Finding out you have cancer can be hard enough. Telling your family, friends and employer that you have cancer can add another layer of stress.
You may wonder when the right time is to share this information or even how much you should share. We asked senior social work counselor Melanie Cavazos and social work counselor Amber Jackson for advice on how to disclose your cancer diagnosis.
How to tell your children you have cancer
Aside from your spouse or partner, you probably spend the most time at home with your children. When sharing your cancer diagnosis with them, it’s important to consider their age(s), their feelings and the environment you’re in.
“You should disclose your cancer diagnosis to your children as soon as possible,” says Cavazos. “You may choose to wait until after you have an official diagnosis and treatment plan, but definitely before treatment begins. This should be done at home, somewhere that feels safe and comfortable for them.”
It’s important to give children plenty of time to process the information and ask questions.
“You don’t want to tell them, and then 10 minutes later you have to take them to school or put them to bed,” she says. “Give them all the time they need to ask questions and be sure to prepare them for any changes that may be coming their way.”
Jackson recommends keeping it brief and concise with younger children and providing a bit more information for older children and teens.
“Reinforce to younger children that it’s nothing that they caused or something they can catch from you. That may be a concern as they try to understand and process the information,” says Jackson. “The most important thing – regardless of age – is to make space for their emotions.”
Let friends and family know how they can help
Telling friends and extended family you have cancer can require a bit of preparation. You may not be able to speak with them in person, so you’ll need to determine the best mode of communication.
“A phone call may be fine for people who live far or who you don’t see often,” says Jackson. “You may even ask a few people to talk via Zoom video call if the ability to see their reaction is something you feel either of you need for that connection.”
They’re likely going to want to help in some way, but they may not know what you need or even how to ask what you need.
“Ask yourself what you’re looking for from that person,” says Cavazos. “Is it just to inform them? Or do you need some sort of support from them, whether it’s emotional support or concrete support, like help with transportation or meals.”
She suggests coming up with a list of tasks that you’ll need help with and giving it to friends and family.
“Instead of saying, ‘I’m not sure what I’ll need, I’m OK right now’ or ‘I don’t need anything,’ give them your list,” says Cavazos. “Your list could include picking up your groceries, bringing you dinner or taking you to doctor appointments. It will make that person feel good because they’re helping, and it will take something off your plate.”
And if all you need from your friend is a listening ear, it’s fine to say that, too, adds Jackson.
Navigating your cancer diagnosis at work
Sharing a cancer diagnosis at work can be especially tricky because of the different dynamics with your employer and colleagues.
“Speak with your HR department to discuss your options as far as paid time off, short-term disability or FMLA,” says Cavazos. “They’re going to require documentation from your physician. This is to protect you so that you can receive the benefits you’ve earned and deserve.”
She often refers patients to an organization called Cancer and Careers, which provides advice on how to thrive in the workplace for people with cancer.
“You do not have to disclose specifics to your immediate boss, but they are going to need to know that you have a medical condition and you’re going to need time off for treatment or doctor’s appointments,” says Cavazos.
“With coworkers, it depends on the work environment and how close you are with them,” she adds. “It’s entirely up to you how much you disclose – or if you disclose – to your coworkers.”
Cavazos encourages patients to speak with their care team before talking to an employer.
“Is your goal to be able to work during treatment? If so, you can be prepared with a plan,” she says. “Instead of saying, ‘I don’t know what I’ll need,’ you can say, ‘I’ll have treatment every three weeks. I’m going to need two days off during these weeks.’”
If you’re a patient at MD Anderson, your social work counselor can help you map out how this conversation should go. You can contact Social Work by calling 713-792-6195.
Set healthy boundaries
If there’s ever a time in your life to be selfish and focus on your own needs, it’s after you receive a cancer diagnosis.
Part of that means setting clear boundaries with family and friends.
“Disclosing a cancer diagnosis is not a one-size-fits-all approach,” says Cavazos. “If you know that somebody tends to not respect boundaries – we all have that family member or friend – then prepare yourself for that conversation. If someone asks a prying or off-putting question, be OK with saying, ‘I don’t feel comfortable answering that right now’ or ‘I don’t have that information. I’d like to discuss that with my doctor first.’”
Questions about prognosis can be especially triggering.
“Thoughts of someone’s life expectancy often come to mind immediately when one hears the word cancer,” says Jackson. “Reframing the conversation can help. Try saying, ‘I’ve met with my medical team, and they’re very thorough. They’ve laid out a few options for me, and I’m taking my time to decide what’s going to be best for me moving forward.’”
Setting boundaries can help family and friends prepare for potential changes in your relationships as well.
“You may not be as present at social events, or you may not be able to respond to their text messages or phone calls immediately if you’re not feeling well,” she says. “It’s important to communicate that things will change but remind them that none of it is done in malice.”
For patients struggling with setting boundaries, Jackson suggests joining myCancerConnection, MD Anderson’s one-on-one cancer support community.
“You can connect with someone who’s also had to disclose their cancer diagnosis,” she says. “They can touch on some of your challenges and help you identify different approaches.”
While having conversations about your cancer diagnosis can be hard, it’s important to do it on your terms and when you’re most comfortable.