Talking With Your Family About Advanced Cancer

When your cancer is advanced, you will want to talk about future steps and what to expect with your health care team and family members. Having these talks may not be easy. But knowing your options will make it easier for you to move forward with your care.

You can hope for the best while still being informed about your choices. And it is okay if you do not feel comfortable talking about these issues. What you say to others is up to you, and you get to decide when, or if, you want to respond at all.

When you tell your loved ones that your cancer is advanced, they may need time to adjust. They have to come to terms with their own feelings, which may include confusion, shock, helplessness, anger, and sadness.

Everyone copes with bad news in their own way. Knowing this helps you understand their feelings. Let people know that the best thing they can do for you is to be themselves and feel at ease with you. Ask them to listen when you need it, rather than try to solve every problem.

Keep in mind that not everyone can handle the thought of losing you. Some people may not know what to say. As a result, relationships may change. This is not because of you, but because others have trouble coping with their own painful feelings.

It is hard to face an uncertain future together, and often people do not know what to say. It is likely that you and your partner are having some of the same thoughts and fears. There will come a time to talk about issues such as when to stop treatment, plans for the future, where to get care, and wishes at the end of life.

Studies show that people who talk things out feel better about the care they get and the decisions they make. Be honest about your feelings, and remember that each person handles things in their own time and way. If it is too hard on your own, a counselor or mental health expert can help.

Children of all ages can sense when things are wrong, and keeping their trust matters. It is best to be as open as you can. Children may worry that they caused the illness, that no one will care for them, or that you are spending less time with them.

Although you cannot protect children from what they feel, you can prepare them. Try to:

• Be honest, telling them you are sick and the doctors are working to help you feel comfortable.
• Let them know nothing they did or said caused the cancer, and that they cannot catch it.
• Tell them you love them and that it is okay to be upset, angry, or scared.
• Be clear and simple, using words they can understand.
• Reassure them that they will always be taken care of and loved.
• Invite their questions, and answer as honestly as you can.

Teenagers need to hear the truth, which may keep them from feeling guilt and stress. But they may try to avoid the subject, become angry, or withdraw. Give them space and time to process their feelings, alone or with friends. Encourage them to keep going to school and activities, and to talk with people they trust.

With adult children, your relationship may change, and you may need to rely on them differently than before. Many people find this hard, especially if they are used to giving support rather than receiving it. Sharing decisions and involving them in what matters to you can help them cope and may bring you closer.

Any problems your family had before are likely to feel more intense now. It is common for families to argue over treatment, when to use hospice, feelings that some people are helping more than others, and money.

Often, talking with the people closest to you is harder than talking with anyone else. If you do not feel comfortable, ask a member of your health care team to help start a conversation. You could also ask a social worker or other professional to hold a family meeting. This can help everyone feel more comfortable expressing their feelings and solving problems together. Studies show that cancer care goes more smoothly when everyone stays open and talks about the issues.