Breaking through the silence of breast cancer

October 15, 2007|By MEG PARTINGTON

The symptoms are silent, but the diagnosis of breast cancer can sound deafening to those who hear it.

Once the words "You have breast cancer" are absorbed by the patient and his or her loved ones, quiet might set in again. Despite the prevalence of breast cancer and all the information available about it, many people still want it to remain a "hush-hush" disease, said Lou Lichti, Ph.D., a psychologist with City Park Psychological Services & Associates LLC in Hagerstown.

In order for the patient to move forward physically and emotionally, however, Lichti said the silence must be broken.

"One of the most important things you can do is talk about your feelings," Lichti said.

Chris Madeo, a licensed clinical social worker in Hagerstown, echoes that sentiment. She urges cancer patients and their loved ones to fight societal pressure to internalize the feelings that such a life-changing diagnosis evokes, emphasizing the importance of reaching out.


"Get a support system as soon as possible," Madeo said.

For all involved, seeking out others who have gone through a similar situation is beneficial. Support groups are available for cancer patients, as well as for their loved ones. Those who don't have a network of friends and/or family to help them could consider counseling, Madeo said, as might those who have battled other mental health issues such as depression, which can recur upon hearing stressful news.

Churches also can be comforting, Madeo said, allowing those affected by a cancer diagnosis to make spiritual connections.

"You can fit into them in your way without having to swallow the party line," Madeo said.

Sharing the news

Since it is likely that not everyone in a patient's circle of family and friends is present when the diagnosis is shared, some of the first conversations about the illness involve sharing the news.

Children have a keen intuition and can sense when "something is in the air," Madeo said. If the family doesn't talk openly about cancer, the children might think the situation is worse than it is.

If patients don't feel strong enough to share the news with their children, they should ask a trusted person to tell them or to be present when the news is shared, Madeo said.

"It's OK to cry in front of the children," she added.

Those younger than about 9 years old don't need as much detail as older children, Madeo advised. They need general information about what the illness is, what part of the body it affects, what kind of treatment will be sought, if any, and how it will affect their lives, she said.

It might be helpful to note some of the changes to which the children have already adapted, Madeo said. For instance, the ill parent might have been more tired than usual lately or not feeling well, and the family worked through that.

Older children might desire more specifics about the disease, but Madeo warned against overloading them with information. Take cues from them about when it's time to stop talking about it, but always leave the door open to more communication, she said.

While adolescence in particular is a time of exploring independence, Madeo said it is wrong to assume that children in that age group don't need others' help in dealing with an illness in the family.

"They need a lot of support," Madeo said.

The effect of the news on parents of the ill person depends on the nature of the parent/child relationship.

"It has the potential of bringing a family together," Madeo said. "People can change in a remarkable way. It can be a very fruitful time, as well as a difficult time."

Emotional response

Once patients have shared the diagnosis with their network of loved ones and friends, two emotions tend to take hold.

"The biggest thing that happens is people are scared," Lichti said. They fear losing the person with cancer and they fear the unknown - how the family's lives will change.

"Across the board, there's a feeling of helplessness," Madeo said.

Hearing the news at some point raises life-and-death issues that might not have been discussed before, Lichti said. Not only are families faced with the reality that their loved one might die from the disease, they also need to make plans in case that happens. That might mean doing tasks that have been avoided, such as writing wills or estate planning.

Those who try to avoid facing the rash of feelings that a cancer diagnosis brings might exhibit their feelings in other ways.

"Small things seem to affect people more," Madeo said. If someone is upset about the diagnosis but hasn't vented, something as simple as a malfunctioning copier machine or a traffic delay can trigger an overly emotional response, she said. Children might fall apart emotionally over a dropped Popsicle.

Young ones might be comforted somewhat if the family has plans in place for days when the patient is hospitalized or not well enough to care for them, Madeo said. If possible, give the children choices of whom they would most like to care for them during those times.

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