Nancy Fraim’s vow to do whatever it took to conquer cancer seemed to reassure son Mike, who was then 7, she recalls.
When Jackie Block was 15, she got in her mother’s car one day after school and immediately knew something was very wrong. “I knew she had an irregular mammogram, but I didn’t think much about it. But when I saw her crying after a doctor visit, I knew,” Jackie recalled recently. “I sat in silence, not knowing what to say. All my mother could say between her tears was, ‘I have cancer. I have cancer.’ ”
Like most who hear this news for the first time, Jackie felt disbelief. She had never seen her mother so vulnerable.
“At that time, I could not make a connection between her illness and my life, but eventually, everything changed.”
Last year, more than 175,000 new cases of breast cancer were diagnosed in American women. The women’s average age was 61, which means many of those women were younger – much younger. And many women who have breast cancer also have children.
We know a great deal about the emotional impact of cancer on women, but far less is known about what happens to children when their mothers have breast cancer. It’s almost as though we have been devoting so many of our resources to dealing with the physical and emotional consequences of the cancer that we have forgotten the children.
When Marlene Lally was diagnosed two years ago, her 9-year-old twins were all she could think about. Even though her mother had died of cancer and she knew her own life might be at risk, all she could focus on was how to tell Christopher and Michelle.
Because of the urgency of her condition, she needed surgery within 48 hours. She knew she needed to tell the twins before her operation, so the next day after school she sat down with them.
“I have always been pretty frank with my kids, so I was honest and did not sugarcoat the information,” Marlene recalled. “I told them that I had cancer and I was going to have surgery and some other treatments.”
The words sound stark and chilling. But cancer means something different to everyone. Christopher, now 11, remembers that day quite well: “One day after school, we had a family meeting. She told us she had breast cancer. I was really scared. I didn’t know what cancer means, but I knew it was really bad and I was scared Mom was going to be really sick.” Michelle was a little more hesitant than her brother, but the emotions were the same: “I was scared. Really scared, and I stayed scared for a long time. I thought my mom was going to die.”
That’s also what Dan Caplan thought. He was 8 years old when he sat in his mother’s hospital room 10 years ago watching an Eagles game with his two younger brothers.
“I didn’t realize how sick she was until I saw her in a turban,” Dan says now. “All of a sudden, my mother looked strange and vulnerable. You see, my grandmother died of cancer two years earlier and I remember her in the turban. When I saw my mom looking like that, I was scared – very scared.”
Joan Herman, director of social services at Fox Chase Cancer Center, says that most people feel overwhelmed when they first hear the words breast cancer.
“This is a terrible time to try to sort out what to tell the children and how truthful to be. Nevertheless, it must be done,” Herman said. “Children need to know what the disease is called and where it is located.”
Herman said that while our instinct is to protect the children, withholding information often does the opposite: “I am always concerned about the child who does not get adequate information at home and goes to school the next day and hears from a classmate, ‘I hear your mother has cancer and she is going to die.’ It is important for mothers – and fathers – to remember that usually children are not as overwhelmed by the word cancer as their parents are.”
Herman also said it is important for children to know what kind of treatment their mother is getting and what kind of reaction she might have. And most important, children need to know they will be cared for during this process – specifically, who will take care of them and when.
Most experts agree that if children are told what is happening to their mother, they will cope better.
Sometimes children are too frightened to ask questions that are important to them, such as, is cancer contagious or will their mother die.
Nancy Fraim didn’t have time to anticipate that question five years ago when she told her 7-year-old son about her breast cancer: “His immediate reaction was to ask me if I was going to die. I couldn’t lie, so I told him I would do anything I had to do to beat this disease. And that I would do whatever the doctors told me, including surgery and taking medicine that would cause me to get sick and lose my hair.” Her son seemed reassured by this information. That was not the case with her 16-year-old daughter, whom she described as angry and withdrawn.
When it comes to dealing with crises, adolescents have predictably different reactions than young children.
Most adolescents are in the process of separating from parents and exploring their own identities. A crisis such as this has the potential to disrupt the process. It is quite normal for an adolescent to be angry with a parent. Some may become conflicted about whether they should continue to spend time on their appearance or devote more time at home. And adolescent girls may develop special concerns about their own prospects for developing breast cancer. According to Herman, many adolescent girls who have a relative with breast cancer wonder about this.
Again, she recommends honesty. “Certainly there is a chance that any woman, as they get older, can develop this disease. But it is very rare for adolescents. It is also important to tell them that there are advances being made every day in how breast cancer is treated. Even if a 15-year-old might get breast cancer 20 years from now, the treatment will be even better than it is today.”
And that’s not the only positive news. As much as we try to protect our children from adversity, sometimes it is only adversity that can teach our children about their own strength, resilience and compassion. Jackie Block said she first coped with her mother’s cancer by being “a typical adolescent, you know, self-absorbed.” But when she saw her mother’s vulnerability, she also saw her own ability to make a contribution to her mother’s care. She took that new-found compassion and, with her mother, volunteered at Living Beyond Breast Cancer in Ardmore.
She said she found the experience empowering and healing. “This was my way of showing my mom I cared about her and everyone in her position.” This kind and self-confident young woman is now in graduate school studying to be a social worker.
Even at age 11, Christopher Lally feels his feelings about his mother have forever changed. “I think I respect her a little more now. I think I respect her more because I helped her when she was sick. I like helping my mom.”
When I spoke with Dan Caplan, he was spending his day off from school helping out at Living Beyond Breast Cancer. As we concluded our discussion, I asked him if there was anything else he wanted to say about his experience.
Without hesitation he said, “I want you to know how proud I am of my mother for fighting through what she has done and the way she has done it.”
Recently, I was waiting for a colleague in the lobby of a local hospital.
This was during one of those many times recently when the whole nation seemed frightened and hyper-vigilant. I saw a mother and what looked to be a 4-year-old son approaching a very large revolving door. The little boy looked at the door and then his mother, and said, “I’m scared, Mommy.” She looked at her child and replied, “You know what, I’m a little scared, too. But we will hold hands and go through this together.”