Enhancing Connections: Talking with Kids about Cancer

Written By Jeanette White

When a young boy heard his mother had breast cancer, he thought she’d be in a coma. Another child blamed Martians for his mom’s breast cancer. Even when the disease is caught early, kids often feel certain their mom will die. Terrified and anxious, do they turn to the person so good at comforting them? Not usually.

“They tell us they hide any sad or bad thoughts from their mother. They read her as very, very burdened, and they don’t want to add to Mommy’s burden,” says Fran Lewis, RN, PhD, a University of Washington researcher and social psychologist. Linda Thompson, RN, director of Providence Cancer Center at Sacred Heart Medical Center and Holy Family Hospital, noticed moms also were struggling with how to talk with their kids. “They’re not able to get their children to tell them what the problem is. They don’t even know where to begin,” says Thompson. “And the mommy doesn’t trust herself to talk to them because it’s too painful.” Women coping with chemotherapy, radiation, nausea, and their own fear and anxiety are often too exhausted to focus on the communication gaps invading their families.

Now, Thompson and Lewis have teamed up to bridge those gaps, which are common in even the most stable families. Breast cancer patients with kids ages 5 to 12 can enroll in a free, first-ofits- kind program called Enhancing Connections, which offers plans for talking with and comforting their children.

Sherri Calhoun, RN, breast cancer care coordinator, and Christine Kemp, ARNP, were recently trained by Lewis and her colleagues to pass along these important skills in 1-on-1 sessions with mothers. For the program’s first year, a Susan G. Komen for the Cure grant will cover costs of up to 16 women. “It’s kind of first come, first served,” says Thompson. While Spokane is first to use the program in a community setting, it’s been proven effective in a 6-state clinical trial, says Lewis, who has spent nearly 2 decades developing and testing programs to help families better deal with cancer. That research has included thousands of interviews with women and children. “The mothers will say, ’I’m so fatigued, so in survival mode. I know the children need me, but I don’t have the energy to listen;’ and these are normal, wonderful mommies,” says Lewis.

When Lewis talks with families dealing with breast cancer, she often envisions a cloud of sadness hovering over the mother and extending to her children. The kids are distressed after watching mom endure surgery, lose her hair, and lie on the couch feeling sick. Yet that cloud can dissipate when women learn to manage their own anxiety and depression.

They’re encouraged to find the balance between not saying enough to their kids about cancer and sharing too many disturbing details. When well-meaning moms discuss their medical condition as if a child is an adult friend, kids are confused and overwhelmed with details they’re not ready to handle.

It’s also important that women identify their own “hotspots,” topics and situations that flood them with emotion related to the breast cancer. (Think questions like, “Mom, will you be here for my next birthday?”) Without planning ahead, moms understandably respond to hotspots by sobbing, clamming up, or leaving the room. Kids learn to avoid hotspots, but instead carry around a silent sorrow with no one to comfort them. Only when mothers have the skills to handle emotionally charged questions will children feel free to open up. “We actually give them ways to respond to the children so they keep talking, keeping the conversation going,” says Lewis. “The key is how do I care and not scare my child?”

For more information, call Providence Cancer Center at (509) 474-5490 or visit: www.providencecancercenter.org