By Bernard Freeman
Talking to Children about Cancer
Breast cancer doesn’t just affect the person diagnosed with it, but the entire family. As difficult as it is to tell children about a breast cancer diagnosis, it is important to do so.
Why? First, it’s hard to keep cancer a secret. Children will see that you are acting differently, they’ll notice changes to your body or even overhear things. If they aren’t told what is happening, they’ll often believe the worst and become more afraid.
What to Tell a Child
The exact information you tell a child will depend on the child’s age and personality. The American Cancer Society recommends telling children the name of the cancer, how it will be treated, what sort of side effects might occur and how the cancer can affect their lives.
The Komen Foundation advises giving honest, real answers to any questions a child asks and to encourage them to talk to you and ask questions. If you don’t know the answer to a question, admit it and tell them you will find out the answer.
It’s OK to tell a child that you are scared and that it’s all right for everyone to have strong feelings about it. Just reassure them that the family will be able to handle whatever comes their way.
How to Tell a Child
The American Cancer Society gives several pieces of advice for talking to children about cancer.
- Find a quiet time where you won’t be disturbed.
- Talk to each child alone so you can customize what you say based on the child’s needs and age.
- Choose a time when you are feeling calm.
- In a two-parent household, talk to children together. In a single-parent household, consider having a trusted friend or relative in on the discussion.
- Plan how you will talk to each child. Anticipate questions they might ask.
- During and after the treatments, check in with your children to see how they are doing.
Respond to Concerns Children Have
Children who are afraid often respond irrationally. The American Cancer Society points out that children often engage in “magical thinking,” where they believe that they make things happen.
Anticipate the guilt your children might feel and head off their natural tendency to blame themselves. Children or teens who have been angry with their parents might feel they are being punished by their parent getting cancer.
Even if children don’t express guilt, the American Cancer Society recommends saying something like, “The doctors have told us that no one can cause someone else to get cancer. It’s nothing that any of us made happen.”
Another fear that children sometimes have is that cancer is contagious or that their other parent will get it too, or even that they will get it. It’s important to explain to them that cancer doesn’t work that way. They might be afraid that everyone who gets cancer dies from it.
Parents can reassure children that medical science has learned a lot about cancer and people are often able to live with it now.
Finally, reassure children that they are still loved and will be taken care of even when their parent is sick.
The Many Forms of Breast Cancer
Not all breast cancers are alike. There are several kinds of breast cancer based on where it shows up, which cells are affected and how it acts.
The Centers for Disease Control and Prevention defines breast cancer as “a disease in which cells in the breast grow out of control.”
Understanding the Breast
To understand the types of cancer, it first helps to know how the breast is constructed. The breast has three main parts:
- Lobules: The glands that produce milk.
- Ducts: the tubes that carry milk to the nipple.
- Connective tissue: Consisting of fibrous and fatty tissue, it surrounds and holds everything together.
Most of the time, the CDC says, breast cancers begin in the ducts or lobules.
Common Types of Breast Cancer
The two most common forms of breast cancer according to the CDC are invasive ductal carcinoma and invasive lobular carcinoma.
With invasive ductal carcinoma, the cancer cells show up in the ducts and spread to other parts of the breast tissue. Sometimes the cancer cells spread to other parts of the body. In invasive lobular carcinoma, cancer cells first appear in the lobules and spread to nearby breast tissues or other parts of the body.
When the cancer cells spread to other parts of the body, it is called metastatic breast cancer, also known as a stage IV breast cancer.
Uncommon Types of Breast Cancer
Some less frequently occurring types of breast cancer are:
- Paget’s disease: Cancer cells appear first in the nipple or the areola, the darker circle around the nipple. People who have this usually also have additional tumors in the same breast. The National Cancer Institute reports that only about 1 to 4% of all breast cancer cases involve Paget’s disease.
- Medullary: This cancer starts in the milk ducts and then spreads to the surrounding breast tissue. It behaves differently than other forms of ductal breast cancer. According to Medical News Today, it represents only 3-5% of all breast cancer diagnoses. The tumors tend to grow slowly and don’t usually spread to the lymph nodes.
- Mucinous: Also known as colloid breast cancer, it begins in the milk ducts and spreads to tissues around the duct. The tumors typically have more than usual amounts of mucous. These tumor cells are less aggressive than other forms of ductal cancer and are more responsive to treatment. John Hopkins Medicine reports that it occurs in only 2% of all breast cancers.
- Inflammatory breast cancer: This form of cancer is highly aggressive. It occurs when cancer cells block lymph vessels and often cause the breast to be swollen, inflamed or red. This form of cancer is fast-moving, often spreading in a matter of weeks or months. While it accounts for only 1 to 5% of breast cancer cases, according to The Cancer Institute, it is more likely to be diagnosed at younger ages and in Black women.
- Angiosarcoma: Angiosarcoma starts in the cells around either the lymph vessels or the blood vessels. The American Cancer Society says that sarcomas of the breast occur in less than 1% of all breast cancers and are sometimes related to prior radiation treatments.
- Triple-negative breast cancer: This is an aggressive, invasive type of breast cancer. The cancer cells lack estrogen and progesterone receptors and either don’t make any of the proteins called HER2 or make very few. The American Cancer Society said this represents 15% of all breast cancers and is difficult to treat.