Having to tell our daughter (who was 4 and three-quarters years old) about my breast cancer diagnosis was daunting, overwhelming and nerve wracking... to say the least. I was quite surprised by how anxious I was about telling her considering the fact that for the past 10 years, I have worked as both an adult and pediatric hospice nurse. In this capacity I have had (way too much!) experience delivering bad news to children.
Now, coping with my personal diagnosis, I found myself on the other side of the bed -- literally. Prior to telling our daughter, I wondered whether all of the advice I have been dispensing for the last decade really works. The Silver Lining is that it DOES!
My personal experience enabled me to be empathetic with the parents who try to hide the truth from children because they assume that "children can't understand what is happening" and because they believe that "children shouldn't be exposed to something so awful." Well, that's 100 percent true: Exposing children to FBC is brutal and heart-wrenching. However, children know when things are haywire in a household (which is an understatement in the face of a cancer diagnosis).
The truth of the matter is that avoiding communication with children sends the message that either they are too unimportant to share the information or that it is so awful that it cannot be discussed. Either way, a child is left alone with the distressing information. How awful is that? Additionally, this isolation forces them to draw inaccurate conclusions or find maladaptive ways of dealing with a cancer diagnosis. While it may seem hard to believe, a child's imagination has the capacity to create things that are far worse than the reality.
Furthermore, if children catch you in a lie of omission or deception (even though lovingly intended), then from that point forward, they will always wonder, "Are Mommy and Daddy not telling me something?" Avoidance may feel better in the short term but has the potential to do long-term damage.
Therefore, including children (of all ages!) in the disease process and treatments, though emotionally burdensome and painful, will ultimately be the greatest gift parents can give their children. Inclusion enables children to have an accurate, healthy and hopeful understanding of the situation and learn adaptive coping mechanisms.
So, where to begin? Based on my clinical experience and the work of Kathleen McCue, I told our daughter:
At some point or another, there are three questions that children will wonder about a cancer diagnosis in a family:
Telling children about a cancer diagnosis in a family is emotionally rotten; however, there are tools to help facilitate the process. I am hopeful that this video will assist you along the way.
To read more about Hollye's holistic and humorous journey over, around, above and below breast cancer, please visit her blog, The Silver Pen (http://www.thesilverpen.com/). You may email her at hollye@TheSilverPen or follow her on Twitter @hollyejacobs.
For more inspiring breast cancer stories, click through the slideshow below.
The actress, who beat ovarian cancer close to a decade ago, shared last month that she had been <a href="http://www.huffingtonpost.com/2012/09/12/kathy-bates-breast-cancer-double-mastectomy_n_1878208.html">diagnosed with breast cancer and underwent a double mastectomy</a>, The Huffington Post reported at the time. "Luckily, I don't have to undergo radiation or chemo," <a href="http://www.people.com/people/article/0,,20628972,00.html">she told <em>People</em> magazine</a>. "My family calls me Kat because I always land on my feet and thankfully this is no exception." <a href="http://www.huffingtonpost.com/2012/09/12/kathy-bates-breast-cancer-double-mastectomy_n_1878208.html">She also shared the news on Twitter</a> -- with her signature sense of humor intact. "I don't miss my breasts as much as I miss Harry's Law. ;-) Thanks for all the sweet tweets," she wrote. "Y’all kept me going."
Tierney was diagnosed with breast cancer in 2009, but she didn't open up publicly about it until earlier this year. "I remember thinking, 'I'm so young, this can't be happening,'" <a href="http://www.people.com/people/article/0,,20611140,00.html">she told <em>People</em> magazine</a>. "In 2009, I was diagnosed with breast cancer and found out I would need chemotherapy," <a href="http://www.chemomythsorfacts.com/index.html">she said in a video for the Chemotherapy Myths Or Facts campaign</a>. "I asked myself all these questions and was utterly terrified, not just because of the cancer diagnosis, but the fear of chemo itself." And that sense of the unknown is what triggered Tierney, whose cancer was found in its early stages, to sign up as a spokesperson for the campaign. "It's important that you feel educated and confident during this time," <a href="http://www.chemomythsorfacts.com/index.html">she said in her introductory video</a>.
The beloved author of favorites such as "Are You There God? It's Me, Margaret," and "Tales Of A Fourth Grade Nothing," revealed that she was diagnosed with invasive ductal carcinoma in a <a href="http://www.judyblume.com/blog.php">blog post on her website this past September</a>. "I haven’t eaten red meat in more than 30 years. I’ve never smoked, I exercise every day, forget alcohol -- it’s bad for my reflux -- I’ve been the same weight my whole adult life," <a href="http://www.judyblume.com/blog.php">she wrote</a>. "How is this possible? Well, guess what -- it’s possible." <a href="http://www.huffingtonpost.com/2012/09/05/invasive-ductal-carcinoma-judy-blume-breast-cancer_n_1858418.html">Blume had a mastectomy</a> on July 30. <a href="http://www.judyblume.com/blog.php">She wrote in her blog</a>: <blockquote>As I've told my friends who've also been treated for breast cancer, I've joined The Club -- not one I wanted to join or even thought I would ever be joining -- but here I am. I’m part of this Sisterhood of the Traveling Breast Cells (apologies to Ann Brashares). Medical diagnoses can leave you feeling alone and scared. When it comes to breast cancer you’re not alone, and scary though it is, there’s a network of amazing women to help you through it.</blockquote>
Wife to Republican presidential hopeful Mitt Romney, Ann was <a href="http://www.huffingtonpost.com/2012/05/03/ann-romney-breast-cancer_n_1475950.html">diagnosed with breast cancer in early 2009</a>. "It's great to have loved ones around you," <a href="http://www.americasradionewsnetwork.com/ann-romney-reflects-on-her-personal-battle-with-breast-cancer">she told America's Radio News Network in an interview</a> earlier this year of where she found post-diagnosis comfort. "And you just fight these battles, listen you don't fight them alone. You fight them with friends and with family. And you put your arms around each other and you move forward." Romney, whose mother and grandmother died from ovarian cancer and whose great-grandmother died from breast cancer, told the program <a href="http://www.americasradionewsnetwork.com/uploads/mp3/showclips/05-03-12ANNROMNEY1.mp3">she's most grateful to have been diagnosed early</a> -- she needed surgery and radiation, but not chemo. "Life is an interesting game, and you just always deal with whatever you're dealt with that day or that week or that month or that year," said Romney, who has <a href="http://www.huffingtonpost.com/2012/06/18/multiple-sclerosis-celebrities_n_1606174.html">also been diagnosed with multiple sclerosis</a>. "No matter what you're living through, we all push forward."
The TV star was diagnosed with breast cancer in 2003, when she was starring in "The Sopranos." "I take very good care of myself (mostly because I didn’t many years ago), and that served me well during chemo," <a href="http://www.health.com/health/article/0,,20411264,00.html">she later wrote in an article for <em>Health</em> magazine</a>. "Running every day made me feel calm and strong, even as my self-image suffered from my hair falling out." After her cancer went into remission, Falco decided to adopt -- her baby boy, Anderson, was born in January 2005. She later <a href="http://www.redbookmag.com/fun-contests/celebrity/edie-falco-nurse-jackie">adopted a daughter</a>, as well. "Obviously, it wasn’t meant for me to die of cancer at 40," <a href="http://www.health.com/health/article/0,,20411264_2,00.html">she wrote</a> in <em>Health</em>. "Every day my life surprises me, just like my cancer diagnosis surprised me."
The "Three's Company" and "Step By Step" actress was first diagnosed with breast cancer in 2000. "We were silent, hardly talking, in disbelief, like this can't be happening, wondering is this a little blip or the end of my life?" <a href="http://www.people.com/people/archive/article/0,,20134247,00.html">she told <em>People</em> magazine in 2001</a>, of hearing the news for the first time with her husband Alan Hamel. Just earlier this year -- more than a decade since her diagnosis -- Somers shared with <em>People</em> that she <a href="http://www.people.com/people/article/0,,20567432,00.html">underwent an experimental breast reconstruction surgery</a>, to repair the damage from a lumpectomy and radiation treatments.
The "Grease" star and singer was diagnosed with breast cancer in 1992 after feeling a lump in a self exam -- <a href="http://ww5.komen.org/BreastCancer/OliviaNewtonJohn.html">her treatment included</a> surgery, chemotherapy, a radical mastectomy and reconstruction. "When you're first diagnosed, people are pulling you in every direction: Do this! Do that! You really have to gather yourself, because you're the one who has to make the hard choices," <a href="http://ww5.komen.org/BreastCancer/OliviaNewtonJohn.html">she said in a Q&A on Susan G. Komen For The Cure's website</a>. "I researched a lot and felt satisfied with my course of treatment. It was sort of an East-meets-West approach." And that meant taking care of her <em>whole</em> body, not just the cancer. "I did everything I could to take care of myself -- body, mind, and spirit," <a href="http://www.everydayhealth.com/breast-cancer/mylife/olivia-newton-john/questions.aspx">she told EverydayHealth.com</a>. "I look at my cancer journey as a gift: It made me slow down and realize the important things in life and taught me to not sweat the small stuff."
The 36-year-old "E! News" host announced last October on<a href="http://theclicker.today.msnbc.msn.com/_news/2011/10/17/8363134-es-giuliana-rancic-reveals-she-has-breast-cancer" target="_hplink"> NBC's Today show</a> that she has breast cancer, and that she was alerted to the cancer via a mammogram during her third in vitro fertilization attempt. "Through my attempt to get pregnant for the third time, we sadly found out that I have early stages of breast cancer," she said <a href="http://theclicker.today.msnbc.msn.com/_news/2011/10/17/8363134-es-giuliana-rancic-reveals-she-has-breast-cancer" target="_hplink">on the Today show</a>. "It's been a shock. A lot of people have been asking, we saw that you went and got IVF, are you pregnant? But sadly, we've had to put that off." Rancic underwent a double lumpectomy and removal of several of her lymph nodes, but she later went on the TODAY show last December to say that the cancer was not completely cleared by those treatments and that she will <a href="http://www.huffingtonpost.com/2011/12/05/double-mastectomy-giuliana-rancic-breast-cancer_n_1129433.html" target="_hplink">undergo a double mastectomy</a>. This year, Rancic finally got her happy ending, <a href="http://www.huffingtonpost.com/2012/09/12/edward-duke-rancic-photo-giuliana-bill-rancic-baby-boy_n_1876694.html">with the birth of son Edward Duke</a> via gestational surrogate on August 29.
In a 2011 interview with Ellen DeGeneres, Wanda Sykes revealed that she had been <a href="http://www.huffingtonpost.com/2011/09/23/wanda-sykes-breast-cancer_n_977761.html#s312402&title=Wanda_Sykes" target="_hplink">diagnosed with breast cancer</a> and underwent a double mastectomy. "I had breast cancer. Yeah, I know it's scary," Sykes said in the interview. "This was in February. I went for the reduction. I had real big boobs and I just got tired of knocking over stuff. Every time I eat ... Oh lord. I'd carry a Tide stick everywhere I go. My back was sore so it was time to have a reduction." After the reduction, the pathology report found ductal carcinoma in situ in her left breast, which prompted Skykes, who has a <a href="http://www.people.com/people/article/0,,20531010,00.html" target="_hplink">family history of breast cancer</a>, to opt for a double mastectomy. And while the diagnosis is scary, she hasn't lost her <a href="http://www.huffingtonpost.com/2011/09/23/wanda-sykes-breast-cancer_n_977761.html#s312402&title=Wanda_Sykes" target="_hplink">signature humor</a>. "I was like, 'I don't know, should I talk about it or what?' How many things could I have? I'm black, then lesbian. I can't be the poster child for everything ... At least with the LGBT issues we get a parade, we get a float, it's a party. [But] I was real hesitant about doing this, because I hate walking. I got a lot of [cancer] walks coming up."
In 2008, actress Christina Applegate shared in a "Good Morning America" interview that she had been <a href="http://abcnews.go.com/GMA/story?id=5606034&page=1" target="_hplink">diagnosed with breast cancer</a> at the age of 36 -- she opted for a bilateral mastectomy instead of radiation or chemotherapy. "I didn't want to go back to the doctors every four months for testing and squishing and everything. I just wanted to kind of get rid of this whole thing for me. This was the choice that I made and it was a tough one," she said <a href="http://abcnews.go.com/GMA/story?id=5606034&page=1" target="_hplink">in the interview</a>. "Sometimes, you know, I cry. And sometimes I scream. And I get really angry. And I get really upset, you know, into wallowing in self-pity sometimes. And I think that it's all part of the healing." Perhaps the best healing of all came in 2011 when Applegate gave birth to baby Sadie with musician Martyn LeNoble. "She's healed me in so many ways. She's just made my life so much better. I've been kind of sad for a long time, and she's just opened my whole soul," Applegate <a href="http://www.people.com/people/archive/article/0,,20467525,00.html" target="_hplink">told <em>People</em></a> in an exclusive interview in 2011.
In 2005, rock-and-roll artist Etheridge underwent a lumpectomy and five rounds of chemotherapy and radiation to eradicate her breast cancer. "I had been running along in my life at a fast pace. When I heard it was cancer, I just stood still," Etheridge told <em>Shape</em> magazine in a 2009 interview. "My life passed over me like a big wave, and after, I was left there standing. This turned out to be a very good thing. I stopped. I looked at my life, I looked at my body and spirit." In the midst of her treatment, Etheridge found out she was <a href="http://www.msnbc.msn.com/id/6994469/ns/dateline_nbc/t/melissa-etheridges-brave-comeback/" target="_hplink">nominated for a Grammy</a> for her song "Breathe" -- and while she wasn't sure she'd make an appearance at first, Etheridge ultimately decided not only to attend, but to perform in a Janis Joplin tribute. Taking to the stage bald and with no eyebrows -- a side-effect of the chemo -- she belted out Joplin's classic, "Piece Of My Heart." "It was very special that I had been presented with a day, that I could come back into this entertainment world, and show everyone that you are back and okay, and thought, okay," Etheridge told <a href="http://www.msnbc.msn.com/id/6994469/ns/dateline_nbc/t/melissa-etheridges-brave-comeback/" target="_hplink">MSNBC at the time</a>. "I'm going to do this. And I'm not gonna be afraid of the truth. The truth is, yes I had cancer. Yes, I got it out of me. Yes, I went through chemotherapy. Yes, I'm bald." Check out Etheridge's breast cancer causes on her <a href="http://www.melissaetheridge.com/pinkpage" target="_hplink">Pink Rage website</a>.
ABC's "Good Morning America" co-host Robin Roberts was diagnosed with breast cancer in 2007. "I never thought I'd be writing this. ... <a href="http://abcnews.go.com/GMA/CancerPreventionAndTreatment/abcs-robin-roberts-breast-cancer/story?id=3430554" target="_hplink">I have breast cancer</a>," she said in a message released by ABC in August 2007. While working on a tribute to her colleague Joel Siegel, who had died from cancer, Robins reported on how key early detection is -- and, taking her own advice, she did a self breast exam and found a lump. "Much as I was hoping the doctor would say it was nothing, she did a biopsy and confirmed that the lump I'd found was indeed an early form of breast cancer," Robins <a href="http://abcnews.go.com/GMA/CancerPreventionAndTreatment/abcs-robin-roberts-breast-cancer/story?id=3430554" target="_hplink">continued in her statement</a>. Robins underwent a partial mastectomy, chemotherapy and radiation. In 2008, she told <em>People</em> magazine that she <a href="http://www.people.com/people/archive/article/0,,20238177,00.html" target="_hplink">complemented her regular doctor's visits</a> with acupuncture, exercise and advice from a nutritionist. "Yes, I am living with cancer," she <a href="http://www.people.com/people/archive/article/0,,20238177,00.html" target="_hplink">told <em>People</em></a>. "But don't go 'woe is me.' I don't want it. Don't need it. I'm still in the game. I don't want to say 'survivor.' I want to thrive." Earlier this year, Roberts announced that she was diagnosed with a <a href="http://www.huffingtonpost.com/2012/09/20/bone-marrow-transplant-robin-roberts-myelodysplastic-syndrome_n_1900324.html">rare blood disorder called myelodysplastic syndrome</a>.
Australian singer Minogue was first diagnosed with breast cancer in May 2005 and underwent surgery and chemotherapy treatment. "When you are stripped of everything and you have to grow your eyelashes back, grow your hair back, it's just astonishing," Minogue told British <em>Glamour</em> magazine. "It's hard to express what I've learned from that, but a deep psychological and emotional shift has obviously taken place." This open and honest approach to her diagnosis led Minogue to be voted the <a href="http://www.reuters.com/article/2010/09/03/us-cancer-celebrities-idUSTRE6820P120100903" target="_hplink">most inspirational breast cancer celebrity</a> in an online British-based poll, Reuters reports.
Singer Sheryl Crow was <a href="http://articles.cnn.com/2006-10-06/health/crow.cancer_1_breast-cancer-early-detection-cancer-patients?_s=PM:HEALTH" target="_hplink">diagnosed with breast cancer</a> in 2006 and, thanks to early detection, underwent a minimally invasive surgery and seven weeks of radiation therapy. Crow told <em>Health</em> magazine that <a href="http://www.health.com/health/article/0,,20411904_2,00.html" target="_hplink">she saw a nutritionist</a> when she was first diagnosed and began a diet full of fish, walnuts, colorful vegetables, fiber and healthy spices. "I kept my breast cancer tattoos -- where the radiation was lined up on my chest," Crow told <em>Health</em>. "Once in a while I look at it to remind myself that I have to put on my oxygen mask first before I put it on anybody else." Today, Crow is focused on spreading the message of early detection. In 2010, she <a href="http://content.usatoday.com/communities/entertainment/post/2010/08/sheryl-crow-opsns-breast-cancer-imaging-center-/1" target="_hplink">founded the Sheryl Crow Center</a> as part of the Pink Lotus Breast Center, which was founded by her own surgeon, ABC News reports. This past June, Crow also revealed that she was diagnosed late last year with a <a href="http://www.huffingtonpost.com/2012/06/05/benign-brain-tumor-sheryl-crow_n_1572008.html">benign brain tumor</a>.
In 2008, the "Sex and the City" star went public with her <a href="http://www.huffingtonpost.com/2008/04/15/cynthia-nixon-on-her-love_n_96749.html" target="_hplink">cancer diagnosis</a>, revealing that she found a lump in its early stages and had it removed through radiation, The Huffington Post reported at the time. Nixon wrote in a 2008 <em>Newsweek</em> article that her mother was <a href="http://www.thedailybeast.com/newsweek/2008/10/03/a-family-of-strong-women.html" target="_hplink">diagnosed with breast cancer twice</a> -- the first time, Nixon was just 13. "I feel like I have a very <a href="http://www.huffingtonpost.com/2011/10/03/slideshow_n_991609.html#s384104&title=Cynthia_Nixon" target="_hplink">concrete story to tell</a>. My story isn't just my story, it's mine and my mother's story," the <a href="http://ww5.komen.org/" target="_hplink">Susan G. Komen for the Cure</a> spokesperson has said.
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