Talking with family

How do I tell my family about my diagnosis?

If you’ve just learned that you have metastatic breast cancer, it can be very upsetting to imagine how you’ll tell your family. It’s completely OK to stop, breathe, and take the time you need before sharing the news. Who you tell and when you tell them is your decision.

When you’re ready to talk with your family, it’s very possible that they may have intense emotional reactions. Since that can increase any stressful feelings you may already have, it can help to choose one close and trusted person to tell first who can be there with you as a support when you share with other family members. Once the people close to you begin to understand and digest what’s happening, together you can start to talk openly about ways they can offer support — whether it’s giving emotional support or helping with day-to-day needs.

On this page, we offer guidance on ways to tell partners, children, and parents about your diagnosis. How you share the news will be different depending on the family member.

How to talk to your partner about your metastatic breast cancer diagnosis

When you tell your partner or spouse about your diagnosis, they may understandably be shocked, overwhelmed, or scared about what life will be like now. This is a significant change for your life and theirs, and each of you needs time to adjust in whatever way works for you. Here are some common partner concerns, and ways to talk about them together:

• Your partner may be worried about whether the diagnosis will impact your ability to handle household responsibilities. Let your partner know what you need. If you can, try to be as specific as possible. For instance, maybe it’s help with laundry or preparing meals. Ask your partner what they need, too. Talk about ways the two of you might be able to enlist the help of other family members or friends with grocery shopping and other tasks to ease the pressure.
• If you haven’t already, invite your partner or spouse to go with you to a doctor appointment so they can understand more about your diagnosis, the kinds of treatment you may have, and side effects that you may experience. Going to appointments and meeting your doctors can help them feel more involved in your care, and can make you feel more connected as a couple.
• Your partner or spouse may also be concerned about physical intimacy and how that may change. It’s not uncommon for partners to feel guilt for wanting sexual connection if you’re not feeling well, or to worry that sex may hurt you. It can help to talk honestly with your partner about how treatment affects your desire for and experience of sex, and to explore new ways to stay physically and emotionally connected. Visit Intimacy and sexuality with metastatic breast cancer for more information.
• Schedule regular time to just be together and talk honestly with each other about what’s happening. Let your partner know how you’re feeling emotionally and physically, and ask them how they’re feeling. Just sharing what you’re worried about can bring you closer together.
• Sometimes the changes that come with a serious diagnosis can trigger fear or anger in partner or spouse. If your partner is not responding in a way that feels supportive to you, suggest that the two of you meet with a therapist who works with couples affected by serious illness. This can be a source of support for both of you.

How to talk to your children about your metastatic breast cancer diagnosis

Video Link: Parenting with Metastatic Breast Cancer

For many parents, it’s a first instinct to try to protect children from news about a metastatic breast cancer diagnosis. One of the hardest parts of telling children about a metastatic breast cancer diagnosis is that it is not curable, and that treatment is ongoing. But it’s important to be as honest as possible.

Christina Wise, MA, GC-C, children and teen program coordinator for Cancer Support Community Greater Philadelphia, says, “I always encourage honesty because most of the time kids can sense that something is going on. Kids might notice that there is whispering, or that a parent goes to the other room to talk when the phone rings.”

Experts say that there is no right or wrong way to talk to children about a diagnosis of metastatic breast cancer, although there are tips to guide the conversation:

• Don’t assume children, even very young ones, won’t find out if you don’t tell them
• Use accurate, specific words that are age- and developmentally appropriate. Since you know your child best, you may already know what may work well
• Be honest, but emphasize that your doctors have medicines that they hope will help you
• Let them know what they can expect in their day-to-day experience, for example: “On treatment days, I’ll be tired, so Uncle Pete will pick you up from softball practice.”
• Tell them you will let them know if there are changes in your health situation
• Invite them to ask questions, and check in with them for regular follow-up conversations
• Let them know there are other trusted adults they can also talk to about the cancer, and let them know who those adults are

If your child is old enough to use the Internet, suggest looking at trusted websites together if they want to understand more about your diagnosis. If you decide to read about breast cancer online with your child, one thing to keep in mind is that looking at survival statistics can sometimes be both upsetting and confusing, because the numbers are based on large groups of people and don’t reflect the experiences of any one individual.

How you talk to your children about your diagnosis also depends on their age.

Talking to your younger children

When sharing the news with children under age 10, keep things as simple as you can:

• Let them know there is cancer in your body and that doctors will treat it. You can point to the areas of your body or use a doll, or pictures, to communicate with small children.
• Explain to them that the cancer is not contagious and that they cannot “catch” it from you.
• Very young children (ages 3 to 6) may have difficulty understanding that the cancer is not their fault or that your treatment is not punishment for something they did. Reassure them that what’s happening has nothing to do with anything they did or thought, and let them know that you love them.
• Tell children how their daily routines may change. For instance, “On Tuesdays and Wednesdays, Dad will help you get ready for school.”
• Let them know about side effects you may experience, such as hair loss or fatigue. Preparing children ahead of time can reduce any fear or anxiety they may have.
• Schedule regular time to be together and just have fun, whether it’s watching a funny movie or playing a game.

Talking to your older children

When talking with older children and teens, it’s OK to share more specific information about your diagnosis:

• Encourage them to ask questions, and provide detailed answers.
• Let them know there will be side effects such as hair loss, nausea, or fatigue.
• Be prepared for questions about death. You could let them know that yes, metastatic breast cancer is serious, but your doctors are prescribing treatments to help you live as long as possible.
• Children 7 to 12 years old may need help with anxiety, which can sometimes show up as headaches or stomachaches. Ask the social worker at your cancer center for a referral to a counselor or reach out to extended family for extra support for your child.
• It’s also important for teenagers to have a safe space to vent their feelings outside of the family. If you can, enlist the help of a trusted family friend or counselor.
• Have regular family time, such as sharing meals or watching favorite TV shows together.

How to talk to your parents about your metastatic breast cancer diagnosis

Telling a parent that you’ve been diagnosed with metastatic breast cancer can bring up many extreme emotions for all of you. Still, it’s important to be honest and let them know.

Here are some ways to have the conversation:

• Schedule some uninterrupted time to talk with your parents about your diagnosis.
• It can help to rehearse what you’re going to say ahead of time. If it’s comfortable, try role-playing what you want to say with a sibling or your partner.
• Share your honest feelings with your parents and let them know what you need.
• Stop, listen, and observe their body language from time to time to see if they’re understanding what you’re telling them.
• Encourage them to ask you any questions they may have.

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The video on this page was supported by the Grant or Cooperative Agreement Number 1 NU58DP006672, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.