Questions & Answers about Adolescents and Teens
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For Any Cancer Diagnosis
- Q.
My teenage son has had body-image issues since having cancer. His treatments caused him to gain weight and surgeries left him with scars. How can I help him deal with this?
A.Body changes may make your teen feel uncomfortable about how they look. These feelings may be strong enough to make them want to avoid their friends, school, public places or having their picture taken. Adolescence is a time where teens engage in social comparisons, often comparing themselves to their peers and friends. It is important to validate your son’s concerns regarding his body image. Self-esteem is very fragile and is often impacted by not only how we view ourselves, but how others view us as well.
Keep an open line of communication with your son about this topic. Explain to him why his treatment is so important even though it has caused him to gain weight. Try to help him understand why his body is changing so that he can understand these changes are not permanent. You may also want to encourage him to engage in some types of physical activity when he is feeling up to it (activities approved by his oncologist or physical therapist). Also, you may want to consult with a nutritionist to create helpful and healthy eating plans while on treatment.
It is important for your son to understand the reason behind his surgeries and scarring. Many times, a conversation before surgery can help teens prepare for body changes so that they are not such a shock. However, after the surgery site has healed, you can experiment with different types of make-up and concealers (there are special ones for scars). Also, different clothing styles may be able to cover the areas that your son is not comfortable exposing.
You can support your son during this time by doing some of the following:
- Providing an outlet to express his feelings (art, music, writing, etc.)
- Listening if and when he wants to talk about body image changes
- Letting him know that you understand what he is feeling and that it is okay to feel the way that he does
Creating a safe space for him to share what he is going through is important. If necessary, reach out to your son’s social worker through the hospital or a child life specialist. It is possible that outside support is necessary in order to make your son feel heard.
If you need additional support, feel free to reach out to CancerCare’s Hopeline (800-813-4673). We can provide psychosocial support as well as local referrals as needed.
Answered by
Sarah Paul, MSW, LCSW, OSW-C, Senior Director of Social Work - Q.
I'm looking for support for my teenage son to help him deal with his sister's cancer. Can you recommend any specific places?
A.A child with cancer can change family dynamics and these changes are often difficult for siblings. It can be challenging for parents to focus on the needs and concerns of their other children, which can lead to siblings feeling “invisible” or alone. Siblings often experience many emotions in this situation such as: fear and anxiety, anger, jealousy and resentment, loneliness, guilt, sadness and grief.
It is important to talk with your other children about cancer while also giving them a safe space to share their feelings and worries. Getting help is important as well; you do not have to learn to cope alone.
In linking your son to support systems it will be important to:
- Reach out to a social worker where your daughter is receiving treatment; they might be able to refer you to a local support group for siblings
- Check out SuperSibs, an organization designed specifically to give support to siblings of cancer patients. Their website has resources and tips as well as camps and events that help connect other siblings going through a similar experience
- Look into an online support group. CancerCare offers an online support group for teens who have a loved one with cancer. This support group is run by a licensed oncology social worker and is designed to create an environment where teens can share and connect with one another
If additional support is needed, you can reach out to an oncology social worker through CancerCare’s Hopeline (800-813-HOPE) for additional information.
Answered by
Sarah Paul, MSW, LCSW, OSW-C, Senior Director of Social Work - Q.
I am 19 and my mother was diagnosed with cancer over a year ago. She has had an operation and been through chemotherapy treatment and is technically 'cancer free' now, however we have been told she has a very slim chance of living past 5 years. My mother has completely changed, and I don't know how to talk to her as she seems like a completely different person since chemo. Is this normal?
A.Undergoing treatment for any type of cancer is an intense experience, not only on an emotional level, but spiritually and physically as well. Often, those that have completed cancer treatment face a new type of difficulty; they must now acknowledge that their life is forever changed. They must deal with a new reality as they shift focus from coping with treatment to adjusting to their “new normal”. I use the term “new normal” because whatever was ‘normal’ for your mother before her diagnosis no longer rings true to her.
It is possible that your mother seems “like a completely different person” since her treatment because she must deal with the uncertainty and ambiguity that can persist following the completion of treatment. Although she may be “cancer free”, she may feel that her life is limited by the five year prognosis which has made her feel vulnerable and afraid. Many emotional challenges arise after treatment because people have focused all of their time and energy on physically fighting their diagnosis; they have neglected the emotional aspects in the process.
Encouraging her to maintain healthy, supportive relationships with those most significant to her is a crucial part of the healing process. You have to ask yourself, “How has my mother changed and is there is different way I can try talking to her?” She might feel alone in her experience and need your support more now than ever before. Does she have emotional support or is she speaking to a therapist or counselor? Anxiety and depression are common in those who are going through or have completed treatment for cancer. It is important to recognize any red flags for these disorders in order to gain the necessary support.
It is also good to be aware of the different types of support available:
- Professional support provides you with information, resources and counseling
- Peer-to-peer support reduces your sense of isolation and helps you connect with others who share similar concerns (e.g., Cancer Hope Network)
To access these types of support, speak with an oncology social worker or join a post-treatment support group at CancerCare. A social worker can also help you identify local support services; contact our Hopeline at 800-813-HOPE to speak to an oncology social worker for more information.
Answered by
Sarah Paul, MSW, LCSW, OSW-C, Senior Director of Social Work - Q.
I have a 14-year-old son who doesn't seem to want to talk about my cancer at all. I know it's hard for him, but it also can't be good for him to keep things bottled up. What should I do?
A.Teens are at a stage in life when they are trying to develop their own identity, sense of self, and independence. Your son’s not wanting to talk about your cancer is a common reaction many teens have. Teens may feel that their questions or concerns might be hurtful or even scare the parent. It’s important for you to keep communicating with him and show him that it is okay to talk about feelings and ask questions. Ask him what he already knows or thinks about cancer and try to provide concise information that will clear up any misinformation he may have gotten from peers or the internet. Keep him up to date about your cancer and treatments, and let him know that if he has any questions or concerns he can always talk with you about them.
It’s important to respect his privacy and to offer him additional support that may be helpful to him. Identifying a relative like an aunt or uncle, or a teacher, coach, or school counselor with whom he can talk more openly can give him a sense of feeling more in control of his situation, and allow him to voice questions or concerns he may not want to with you.
If you haven’t done so already, I would also encourage you to inform his school. Teachers and school counselors can be supports for both your son and yourself. They can watch for and inform you of any concerns or behavioral changes your son may be displaying, and can advise you should they feel your son might need additional professional help.
The following publications may help as you navigate the sometimes tricky territory of having cancer while parenting a teen:
- CancerCare’s Helping Teens When a Parent Has Cancer
- CancerCare’s Helping Children When a Family Member Has Cancer
- How to Help Children Through a Parent’s Serious Illness by Kathleen McCue and Ron Bonn (St. Martin’s Press: 1994)
- When a Parent Has Cancer : A Guide to Caring for Your Children by Wendy Schlessel Harpham, MD (Harper Collins: 2004)
Answered by
Victoria Puzo, MSW, LCSW, Online Support Group Program Director - Q.
Last week I told my son that I had cancer and we have barely spoken about it since. What can I do to help support my son?
A.As a caring parent you want to help your son understand what you are going through. Children want to know the facts and how they will be affected.
Children, and especially teens, are mostly focused on themselves and their own day-to-day life. You may notice your child is still focused on school, friends, and other activities. That doesn’t mean your child is ignoring your diagnosis. It takes time for a child to mentally process this kind of information and he may not completely understand the implications of your diagnosis until he notices physical changes or if there are disruptions in day-to-day life. Here are some age-specific strategies for communicating with children about cancer:
If your son is under 5, he is likely to ask you a question or bring up your cancer when he is most closely engaged with you one on one. His questions will most likely be brief and concrete, such as: What does your cancer look like? Does the medicine taste bad? He may be scared that cancer is contagious or that he might get cancer too. Your answers should be brief, factual and in words he understands.
Children ages 6-11 typically are more interested in the mechanics of treatment. The “killing” of cancer cells and seeing your treatment as a “battle” or “fight” – whether or not you yourself use these images – is very likely how your son will think of your experience. Some parents are comfortable using this language; others may choose to describe their experience using non-violent imagery. Either way is okay.
If your son is a teenager, he will be wrestling with a variety of conflicting thoughts and feelings. He will want to ask questions but may not want to add to your stress by asking questions or showing concern. He may feel sad about the situation but think it is “unmanly” to have that feeling. He will be certain that none of this “shows” at all but you will see it clearly in his face and demeanor. If you ask him questions he will most likely tell you that he is “fine.” Try not to force the conversation and give him space to process his emotions on his own.
No matter what age your son is, he will let you know when he is ready to talk. There may be times when you need to start the conversation because you are going to lose your hair, or need to rest more, or will be hospitalized. In these cases, be factual, brief, and use words you know your son will understand. Children and teens like to be kept in the loop and the more they are informed, the less anxious they will be when these changes happen. Also, periodically check in with your son, ask if he has questions or wants to talk in order to show him that you are comfortable talking about it and that you are available to talk whenever he is ready.
Here are some additional tips:
- Let your child know that you are always available to answer their questions
- Try to keep family time consistent. When possible, eat meals together, have a movie night, etc.
- Ask your child if there are aunts, uncles, school counselors or other professionals (social workers, psychologists) that they would like to talk to about how they are coping. Sometimes children are more comfortable talking to someone other than the person who is diagnosed
- Find age-appropriate support groups for your children that will help them feel connected to other children who have a similar experience
Here are some publication and book recommendations for further information:
- Helping Your Children Cope with Your Cancer by Peter Vandernoot (Hatherleigh Press, New York)
- Kemo Shark by Kidscope, Inc. (www.kidscope.org). A cartoon illustrated book featuring “Kemo” the shark who explains how chemotherapy works to fight cancer. Also available in Spanish. Ages 3-12.
- What About Me? A Booklet for Teenage Children of Cancer Patients by Linda Leopid Strauss. A book addressing the specific needs of teens when their parent has cancer.
Answered by
Victoria Puzo, MSW, LCSW, Online Support Group Program Director - Q.
My 11-year-old daughter has been distant since I was diagnosed with breast cancer earlier this year. I’m looking for advice on how to talk to her and support her. I know it’s not easy for her.
A.It can be so difficult to support your child emotionally while dealing with a cancer diagnosis yourself. Please know that the distance is normal for someone her age, however; it can be a sign that she is experiencing fear and/or doubt about your current situation. Even though she is young, she is at an age where she may be questioning the world around her, forming her own identity and searching for independence. How transparent have you been with her about your diagnosis? At this point, information can be used as a tool to help her cope with what she is experiencing. From her perspective, she may be scared that your cancer is going to return or she may be confused about the current situation. When talking to her about your cancer diagnosis it is important to keep a few things in mind:
Set the tone: Use a calm and reassuring voice when speaking with her; this will let her know that you are doing your best to cope that that you want her to feel confident with the information that you are giving her.
Share information about your cancer: She is 11, meaning that she most likely has access to the internet which can be a dangerous thing. If she is confused or scared, she may use the internet to get her questions answered and we know that each cancer diagnosis/treatment plan is unique. Do not be afraid to use the word “cancer” with her and explain how your treatment or surgery has affected your body.
Answer her questions accurately: It is common to want to protect your child from any information that may cause her stress or worry; however, she may feel more open with you if you can talk freely about your experience and answer any questions she may have.
Let her know that she is supported: Regardless of the current situation, let her know that she can talk to you whenever she needs, or turn to a family member and/or friend for additional support. Do not be afraid to let her school know about your situation (if you have not done so already) as this can strengthen her support system and allow her another outlet to talk if she needs to.
Make communication a priority and remain consistent: Let her know that although things are different now, your love for her has not changed. Sometimes, you may not know what to say. This is normal and okay. Remember that you are the expert on your child. Cancer can be overwhelming and disruptive, but it doesn’t change the fact that you know your daughter best. Trust your sense of how to best support her during this difficult time.
An oncology social worker from CancerCare can provide information, resources and counseling; contact our Hopeline at 800-813-HOPE to explore services that could be helpful.
Answered by
Sarah Paul, MSW, LCSW, OSW-C, Senior Director of Social Work - Q.
My 51-year-old husband is in the last stage of cancer. It's very difficult for all of us and specially for our teenage son. He needs some counseling and maybe groups to talk. I need help regarding this especially during the holidays.
A.A good place to begin your search for counseling for your son would be the hospital where your husband receives treatment. The social work staff may be able to provide individual counseling and/or support groups. If these services aren’t available at the hospital where your husband is being treated, they might be able to provide you with the name of a local therapist who moderates groups or who works with adolescents individually. Your general practitioner might also be a good source for referrals to these types of services. If your husband is receiving hospice care, the hospice team often provides counseling for the family.
It would likely be helpful to discuss with your son what he thinks would be the best way for him to process his feelings. Does he want to participate in a group, or would he be more comfortable talking one-on-one with a counselor? Opening up a dialogue and eliciting questions will help you understand what your son is feeling and can deepen the connection between you. Despite the difficulty of the situation, he will also see your concern and dedication to helping him bear the reality of the situation.
Additional resources that may be helpful include:
- Our podcast Helping Children and Teens Understand When a Parent or Loved One Has Cancer
- Our publication “Helping Teenagers When a Parent Has Cancer”
Although CancerCare does not provide telephone counseling to teens, you may call us to speak with one of our oncology social workers who can help support you as you help your son cope with his father’s illness. Our social workers can also help you find local resources. We can be reached by calling 800-813-4673.
Answered by
Andrew Chesler, MSW, LMSW - Q.
I've recently started treatment and I'm trying to find things that can help support my 13-year-old such as groups, counseling, etc. Do you have recommendations?
A.Children and teenagers experience a range of feelings after a loved one is diagnosed with cancer and it is common for parents to wonder how they can best support their children. While some teenagers may outwardly express their fears, questions and concerns, others may be less expressive. Let your son/daughter know that you are available to talk when he/she is ready. Encourage him/her to come to you with questions and that if you don’t know an answer you will work together to find it out.
Together with your son/daughter, identify the people he/she would feel comfortable turning to for support. For example, you, other family members, teacher, school social worker, religious advisor or family friend. It can be helpful to inform your child’s teacher and school social worker about your diagnosis so that they can provide additional support to your son/daughter at school.
In addition to individual support, teenagers can benefit from participating in a support group. Teenagers often feel isolated and alone as they cope with the cancer diagnosis of a loved one and support groups provide the opportunity for teenagers to meet others who know what it’s like to have a loved one with cancer. This gives them a safe space to express how they feel, give and get support from their peers and learn healthy coping skills.
The Cancer Support Community lists support centers in several states that provide support groups for children and teens. You may also want to speak with the social worker at your hospital or treatment center about local services available for children and teens.
The American Cancer Society may also provide a listing of support services available in your area. They can be reached at 1-800-227-2345.
To learn more about supporting a teen when a loved one has cancer, please read Helping Teenagers When a Parent Has Cancer. An additional resource you may find helpful is our Connect Education Workshop, Helping Children and Teens Understand When a Parent or Loved One Has Cancer.
CancerCare offers free telephone counseling and support to parents who have been diagnosed with cancer. To speak with an oncology social worker for more information about finding the right type of support for your child based on his/her unique needs, call our Hopeline at 800-813-HOPE (4673).
Answered by For Pancreatic Cancer
- Q.
I was diagnosed last fall with Stage 2 pancreatic cancer. The survival rates are not great, but I am quite hopeful. My 18-year-old daughter, however, has told me that she cannot be hopeful because she can't handle being let down if I die. While this makes sense to me, what can I do to help her?
A.Everyone responds differently to a cancer diagnosis – some people are optimistic, and others, like your daughter, are afraid to be hopeful. Your ability to respect your daughter’s views and understand the difficulty she is having with your diagnosis is important. While you may not be able to change her outlook, you can be supportive of her through this challenging situation.
Encourage your daughter to share her thoughts and feelings about your diagnosis with you. What are her fears? Worries? Hopes? Allowing her to express her feelings freely can provide you with the opportunity to talk openly about your situation. You can even start the conversation by sharing your own worries, hopes, and fears with her. Telling her that you, too, have uncertainties will help to validate her feelings and make it easier for her to open up.
Communication is the key for families coping with cancer. By opening up to your daughter, you are showing her that it’s okay to discuss her feelings. The fact that she has expressed her fears about being let down indicates that she feels the two of you have a trusting relationship. It is understandable that you want your daughter to be optimistic; however, your being able to accept her fears gives her permission to share exactly how she is feeling.
Teens often struggle talking with their parents about illness. Look to adult relatives, teachers, and coaches as potential sources of support for your daughter. She may also benefit from talking one-on-one with a counselor. She can call us and speak with an oncology social worker and we can also help her find local support services.
Your daughter might also find helpful resources online that are specifically designed for teens with a parent with cancer, such as Cancer Really Sucks.
For yourself, CancerCare offers support groups for people coping with coping with cancer. This is a safe place to discuss all the concerns and issues that arise from your diagnosis. Please contact us at 1-800-813-HOPE (4673) for more information.
Answered by
Wade Iwata, MSW, LMSW