One of the hardest parts of a cancer diagnosis is breaking the news to your family. Deciding how much information to share and how to share it are good first steps.

There’s no easy way to tell loved ones you’ve been diagnosed with cancer.

Many people find it’s best to work through the information and emotions with a caregiver, before telling other family members or close friends about the diagnosis.  This may help separate your thoughts and decisions from their reactions, and give you a chance to create a treatment plan—so your loved ones are reassured steps are being taken to improve your health.

Together with your caregiver, agree on how much information to share, how to share it and whom to share it with. Then (depending on your age, health status, ability to communicate and general mood) determine who will take the lead on communicating the news.

Breaking the News to Your Children

Clinical social worker Amy Sales, a grief counselor at the Sidney Kimmel Cancer Center at Johns Hopkins, suggests breaking the news to children before anyone else. If your children are young, helping them understand the situation can be challenging. However, regardless of their age, it’s best to tell your kids about your condition as soon as you can for several reasons:

• Conventional wisdom tells us not to shield children from life, but teach them how to deal with whatever life throws at them.

• Your children will hear about it sooner or later. They may even attempt to figure out what’s going on, putting together bits and pieces of information, which can lead to the wrong conclusions.

• Older children will likely play a big role in your care—telling them early will be helpful, as they may play a role in helping determine your care plan.

If your children are young, deciding how much and what information to share with children depends on a number of factors:

• Consider the child's age, the individual child and what seems right to you. Telling toddlers about a cancer diagnosis can be particularly difficult since they won’t fully understand the situation. When breaking the news to children who are 3-7 years old, focusing on the symptoms and using simple explanations can help.

• Learning about a parent’s cancer diagnosis can be difficult for teens, who are already managing a surge of emotions. It’s important for them to realize death is not a certainty, and it’s normal to feel sad, upset or angry.

• Consider the same factors above when deciding whether to prepare a child or teen for any likely change in your appearance. Ask them if they have any concerns or fears about possible physical changes.

• Always use the name of your health condition. Children will likely hear it used and will understand what you are talking about.

• Let young children know your condition is not something they, or anyone else, can catch.

• Watch for changes in their behavior that could indicate they’re having difficulty coping. Be aware of common signs kids are having difficultly coping, and tell each child’s teachers about your health condition, so they can watch out for problems that may appear at school. 

Warn older children who have Internet access about misinformation and scary statistics that don't necessarily apply to you. Suggest that the child come to you when he or she wants more information, rather than asking someone else or doing his or her own research.

Reassure your children that no matter what happens, they are loved and will be cared for. If appropriate to your situation, you may also want to talk about death with your child. During the discussion, listen to your child’s fears and provide as much reassurance as you can. 

Telling Grandkids About Your Diagnosis

Grandkids are a source of great joy and love for grandparents. In many cases, spending time with them after a diagnosis is a much needed relief. Telling grandchildren about a cancer diagnosis can be trying, because your children (their parents) may have differing view on how to break the news and how much information grandchildren should be given. 

This is yet another reason why it’s best to discuss the matter with your child first, so you are both on the same page and can come to an agreement. If you don’t see your grandchildren on a regular basis, you may also need to prepare them for the stark physical changes that can come with treatment. 

Sharing the News With Parents and Siblings

Because some types of cancer are genetically related, it’s important for your siblings and parents to also know about the diagnosis. Even if genetic factors aren’t relevant, your family members may have been exposed to similar environmental factors that could put them at risk, depending on the diagnosis. 

The most important thing about sharing information with adult relatives is to set expectations and boundaries for communication:

• Make it known family members should not contact or communicate with your doctors without your knowledge.

• It may be helpful for you to have a conference with the medical team, your caregiver and anyone else you want to include. During the conference, clarify the decision-making process to help others understand why certain treatments are being used.

• Social workers can also help communicate your wishes to your medical team if there’s someone you don’t want your information shared with. 

• Consider a blog (e.g., LotsaHelpingHands.com, CaringBridge.org and MyLifeLine.org) to keep all loved ones informed regarding your treatment progresses.

• Some patients even email monthly newsletters with information about their treatment progress—as well as other positive events in their lives. Weaving in non-cancer stories about your life will help you and your family and friends stay positive.

• Mention to family members—for times when they may feel upset—it’s best for them to talk to someone other than you or your caregiver. You’ll want to focus your energy on managing your own stress and emotions. They will understand.

At any point, if you feel like communicating your diagnosis is too difficult to handle on your own, consider enlisting the help of a clinical social worker. They can help you decide whether it’s best to keep matters private for the time being and when to share certain details with family members.