How does a parent who has just received a
cancer diagnosis break the news to children? Eveline Gan finds out
Being
told that you have cancer is a frightening experience.
Throw
young children into the equation, and navigating the life-threatening illness
often becomes more complex.
Parents
who have been hit by the disease said one of their topmost concerns following
their diagnosis is: "Should I tell the children?"
Mr Kelvin
Choo, 50, chose not to share the news with his four children when he was
battling advanced colon cancer in 2012 and 2013. As part of his treatment, the
primary school teacher had surgery to remove 15cm of his large intestine and
underwent chemotherapy.
His
reason: At just two to seven years old then, his children were too young to
understand the gravity of the situation.
"My
wife and I just told them that I was not feeling too good and needed some time
to recover," said Mr Choo.
Another
parent, Janice (not her real name), kept her condition a secret until a few
weeks before her death. In her 40s, she did so to protect her only child from
the horrors of the disease, which could not be contained despite aggressive
treatment. But when she called her 10-year-old son to her bedside in the last
weeks of her life, he rejected her.
By then,
she had physically deteriorated so much that she was a shadow of her former
self, said Ms Jayne Leong, manager of psychosocial services at the Singapore
Cancer Society (SCS), which provided home hospice support to Janice's family.
Nobody
told the boy or prepared him for it. The dying mother wanted her son to be near
her. "But to the child, witnessing his mother's physical change must have
been frightening," said Ms Leong.
Despite
parents' good intentions of protecting their children, counsellors said hiding
the disease beneath a shroud of secrecy can backfire.
This is
because children, even the really young, are able to observe what is happening
around them, said Mr Travis Loh, principal medical social worker from the
psychosocial oncology division at National Cancer Centre, Singapore (NCCS).
Ms Saryna
Ong, another medical social worker from the psychosocial oncology division,
said: "Children can recognise that something is not right when their
parents are sick."
When
children are not given the right information, they become more frightened. In
addition, said Ms Leong, trust may be broken if the children hear about the
diagnosis from another person other than the parent himself.
Sharing
information about the illness early - in an age-appropriate manner - opens the
door for communication between parent and children. It also addresses any
misconceptions the children may develop when they are being kept in the dark,
added Mr Loh.
Ms Leong
said that parents who want to protect the children do not realise that the
youngsters need help to make sense of reality.
A case in
point is Janice's son. In his naive 10-year-old mind, he had blamed himself for
his mother's cancer. "He thought his mother was very sick because he was
naughty. Children may think their parent's illness is their fault, when not
given information and assurance," said Ms Leong.
BEING UPFRONT ABOUT ILLNESS
Senior
enrolled nurse Zulfa Anas, 47, has seen first-hand the lasting regret secrecy
can cause. She was diagnosed with a rare bone cancer in 2006 and has suffered
two cancer relapses since then.
A mother
of two boys aged 12 and nine, she said: "My friend did not tell her
teenage sons she had cervical cancer until it was too late. At her wake, her
children were so angry that they were not informed about her illness earlier.
"They
also had a lot of regrets about not spending more time with their mum."
NCCS' Ms
Ong said giving children appropriate and timely updates on their parents'
disease helps minimise the shock they may experience if bad news is broken to
them suddenly.
For that
reason, Madam Zulfa has openly shared and involved her sons in her cancer
journey.
She has
even informed them who will take care of them, in the event that she dies.
"I
don't want my kids to blame me or feel lost if I'm no longer around," she said.
She is currently on maintenance treatment, in stable condition, but the doctor
has not given her the all-clear.
Similarly,
being upfront about her illness was a necessity for Madam Sandar Myint, 45, who
is battling stage three breast cancer. Her three children are aged 14, nine and
five.
Her
husband, Mr Nay Myo Hun, 38, said: "They realised very early on that their
mother was seriously sick when we took them along to the hospital for her
treatments because no one else could care for them."
The illness
has also affected the couple's finances. They had to explain why they could not
afford many things when the new school term started. "I felt embarrassed
telling the kids about our financial struggles, but it was necessary for them
to understand," said Mr Nay Myo Hun.
While it
may not always be possible, maintaining normalcy in your child's schedules will
help him feel more secure.
Despite
having no domestic help at home, Mr Choo and his wife, a 42-year-old insurance
agent, tried to stick to their children's regular routines as much as possible.
They
formed a tag team, working out a schedule to manage the children's routines,
their work and his treatments.
"The
only setback was not being able to take them out during my treatments," Mr
Choo said.
But they
made up for it by watching movies or playing educational games together at
home. Mr Choo is currently cancer-free and does not need further treatment.
He
eventually told his children about his brush with cancer, when the topic of
death came up after his father died from prostate cancer last year.
"They
are now older and at an age where they would ask many questions. We explained
what cancer is, and they have also found out more information about the
condition through the media," he said.
While telling
your children about your illness is important, so is offering them ample
support.
But for
parents struggling to cope with their disease, that can be a huge challenge,
said counsellors.
Ms Leong
advises parents to rope in professional help - available at SCS and all
restructured hospitals with a team of medical social workers - if they are
unable or do not know how to do this.
They
should also watch for changes in their children's behaviour - it may affect
their academic performance, regular activities and mood.
"The
ways children cope with difficulties in their lives can be very different from
that of adults. They do not necessarily always verbally share their feelings
and struggles," she said.
Hence, Mr
Loh added, engaging them through non-verbal means, such as through play and
art, can be more effective at times.
SCS and
NCCS currently have support programmes in place to help children cope. About
100 children have gone through NCCS' art therapy and bereavement programmes.
Its
medical social workers also provide counselling and psychosocial support to
children affected by their parent's illness.
At SCS,
the Help the Children and Youth programme has educational financial assistance
schemes, free home tuition, and activities such as camps and family engagement
programmes.
Through
these day trips and activities, the family is brought together and experience
what life was probably like before cancer.
Said Ms
Leong: "Very often, families affected by cancer focus on the treatment
plan and forget the need to have fun too."
Madam
Zulfa and Mr Nay Myo Hun said sharing information with their little ones has
its silver lining.
Mr Nay
Myo Hun said his oldest child seems to have "grown up".
"He
has become more understanding and proactive. Previously, he left all the
household chores to his mother but, now, he helps out at mealtimes. He has also
been working harder in school," he said.
Madam
Zulfa said her illness has drawn the family closer.
"Every
day, the children, especially my older boy, still tell me they love me very
much before I leave for work," she said.
"Through
this cancer journey, we have learnt to really treasure the time we have
together as a family."
