react. Even after you’ve shared the news, you may find it difficult to communicate openly at times. Sometimes it’s uncomfortable to ask for help, answer questions about how you’re doing, or tell well-meaning relatives and friends that you need some time and space for yourself.
The conversation you have will be different depending on to whom you’re talking: your partner or spouse, your children, a close friend, or a co-worker. The most important thing to keep in mind is that you’re always in control of the conversation. The amount of information you share and the depth of the feelings you share are entirely up to you.
Talking to your spouse or partner
If you’re married or living together in a committed relationship, your diagnosis will not only have a life-changing impact on you; it will also have a significant impact on your spouse or partner. It’s natural for your partner to fear for your health and well-being and feel concerned about what will happen in the future. Since you run a household together, you’ve probably grown accustomed to certain roles and responsibilities. Your partner may wonder what will happen if you can’t always handle your usual tasks, whether that means earning income, caring for children, paying bills, preparing meals, or any of the other activities of day-to-day life.
Breast cancer can intensify whatever patterns of communication existed in your relationship before. If you and your partner have always been able to talk through difficult issues, that ability will probably work well for you now. If open communication has been difficult, you might need to do some extra work to talk about cancer and what it means for your relationship and your household.
Every relationship is unique. If you’re not doing so already, you may find it helpful to:
- involve your partner in medical appointments
- make sure you’re being clear about your needs
- ask your partner what he or she needs
- schedule time for the two of you to be alone
- accept that you may have different coping styles
- figure out what adjustments are needed in the household and ask for help together
- prepare for possible changes in your sexual relationship if you experience side effects such as fatigue, depression, or lowered libido
- get professional help if you need it
Talking to young children
If you care for young children (ages 3 to 9) as a parent or grandparent, it may be tempting to shield them from your diagnosis. Experts agree that this is not a good idea. Even very young children can sense when family members seem stressed or anxious, or when usual routines are disrupted. They will notice changes in your appearance and your energy level, and they will know that you are spending time at the hospital or treatment center.
Although young children do not need detailed information, they do need honesty and reassurance. Without any direct explanation from you, children may imagine a situation that is actually much worse than reality. Being honest with them builds a sense of trust that will be helpful in facing not only this situation, but also other challenges that life inevitably brings.
Talking to older children
While much of the advice for talking to young children also applies to children in middle and high school (ages 10 to 18), older children have additional information needs. Breast cancer is talked about on television and in other media, so older children are likely to be aware of the seriousness of metastatic cancer. In addition to your honesty and reassurance, they may crave more information than younger children do. Also remember that older children may express their feelings in ways that seem inappropriate, such as embarrassment or anger. Providing them with information and helping them know that it’s perfectly fine to keep up with school and social activities while you’re managing the cancer can help them maintain a sense of normalcy.