Cancer Conversations

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Cancer is a difficult subject to talk about, and many parents coping with a diagnosis or a loved one’s diagnosis may try to avoid the topic in fear that they will scare their children. What to say about cancer, how to say it, and how much information to share are common concerns. Cancer is a topic that needs to be handled carefully and sensitively; according to a study published in Cancer, children of patients with cancer may be at a significantly increased risk for mental and behavioral health problems.1 The report concludes, “Psychological services need to be both family-oriented and child-centered and focus on family dysfunction to prevent mental health problems in children.”1

Creative Therapy
The use of art therapy interventions can be an effective strategy for working with families. Engaging family members in alternatives to traditional therapy often creates an environment where individual members are able to express thoughts and feelings they might not otherwise be willing to reveal. A more playful approach can often circumvent barriers and facilitate a broader level of expressiveness.

The most effective therapeutically-based creative projects will foster family identification in order to strengthen the family unit. Along with promoting normalization of the family’s thoughts, feelings and reactions to a cancer diagnosis in the family, projects should promote:

  • Increased positive communication within the family system
  • Establishment of a time of reflection and common memory of a family bonding experience
  • Creation of an object of comfort and strength to patients, loved ones, and the bereaved

Pillow Talk
As one example of a creative project that can bring families together to talk about cancer, national nonprofit CancerCare, with a sponsorship from Bayer, recently developed a free at-home activity kit to help facilitate these discussions, called “Pillow Talk: Conversations about Cancer.” Families who are supporting a loved one with cancer can order a free Pillow Talk Care Package that includes a hands-on, pillow-decorating project as well as materials that will help initiate those often-difficult conversations. With this care package, patients and their families bring a blank pillow to life – it has a sleeve for pictures or notes (to pass back and forth between patient and family), fabric markers, and decorative materials that let families’ creative expression drive the discussion.

“Family art projects are a fun way to help families express and share their thoughts and feelings when a loved one has been diagnosed with cancer,” noted Jimmie Holland, MD, attending psychiatrist at Memorial Sloan Kettering Cancer Center and the founding president of both the International Psycho-Oncology Society and the American Psychosocial and Behavioral Oncology Society. “Creative activities like [the Pillow Talk Care Package]can increase positive communication and create a common memory of a family bonding experience.”

CancerCare client Susan, of Connecticut, was faced with figuring out the best way to start the difficult cancer conversation with her 5-year-old son Henri after her husband Chris’ diagnosis of stage 4 colon cancer. The family sat together and colored the pillow that now features her son’s favorite things – superheroes, rainbows, planets and rocket ships.

“Henri knows that something is wrong, and I’m sure he knows more than he is able to articulate. He knows that daddy is sick,” shared Susan. “CancerCare and their resources have been so helpful. Chris and Henri sat on the floor together, spread out all of the kit materials and colored on the pillow. It was a really great exercise for Chris – a really special bonding moment and it’s something they’ll always have together.”

Susan feels the activity has brought the family closer and has allowed them to have difficult conversations about cancer. “When Chris has to leave for chemotherapy, he is oftentimes gone before Henri wakes up and doesn’t return until after he goes to bed. On those days, Henri can pull out the pillow and know that he is loved and can read the special message on an enclosed heart from his dad.”

Starting the Conversation
Families struggling to start a dialogue may find these additional tips helpful:

  • Let your child know that you are always available to answer their questions
  • Try to keep family time consistent
  • Ask children 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
  • Find age-appropriate support groups for your children that will help them feel connected to other children who have a similar experience

Additional Resources
Many organizations offer creative interventions that bring families together free of charge, or for a small fee. The American Cancer Society offers a kids activity book, Because . Someone I Love Has Cancer, that addresses the basic goals of therapeutic support for children who have a loved one with cancer through fun activities. Another great activity book for kids is The Children’s Treehouse Foundation’s interactive workbook, Talking With My Treehouse Friends About Cancer. Kids Konnected offers a Hope The Bear Care Package that includes a teddy bear, activity books, and other materials.

Sandra Tripodi is CancerCare senior director of Community Engagement.

Reference
1. M”ller B, et al. Children of cancer patients: prevalence and predictors of emotional and behavioral problems. Cancer. 2014;120(15):2361-2370.

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