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The Hardest Conversation

Posted 2/22/2013

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  For all of us, our children are our biggest grief and worry when we consider the possibility of an early death. This is surely not true only for women with breast cancer, but applies to everyone with any diagnosis of a life-threatening illness. Earlier this week, I met with a 45 year old man who has just been diagnosed with Stage III colon cancer; he and his wife were overwhelmed, devastated and most focused on what to tell their two young sons about their father's illness. Their worries were compounded by the reality that another family member and a close friend had both died of cancer within the past year. It was real to recognize that their boys were likely to make the immediate assumption that this would be their dad's fate, too.

  The basic advice about talking with children is to give them honest, age-appropriate information. I often frame it as using the same model one would for sex education: try to speak matter-of-factly, use the real words, don't flood them with too much information at once, but make it clear that this is a subject that can be discussed over and over. I also suggest that parents tell their children directly something like this: "I will always tell you the truth. I promise I will let you know if it is time to worry. This is not that time."

    I easily and painfully remember telling my daughters each time of my cancer diagnosis. The second time was not easier; practice didn't help. In some ways, the second time was harder as they were 12 years older and much more aware of the realities. This is a common conversation in my office, with groups and with individual women. We struggle and weep and sometimes practice what to say. One wonderful woman who attends my group for women with advanced breast cancer decided to call a family meeting soon after getting some really bad news. She and her husband sat with their adult daughters, and she opened with: "We need to be honest with each other in order to get through this together. I will tell you what most frightens me, and you need to tell me the same. Then we will figure out how to deal with each of our fears." This worked, and she and her family have continued to support and love each other through her very serious illness.

  Some of you are familiar with Lisa Bonchek Adam's blog, and this is an especially moving and thoughtful essay about a conversation with her teenage daughter. I give you the beginning and a link:

The Hardest Conversation

From the time my oldest child Paige was born everyone kept telling me, "Just you wait." When she made it through the terrible twos without much of a tantrum. When she made it through elementary school and a move from NYC without trouble. "Just you wait," they said, "girls are drama. You got lucky before. But the teen years? Oh boy... just you wait."

Today she prepared me a bowl of soup and brought it up to my bedroom. I was resting after my surgery yesterday, the room was dark. I invited her to come snuggle with me in the big bed. We've never let our children sleep in our bed so they think climbing in is a big treat. I asked her if she wanted to talk about what was going on, about my news about having metastatic breast cancer. She did.

And so it began: an hour-long talk that started with her first question, "Are you scared?" She asked questions about genetics and risks of getting cancer to what kind of treatments I might need. She asked me again, as if to confirm for herself, "It's not curable, right?"


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