Breaking the NEWS About CANCER to FAMILY and FRIENDS To Tell or Not To Tell... Karen V. de la Cruz, Ph.D.

Sharing a diagnosis of cancer isn't easy. You may be unsure of how you or your family and friends will react when you tell them. But talking to other people about the diagnosis helps share anxiety and fears. It also reinforces that you don't have to face cancer alone.

The Difficulty in Telling Others Why some cancer patients find it difficult to tell others about their illness worry about how people would react fear that they might cry when they start talking to others about it discomfort with their own emotions they would not know how to handle the emotions of others just the mere mention of the word “cancer” already sends signals of anxiety, agitation and apprehension

Should you tell? Trying to hide the diagnosis is usually unsuccessful. Sooner or later family and friends learn that you have cancer, and they may feel hurt or left out that you didn't tell them sooner. It also helps to eventually talk about it -- but it should be at your own time and in your own pace. No pressure.

FACTORS THAT AFFECT THE CAPACITY TO TELL The decision on whether to convey the news or not, and how to convey the news may depend on the following factors: how we view cancer - what we think of it how we view ourselves with the cancer - what we think about us now that we have it how we see our relatives and friends taking the news - - can they handle it? how we think they will see us now that we have cancer

The Patient’s Perspective The range of thoughts and emotions running in our mind and heart the ambiguity in not knowing how people will react, respond and feel about us the presence of contrasting thoughts and conflicting emotions

Tips for telling others THE READINESS THING - Break the news when you feel ready. Let family or friends take care of telling others if you don't feel like it or are not sure how to say Be prepared - for questions, for sympathy, for empathy, for any possible reaction. People in general do not typically know how to handle this type of news. Draw boundaries. You don't have to share every detail with everyone. Look at every conversation about the topic a learning experience -- you are not the only one who has this illness. You may learn something from others.

Talking about your feelings Talking about your feelings can be difficult. Here are some things to keep in mind when the time comes to discuss your illness and the way you feel about it with others. Some people will be ready to talk sooner than others. It's OK to tell people you're not ready to talk and that you'd rather wait for another time. There may be times when you want to be left alone. This can be hard for family and friends who may not understand how you feel and want to share this difficult time with you. Your family and friends may try to support you by putting on a happy face or by being overly caring. Let your family and friends know when their behaviour upsets you. They will probably appreciate some direction on how to act. If you prefer, you can talk to your religious or spiritual adviser, social worker, counselor or psychologist. A support group may also provide the help you need.

When It Comes to Our Kids It's understandable that parents want to protect their children from upsetting news. When deciding whether to break the news to your children, it is important to consider that: Children usually guess something is wrong even if they don't know what it is. By telling the children, you give them the opportunity to ask questions and express their feelings. Many children need reassurance that your illness is not their fault. When not told what is wrong, children may imagine the worst, feel left out or become angry at the lack of attention.

Helping your family adjust Cancer is difficult for everyone it affects. Everyone reacts in different ways, but in general your family needs to adjust to the diagnosis too. They may feel uncomfortable because they don't know what to say or how you'll react. As you express your own feelings, remember that others may need to do the same. They may experience the same fears, anxieties or anger, and need as much information and advice as you do. It often helps to bring some members of the family or friends you are comfortable with when you go to see your doctor. If you need to cry, CRY. It is important to express emotions, to ventilate, to have psychological air. Allow your family members to also cry if they need to. At this point, you all need each other’s strengths.

When friends stay away Cancer can change friendships. Some friends handle it well, others cut off all contact. Friends stay away for different reasons. They may not be able to cope with their feelings or know how to respond to a change in your appearance. Your friends may still care for you, even if they stay away. They may be uneasy about your illness. If you think this is the case, call them to ease the way. Remember that you can't always deal with all the reasons why people avoid you; some still believe that cancer is contagious and that they can catch it from you. Sometimes you have to be honest with yourself - are friends staying away or have you withdrawn from them to avoid talking about your fears and anxieties? You may find that talking about your illness helps you cope with it better. Going it alone Sometimes people live alone or have no family. This may make them feel lonely or that they have no one to live for. If you would like company, support groups may provide some comfort or offer the encouragement you need to stay positive.