- Cancer can be unutterably lonely. No one should try to bear it
- Patient, family, and friends usually learn the diagnosis sooner
or later. Most people find it easier for all if everybody can share
their feelings instead of hiding them. This frees people to offer
each other support.
- Patients usually agree that hiding the diagnosis from them
denies them the right to make important choices about their life
and their treatment.
- Families say patients who try to keep the diagnosis secret rob
loved ones of the chance to express that love and to offer help and
- Family members and intimate friends also bear great emotional
burdens and should be able to share them openly with each other and
- Even children should be told. They sense when something is
amiss, and they may imagine a situation worse than it really
- The patient might want to tell the children directly, or it may
be easier to have a close friend or loving relative do so.
- The children's ages and emotional maturity should be a guide in
deciding how much to tell. The goal is to let children express
their feelings and ask questions about the cancer.
- By sharing the diagnosis, patient, family, and friends build
foundations of mutual understanding and trust.
One question many people ask after diagnosis is "Should I
tell?" Perhaps not. A family member could be too old, too young, or
too emotionally fragile to accept the diagnosis, but people are
surprisingly resilient. Most find ways to deal with the reality of
illness and the possibility of death-even when it involves those
they love most. They find the strength to bounce back from
situations that seem to cause unbearable grief.
The way in which people differ is in the speed with which they
bounce back. The diagnosis of cancer hits most of us with a wave of
shock, of fright, of denial. Each person needs a different amount
of time to pull himself or herself together and to deal with the
reality of cancer. In reading the sections that follow, you should
remember that only you really know your emotional timetable. Think
about sharing at a time when you are ready to do so.
Usually, family and close friends learn sooner or later that
you have cancer. Most people with cancer have found the best choice
is to share the diagnosis and to give those closest to them the
opportunity to offer their support. They have found it easier, in
the long run, to confide their fears and hopes rather than trying
to hide them. Of course, you must comfortably time your words in
telling family and friends that you have cancer. We will talk more
about that in the next chapter.
If you have no family, it is especially true that the road
appears less lonely when shared with a few close friends. You might
lose one or two. Some people will find it too difficult to talk
with you or to be around you, and they will slip away. On the other
hand, you may discover hidden strengths and compassion in the least
likely of companions.
A woman with cancer wrote, "As for whether or not people should
keep their illness a secret, I think they will learn with whom they
can talk. Some people make themselves scarce if cancer is
mentioned. But, cancer patients soon learn who their trusted
Another person said, "I don't think a cancer patient should
keep it to himself. If it isn't revealed, family and friends are
robbed of the opportunity to share the feelings and anxieties that
arise from having the disease. At most, life is very short for
everyone. Because there are no guarantees, we should make the most
of each day."
On a practical level, trying to hide the diagnosis is usually
fruitless. As you move from hope to despair and back again, family
and close friends will sense something is deeply troubling you,
even before they learn the facts. When you feel ready, try to share
your news with them.
As you ponder whether you can share the diagnosis of cancer
with others, it might help to remember the following. In telling
loved ones about your cancer, you give them the opportunity to
express their feelings, to voice their fears and hopes and to offer
their hand in support. Then, each can give and take strength as
they are able.
Sometimes family members are the first to learn the diagnosis.
If, as a family member, the decision falls to you, should you tell
the patient? Some might think not, but most people with cancer
disagree. "I think a cancer patient should be told the truth," one
wrote. "Time is so valuable, and there may be things the person
would like to accomplish. There are decisions to be made..."
All of us have important life choices to make. People with
cancer often find these choices become crystal clear when they feel
their life span could be cut short. They might outlive any one of
us, but people with cancer have the right to know and decide how
they will spend their remaining days. There are exceptions to any
generalization, but most people relate that "Mom took the news much
better than we thought she would."
A woman who herself has cancer recalled how things have changed
since her mother was diagnosed in 1930. "My relatives never told my
mother that she had cancer. Of course, then, they didn't have the
treatment they have available now. Looking back I realize no one
fooled her. In not telling her, though, she was deprived of a very
valuable outlet for her emotions."
Family members also bear great emotional burdens during the
period of diagnosis. They, too, need the comfort of sharing their
feelings. Yet, it is almost impossible to support the rest of the
family if you are hiding the diagnosis from the person with cancer.
He or she inevitably learns the truth. The consequences can be deep
anger, hurt, or bitterness. The patient might believe that no one
is being honest about the diagnosis because the cancer is terminal.
On the other hand, while you are trying to "spare the patient," the
person with cancer might be trying to protect family and friends
from learning the truth. Then each ends up suffering alone, with
thoughts and feelings locked within.
Even children sense the truth. Some parents who tried to
"spare" their children from knowing later voiced regret at not
discussing the truth during the course of the disease. Children
have amazing capabilities when they understand a situation.
However, when their normal world is turned upside down and
whispered conversations go on behind closed doors, they often
imagine situations that are worse than reality. Young children
dwell on "terrible" things
have done or said that place
responsibility for the upheaval in the household on themselves.
This is especially true if the child is going through a period of
testing parental authority or in some other way is in disagreement
with family members. Children, especially young ones, tend to view
themselves as the center of the universe and see many situations
only in direct relationship to themselves.
The children's ages and emotional maturity should suggest what
and how much to disclose. It might help to realize that including
the children, among those who know, comforts them by confirming
their belief that something is amiss within the family.
A parent with cancer might want to tell the children directly.
"I've been sick a lot lately, haven't I? I have a disease called
cancer. The doctors are doing every thing they can to make me well.
I can't spend as much time with you as I wish to; it's going to be
hard on all of us, but I still love you very much."
Perhaps this is too painful. A close and loving aunt or uncle
or friend might be able to explain things more comfortably. "Your
daddy is ill. The doctors are almost sure they can make him well,
but sometimes his treatments make him feel sad or grouchy. It's
nothing you children have done, but he needs your patience and
The goal in telling the children that someone in the family has
cancer is to give them opportunities to ask questions about the
disease and to express their feelings about it. Of course, all of
us want to shield our children from pain, but pain they understand
is easier for them to cope with than hurts that they imagine. Some
adults tell us that they still remember the feelings of rejection
they suffered as children of cancer patients. As children they were
aware of great disruption within the family, but at the time they
were denied knowledge of the cause. They were hurt and confused by
what seemed to be lack of attention and unreasonable demands or
We begin to see that the most compelling reason for sharing the
diagnosis with adults and children alike is that cancer can be so
terribly lonely. No one need try to bear it alone. At times you
will feel totally without ally or solace, regardless of supports.
There is no need to increase these moments with poses meant to
convince others close to you that you do not need their help. At a
time when each of us who is trying to cope with cancer is in need
of mutual support, we should not shut each other out. Through
sharing we can build foundations of mutual understanding to sustain
us through the long period ahead. We can share anxiety and sorrow,
but we also can share love and joy and express our appreciation for
each other in ways we ordinarily might find difficult or