How to talk to loved ones if you have breast cancer

Sharing news of a breast cancer diagnosis with family and friends may not be easy. But it’s important to let your loved ones know.

Whether you have recently been diagnosed with breast cancer or you have been living with cancer for months or years, the most important relationship in your life is the one you have with yourself. Even if you have a supportive and loving network of family, friends, and neighbors, you may feel overwhelmed at times by their opinions and advice. First and foremost, remind yourself to listen to your own inner voice when you feel uncertain about a choice you are facing. No one else has had your experiences; no one else lives in your body.

Still, having a strong support network can benefit your health. A study in the journal Cancer showed that women diagnosed with breast cancer live longer if they have a large network of family, friends, and community members who can provide emotional, physical, or financial help during times of need.

Once you’ve started to let loved ones know about your diagnosis, different people may take on different support roles. For instance, a spouse or partner may act as your primary caregiver. In other cases, another family member or close friend may fill that role, or caregiving may be split between two or more people who are close to you.

Family and friends

Just as you have your unique way of dealing with the news, so will your family and friends. Sometimes family members do not respond the way you might expect or hope. Friends may not always know what to say, or they may say things that feel insensitive to you. Remember that these responses have to do with their fears and worries, and not with how they feel about you. It’s also possible for loved ones you didn’t expect to be supportive to surprise you — in a good way!

Sharing the news with your family and friends is entirely your decision, and you can share it when and how you choose. You do not have to share the news immediately or with everyone you know. Keep in mind that you don’t owe anything to anyone. You may want to:

• Make a list of the people you want to tell and how you want to tell them. You do not need to call each of your siblings, for example, one by one. You may want to email all of them together and ask them not to call you right away so they don’t overwhelm you. You can schedule a conference or video call later. That also gives your loved ones time to process the news. A group email or text to co-workers or certain friends may be a good idea, too.
• Ask your partner or spouse to tell friends and family who live far away.
• Start a blog, group email, or text to keep people updated about your treatment and how you’re feeling. Or, use a special website such as CaringBridge that allows you to share updates. That way, you don’t have to answer the same questions many times for many different people.

It’s important to know you have choices about how you want to communicate. If you want people to call you, let them know that calls are welcome. If you don’t want calls, let them know that. Do you prefer emails or texts? Let loved ones know how they can best give you what you need – which may be some quiet time and space.

Sometimes, there are people who ask more questions than you want to answer. Remember, you are in control of how much information you share, and you have the right to set personal boundaries. You can share information with some people that you’re not comfortable sharing with others. Before you share, it can help to think about how you will respond to certain questions that you don’t want to answer.

It may also be helpful to ask your loved ones what they want to know. Some people will be comfortable hearing good news, bad news, and details that may be hard for others to hear; other people may ask that you only share good news with them. If you know ahead of time what others want, you are less likely to be disappointed when someone doesn’t respond or react as you had hoped.

Remember, “If loved ones tell you they can’t handle hearing all the details of your treatment, that doesn’t mean they don’t love you,” says Kelly Grosklags, LICSW, BCD, fellow, American Academy of Grief Counseling.

Talking to family and friends if you have a metastatic diagnosis

When breast cancer cells spread to other parts of the body, it’s called metastatic breast cancer. This includes stage IV breast cancer. Metastatic breast cancer cannot be cured, and treatment is ongoing, but people diagnosed with metastatic breast cancer can live for years.

If you’ve just learned that you have metastatic breast cancer, it may be very hard to imagine how you will tell your family. You may want to take some time before sharing the news. Who you tell and when you tell them is your decision. “People who are living with cancer are in a very vulnerable place. When you feel vulnerable, you only want to be around people who make you feel safe. Those people are different for everyone,” says Kelly.

When you talk with your family and friends, it’s very possible they will have intense emotional reactions. Since that can increase stressful feelings you may already have, it can help to first tell your partner or spouse, or a trusted friend, who can be there with you when you share with other family members and friends. “It’s important to protect your energy so that you can take care of yourself. You do not need to take care of others’ fears and worries about you,” says Kelly.

Once the people close to you begin to understand and digest what’s happening, together you can start to talk openly about ways they can offer support — whether it’s giving emotional comfort or helping with day-to-day needs.

Partners

If you have a spouse or partner, that person will most likely be the first one you talk to about your breast cancer diagnosis, and the first one you go to for love and support. When you share the news, your partner may be shocked, overwhelmed, or scared about what life will be like now. This is a major change for your life and your partner’s, and each of you needs time to adjust in your own way. Here are some common partner concerns, and ways to talk about them together:

• Your partner may be worried about whether the diagnosis will impact your ability to handle household responsibilities. Talk to your partner about what you think you will need. If you can, try to be as specific as possible. For instance, maybe it’s help with laundry or preparing meals. Ask your partner what they need, too. Talk about ways the two of you might be able to enlist the help of older children, other family members, or friends with grocery shopping or dog walking and other tasks to ease the pressure.
• If you haven’t already, invite your partner or spouse to go with you to a doctor’s appointment so they can understand more about your diagnosis, the kinds of treatment you may have, and the side effects you may experience. Going to appointments and meeting your doctors can help your partner feel more involved in your care, and can make you feel more connected as a couple.
• Your partner or spouse may also be concerned about physical intimacy and how that may change. It’s not uncommon for partners to feel guilty for wanting to have sex if you’re not feeling well, or to worry that sex may hurt you. It can help to talk honestly with your partner about how treatment affects your desire for and experience of sex, and to explore new ways to stay physically and emotionally connected. Learn more about sex and intimacy during breast cancer treatment.

On the other hand, your partner may not be the first person you want to tell — depending on your unique situation, your relationship with your partner, and your other relationships. “Trust yourself; if you want to tell your best friend or your cousin first, it’s ok to do that. There is no recipe for this,” says Kelly.

Talking to a partner if you have metastatic breast cancer

Since metastatic cancer does not have a cure, quality of life often becomes the main focus. One of the biggest challenges of living with metastatic breast cancer for you and your partner is the uncertainty. The future, which you may have talked about and planned for before diagnosis, becomes unknown.

If you have a partner or spouse, as you prepare to give them the news and have conversations about your diagnosis, remember that everyone responds differently to hearing painful things. Your partner may process thoughts and fears differently than you do. Here are some things to keep in mind when talking to your partner:

• Accept that what you will face together is unknown and will change, and that sometimes, those things can feel scary. Many things, like if a treatment will work, are beyond your control.
• Discuss how you can control the things you can — and what things in your life are important to you.
• Schedule regular time to be together and talk honestly about what’s happening. Let your partner know how you’re feeling emotionally and physically, and ask them how they’re feeling. Just sharing what you’re worried about can give you relief and bring you closer.
• Ask your spouse or partner how much they want to know. Even the person who is closest to you may not be able to handle all the details of treatment and side effects. Talking honestly about how much to share can help you know what to expect from your partner.
• Encourage your partner to seek comfort and help from other family and community members and friends when needed.
• Sometimes the changes that come with a serious diagnosis can trigger fear or anger in a partner or spouse. If your partner is not responding in a way that feels compassionate to you, suggest that the two of you meet with a therapist who works with couples affected by serious illness. This can be a source of support for both of you.
• You can still enjoy physical pleasure and emotional closeness with your partner. Learn more about intimacy and sexuality with metastatic breast cancer.

Children

Nearly 3 million children and teenagers in the United States have a parent who has had or has cancer. If you are a parent and you have been diagnosed with breast cancer, you are not alone — and neither are your children. In this section, we provide guidance for talking with children under the age of 18.

Whether you’re a parent, grandparent, aunt, uncle, or other important person in a child’s life, it helps to let them know about your diagnosis. You may be tempted to shield them from the news, but children usually cope better than adults expect. Over the long run, it’s hard to keep a breast cancer diagnosis a secret. Even young children will notice changes in the way you look or behave due to changes in your own emotions, schedule, or treatment side effects. Children can feel more anxious when they notice these changes and don’t know why they are happening. They may sense adults are hiding something, and what they imagine may be worse than what is really going on.

Talk with your child in a way that makes sense for your child’s age, personality, and emotional readiness. If you’re a parent, you know your child better than anyone, so you are the best person to decide what might work well.

With children of all ages

• Always tell the truth. You don’t have to share every detail of your treatment. Just make sure that everything you say is true, even if this means saying, “I don’t know.”
• You can always emphasize what is going well — that you trust your doctors and that they have medicines they hope will help you.
• Use your doctor’s name when you talk about them to your child.
• Tell children how their daily routines may change. For instance, “On treatment days, Dad or your aunt will help you get ready for school or drive you to practice.”
• Prepare them for side effects such as hair loss, nausea, or fatigue; knowing what to expect may help reduce their worries. Let them know they can ask questions about these changes as they occur.
• Be aware of your child’s behavior. If a child who is toilet-trained begins to have accidents or an older child’s grades begin to slip, they may need help. If these changes last more than a couple of weeks, seek professional support for them.

With children ages 3 to 6

• Let them know there is cancer in your body and that doctors will treat it. You can point to the areas of your body or use a doll, or pictures.
• Use real words, such as “cancer” and “chemotherapy,” to help children understand that they won’t lose their hair or have other side effects the next time they have a cold or an ear infection.
• You may want to use one of the many picture books available to help the young people in your life understand cancer. Visit our Reading for Reassurance program page to learn about free books.
• Start with the basics. Then, add more details if they ask for more information. You can say, “I am sick with cancer, but I am taking medicine to make me better. The medicine may make me tired or lose my hair, but I am still the same person you know.”
• Invite them to ask questions, and regularly check in with them for follow-up conversations.
• Explain to children that cancer is not contagious and that they cannot “catch” it from you.
• Children may believe that the cancer is their fault or that your treatment is punishment for something they did. Reassure young people that what’s happening has nothing to do with anything they did or thought, and let them know that you love them.

With older children and teens

• Ask them what they want to know. Some children may want to know all the details; some may not.
• Tell them you will let them know if there are changes in your health situation.
• Invite them to ask questions and check in with them for regular follow-up conversations. Encourage your children to write down questions, if writing is more comfortable for them.
• Let them know there are other trusted adults they can also talk to about the cancer and how they’re feeling, and tell them who those adults are. You may want to ask a social worker at your cancer center for a referral to a therapist who can support them. You can also ask about support at your child’s school, such as a guidance counselor.
• When you’re driving in the car, try asking your child, “is this a good time to update you about my recent doctor’s appointment?” If the child says, “no, I’m thinking about a test I’m taking tomorrow,” respect that it’s not a good time for them.
• Keep in mind that 7- to 12-year-olds may need help recognizing and managing anxiety, which can sometimes show up as headaches or stomachaches.
• It’s fine to talk to teens on an adult level. It’s OK to use the same words that you’d use with another adult. But it’s important to remember that teens don’t have the same emotional capacity as adults, so their reactions to these conversations may be different than what you may experience with adults. Answer teens’ questions and allow them time to think about what you tell them. Let your teen know it’s important to you that they still maintain their lives and friendships outside of your family.

If your child uses the Internet, suggest looking at trusted websites together if they want to understand more about your diagnosis. If you decide to read about breast cancer online with your child or teen, one thing to keep in mind — and to share with your child — is that looking at survival statistics can sometimes be both upsetting and confusing, because the numbers are based on large groups of people and don’t reflect the experiences of any one individual.

Talking with children if you have metastatic breast cancer

If you’ve been diagnosed with metastatic breast cancer, conversations with children will be ongoing, and they’ll evolve as circumstances change. Knowing that communication is a continuous process can lower some of the pressure of getting it “right” the first time you talk about your diagnosis. Give children important information at a pace that feels comfortable for them. Ongoing conversations can help to make things feel less uncertain, and it can help them feel comfortable knowing that the lines of communication are always open.

As with any conversation about illness, how you talk to your children about your diagnosis also depends on their age. But it’s still important to be as honest as possible, and to resist making promises you can’t keep. Here are some general guidelines for talking with children of different ages about a metastatic breast cancer diagnosis:

When talking with children of any age, let them know they will always have someone to care for and love them. Expect to share more specific information about your diagnosis. Be prepared for questions about end of life and death. You could let them know that yes, metastatic breast cancer is serious, but your doctors are prescribing treatments to help you live as long and as comfortably as possible.

If you’re a parent, it’s normal to be concerned that sharing this information might mean that your child will always be worried about you. But most of the time, this is not the case, according to Eliza Park, MD, assistant professor of psychiatry and medicine at the University of North Carolina at Chapel Hill. “Kids can compartmentalize — often better than adults, and live happy, healthy, busy lives despite knowledge of a parent’s serious illness,” she says.

Resources for talking with children about breast cancer

LBBC can offer support for you and the children in your life with these resources:

• Our Breast Cancer Helpline volunteers are available to help you think about how to communicate a breast cancer diagnosis news to the children in your life.
• Our Reading for Reassurance program offers free books tailored for children aged 4-17 with a parent who has been diagnosed with breast cancer within the last 6 months.

Parents

Telling your parents that you’ve been diagnosed with breast cancer can bring up extreme emotions for all of you. Your relationship with your parent or parents is not like anyone else’s relationship with their parents. If you have a healthy relationship with your parents, and they live nearby and can provide help and support to you and your family, you will want to tell them what’s going on. If your parents don’t live nearby or they have their own challenges with their physical, mental, or cognitive health, you may choose not to tell them. You are the one who decides, based on your relationships.

If you want your parents to know, but you don’t want to be the one who tells them, it’s OK to ask a sibling or partner to tell them for you. Remember that you only have a certain amount of energy, and you need to be your first priority. Your energy should be preserved for own your health and wellness.

Here are some things to keep in mind when talking to your parents:

• You may want to schedule some uninterrupted time to talk with your parents about your diagnosis.
• It can help to rehearse what you’re going to say ahead of time. If it’s comfortable, try role-playing what you want to say with a sibling or your partner.
• Share your honest feelings and let them know what you need. Encourage them to ask you any questions they may have.
• Acknowledge how hard it must be for them to hear that their child has cancer.
• It is not uncommon for a parent to feel guilty when they learn their child has cancer. Let your parents know that they did not do anything to cause you to develop cancer, and that it is not their fault that you did.
• Encourage your parents to seek emotional support from each other and their friends, not from you.

Talking to parents if you have metastatic breast cancer

No child ever wants to tell their parents they have metastatic breast cancer. There is no doubt the first discussion, and the ones you will likely continue to have, will be some of the most challenging and upsetting talks of your life, and theirs.

You may make choices about treatment and care that your parents may not agree with, but remember that those decisions are yours — and only yours — to make.

Whether you have metastatic breast cancer or early-stage breast cancer, it’s important to remember that there is no right way or wrong way to talk to your parents, or any of your loved ones, about it.