A diagnosis of breast cancer can be a devastating experience for any patient, and is usually accompanied by a flood of conflicting emotions-fear, confusion, anger and despair. But it can also cause emotional upheavals within the family.

The following steps on helping a family cope with a cancer diagnosis are provided by the Department of Defense Breast Cancer Research Program in its Breast Cancer Decision Guide:

Husband or Partner

The patient's husband or partner will probably be affected by the diagnosis just as strongly. In some ways a partner's role will be particularly difficult because it will involve managing the new emotions, as well as shouldering the task of acting as the key supporter. Perhaps the most important thing a woman can do right away is to involve her husband or partner as soon as possible, so the two can share their feelings and fears, and establish lines of communication for the weeks and months to come.

Most couples find ways to face and overcome the stress that cancer places on their relationship. They find strength in each other, and they work together to establish a new and comfortable routine.

Sharing feelings is usually the first step toward finding effective solutions. Facing cancer can strengthen everything that is good in the relationship. Sometimes, it shows that problems that seemed important at one time, really are minor.

However, cancer can also strain a relationship already stressed by other serious problems. Couples may have difficulty adjusting to the role changes that are sometimes necessary.

A partner who was sharing the load of daily activities before, may now become the sole breadwinner and homemaker, responsible for going to work, preparing dinner, changing the bedding and dressings, and providing companionship and emotional support. The sheer weight of these responsibilities can destroy normal associations, devour time needed for rest and recreation, and deprive everyone of opportunities to express anxiety and resentment.

Family

The people who are close will also be affected by the news. They too may need to be angry, cry and express their emotions. It's a natural part of adjusting to a diagnosis of breast cancer.

It will help both the woman and her family to talk openly about each other's feelings. Open communication from the start will go a long way to strengthening the bonds with loved ones, and securing needed support.

Problems within the family

Cancer is a blow to every family it touches. How the family handles it is determined to a great extent by how they have functioned 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.

Some in the family are able to absorb the impact of diagnosis sooner than others. This can create conflicting needs as some wish to talk and some need to be private and introspective.

The person with cancer has the primary right to set the timetable for when she is ready to talk. Others can encourage that readiness through their love and continued presence.

False cheeriness-the "everything will be all right" routine-denies the person with cancer the opportunity to discuss fears and anxieties.

Often the problem is not an individual one. It can be difficult for family members to discuss their emotions. People are particularly hesitant to express negative feelings when no one is "at fault." Yet major shifts in responsibilities such as those cancer brings to a family can cause great resentment by those shouldering (or incapable of shouldering) extra burdens, and these shifts need to be discussed.

Children, especially, find that their usual roles are no longer clearly defined. Parents may not have the emotional energy to provide the usual support, love, and authority. Teenagers can feel torn between expressing independence and a need to remain close to the sick parent.

All of us want to shield our children from pain. But their insight is greater than most people realize, and trying to keep a complex situation such as cancer a secret, is practically impossible.

A simple and straightforward explanation, geared to the children's age and ability to understand, will establish an open and honest path for communication.

Children have amazing abilities to cope with situations they understand. However, when their normal world is turned upside down and whispered conversations go on behind closed doors, they often imagine things that are worse than reality.

Childrens' ability to process information about their mother's breast cancer depends on their age, and the parent will need to adjust her explanation accordingly. Being direct is often the best approach. For example, "I've been sick a lot lately, haven't I? I have a disease called cancer."

A close and loving aunt or uncle or friend might be able to explain things more comfortably. "Your mommy is ill. The doctors are almost sure they can make her well, but sometimes the treatments make her feel sad or grouchy. It's nothing you have done, but she needs your patience and understanding."

The goal in telling 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.

Help For The Children

Children might have difficulty coping with cancer in a parent. Mom may be in a hospital hundreds of miles from the home, or home in bed in obvious discomfort.

In the face of this upheaval, children often are asked 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 who were formerly independent, now become anxious about leaving home. Discipline problems can arise. It may help if a favorite relative or family friend can devote extra time and attention to the children.

Trips to the zoo are important, but so is regular help with homework and someone to attend the basketball awards banquet. If efforts to provide support and security fail, professional counseling for a child, or child and parent together, may be necessary and should not be overlooked.

SOURCE:
Department of Defense Breast Cancer Decision Guide (http://www.bcdg.org)