- Cancer is a blow to every family it touches. How it is handled
is determined to a great extent by how the family has functioned as
a unit in the past.
- Problems within the family can be the most difficult to handle;
you cannot go home to escape them.
- Adjusting to role changes can cause great upheavals in the way
family members interact.
- Performing too many roles at once endangers anyone's emotional
well-being and ability to cope. Examine what tasks are necessary
and let others slide.
- Consider hiring professional nurses or homemakers. Financial
costs need to be compared with the physical and emotional cost of
shouldering the load alone.
- Children may need special attention. They need comfort,
reassurance, affection, guidance, and discipline at times of
disruption in their routine.
Although cancer has "come out of the closet," much of what we
read in newspapers and magazines is about the disease itself-its
probable causes or new methods of treatment. There is little
information about how families deal with cancer on a day-to-day
basis. This gap reinforces feelings that families coping with
cancer are isolated from the rest of the world: that everyone else
is managing nicely while you flounder with your feelings, hide from
your spouse, and are incapable of talking to the children.
Cancer is a blow to every family it touches. How you handle it is
determined to a great extent by how you have functioned as a family
in the past. Families who are used to sharing their feelings with
each other usually are able to talk about the disease and the
changes it brings. Families in which each member solves problems
alone or in which one person has played the major role in making
decisions might have more difficulty coping.
Problems within the family can be the most difficult to handle
simply because you cannot go home to escape them. Some family
members may deny the reality of cancer or refuse to discuss
It is not uncommon to feel deserted or to feel unable to face
cancer openly. "My brother-in-law is suffering from cancer," one
man confided. "The entire situation is depressing, and my reaction
has been one of running and hiding. I have not visited them for I
feel I have nothing to offer."
A woman with cancer found none of her family could help her.
"My two wonderful sons tolerated their dad's heart surgeries very
well, but now I have cancer, and they don't know how to act. Phone
calls and letters expressing sympathy are not what I need. I've
tried since last November to express my thoughts to my husband, but
he shuts out what I'm saying. I know that he's uncertain about our
future, but I can't seem to get through to him; I've learned from
other patients that it's a common concern."
In these situations individual counseling or cancer patient
groups can provide needed support and reinforcement. Moreover,
these resources provide an outlet for the frustrations you are
facing within the family.
Families may have difficulty adjusting to the role changes that
are sometimes necessary. One husband found it overwhelming to come
home from work, prepare dinner, oversee the children's homework,
change bedding and dressings, and still try to provide
companionship and emotional support for his children and ill
In addition to roles as wife, mother, and nurse, a woman might
have to add a job outside the home for the first time. A spouse who
was sharing the load sometimes becomes the sole breadwinner and
home maker. The usual head of the household might now be its most
These changes can cause great upheavals in the ways members of
the family interact. The usual patterns are gone. Parents might
look to children for emotional support at a time when the children
themselves need it most. Teenagers might have to take over major
household responsibilities. Young children can revert to infantile
behavior as a way of dealing with the impact of cancer on the
family as a unit and on themselves as individuals. The sheer weight
of responsibility can become insurmountable, destroying normal
family associations, devouring time needed for rest and recreation,
and depriving family members of wholesome opportunities for
expressing anxiety and resentment.
Performing too many roles at once can endanger emotional
well-being and the ability to cope. Examining what's important can
solve the problem. For example, you can relax housekeeping
standards or learn to prepare simpler meals. Perhaps the children
can take on a few more household chores than they have been
If a simple solution is not enough, consider getting outside
help. Licensed practical nurses can help with the patient; county
or private agencies might provide trained homemakers. If outreach
is an important part of your church, feel free to ask for help with
cooking, shopping, transportation, and other homemaking tasks. One
family was adopted by the daughter's scout troop when the girls
learned of the extra responsibility she had assumed. Everyone
benefited from the relationship.
Let someone who can be objective help you sort out necessary
tasks from those that can go undone. The financial cost of
professional services needs to be compared with the emotional and
physical cost of shouldering the load alone. You also may be able
to obtain assistance from hospital, community, or self help groups
or from a clergy member. It is important to remember that the
family is still a unit. If the family strength is sapped, the
patient suffers, too.
The San Diego chapter of Make Today Count, a mutual support
group for patients and families, compiled a "Bill of Rights for the
Friends and Relatives of Cancer Patients." Several items address
the problems of family burdens:
- The relative of a cancer patient has the right and obligation
to take care of his own needs. Even though he may be accused of
being selfish, he must do what he has to do to keep his own peace
of mind, so that he can better minister to the needs of the
- Each person will have different needs. . . These needs must be
satisfied. The patient will benefit, too, by having a more cheerful
person to care for him.
- The relative may need help from outsiders in caring for the
patient. Although the patient may object to this, the relative has
the right to assess his own limitations of strength and endurance
and to obtain assistance when required.
- . . . When the relative knows that he is already doing all that
can reasonably be expected of anyone in caring for the patient, he
can have a clear conscience in maintaining contacts with the rest
of the world.
- If the patient attempts to use his illness as a weapon, the
relative has the right to reject that and to do only what can
reasonably be expected of him.
- If the cancer patient's relative responds only to the genuine
needs of the moment-both his own needs and those of the patient-the
stress associated with the illness can be minimized.
Increased burdens and shifting responsibilities can occur
whether the patient in the household is a spouse, a child, or an
elderly parent. Each family member must take care to meet his or
her own needs and those of the other healthy members of the family
as well as those of the patient.
Children might have difficulty coping with cancer in a parent.
Mother or Dad may be gone from the house-in a hospital that may be
hundreds of miles from home-or home in bed, in obvious discomfort,
and perhaps visibly altered in appearance.
In the face of this upheaval, children often are asked also to
behave exceptionally well: to "play quietly," to perform extra
tasks or to be understanding of others' moods beyond the maturity
of their years. The children may resent lost attention. Some fear
the loss of their parent or begin to imagine their own death. Some
children, formerly independent, now become anxious about leaving
home and parents. Discipline problems can arise if children attempt
to command the attention they feel they are missing.
It may help if a favorite relative or family friend can devote
extra time and attention to the children, who need comfort and
reassurance, affection, guidance, and discipline. Trips to the zoo
are important, but so is regular help with homework and someone to
attend the basketball awards banquet. If your efforts to provide
support and security fail, professional counseling for a child, or
child and parent together, may be necessary and should not be