Talking to Children about Male Cancers
Talking to Children about Male Cancer by Kathleen Russell
Do I need to tell my child I have cancer?
Deciding what and how much to tell a child about your cancer is a very personal choice. No parent wants to tell their children they have cancer. Instead every parent wants to protect their children from life’s uncertainties. However, a diagnosis of cancer affects the whole family. Children may notice a change in routine or pick up on your tension or anxiety, even if you think you are hiding it. Therefore, it is important to consider your children’s age and maturity level. By age-appropriately talking to your children, the entire family will be better placed to cope together.
Why is communication important?
Whenever possible open communication is very important, it allows children to:
- Ask questions,
- Share feelings,
- Gain knowledge.
Providing accurate information can be a powerful way of helping children to feel more in control of the situation. Knowing more about cancer and its treatments can take some of the fear away. Most people feel better when they know what to expect. Check their understanding to correct any misconceptions they may have.
Honest communication during childhood establishes a pattern for life. Being open with your children sets an example that you are willing to discuss difficult challenges and situations which can be particularly helpful during adolescent years.
What kind of information should be communicated to your children?
The word cancer can be frightening but this can be minimized by explaining simply:
- What cancer is
- What the treatments are
- Reinforcing the message that male cancers are very treatable.
The communication should be age appropriate, open, honest, and timely and repeated numerous times.
Along with the facts it is vital to reassure children that they will continue to be loved and cared for. They also need to be encouraged to ask questions and share their thoughts and feelings. All specific cancer terms are underlined and in italics. Definitions can be found in the glossary at the bottom of the article.
When should children be told?
Children’s cognitive development may vary and each child’s capacity for learning and wanting information should be assessed individually, taking into account their unique personalities.
Children are very perspective to verbal and non-verbal communication and have active imaginations. They may pick up on subtle signs and suspect a secret is being kept from them. Better to be honest early on and prevent them from inventing their own reasons or worse yet blaming themselves for tensions.
How should children be told?
Simple diagrams can be an extremely effective way of explaining what cancer is. Something as easy as smiley faces for the good cells and grumpy faces for the cancer cells can provide children with an image to help them better understand the nature of the disease.
What about teenagers?
While teenagers may have a better understanding about cancer than younger children, it is still important to provide them with accurate information and ensure they have the right facts.
Teenagers are at a stage where they are becoming increasingly independent and want their freedom. Therefore, it may be a particularly challenging time to ask them to take on more responsibilities. Try to make sure they are not overburdened with responsibilities and chores.
Teenagers don’t always share their feelings with their parents. It is important to encourage them to talk to someone close; for example, their friends, teachers, or grandparents.
Encourage them to visit reliable websites specifically designed for teenagers when a parent has cancer such as riprap.org.uk
Below are some typical questions that children may ask and some suggested responses. Each question has three levels of responses. The first response is for primary school age children between 7 to 11 who benefit from concrete, simple explanations. Diagrams are also always helpful.
The second set of responses provides more detail for Key Stage Three children, between the ages of 12-14, who are beginning to learn about cancer in their core science classes.
The third set of responses is for teenagers who have more of a grasp of scientific concepts as well as the emotional impact the disease may have on a parent as well as themselves.
All specific cancer terms are underlined and in italics. Definitions can be found in the glossary at the bottom of the article.
What is cancer?
7 to 11 year olds
All living organisms including our bodies are made of really, really, tiny building blocks called cells. Our bodies are made up of millions of these cells. Most cells are way too small to be seen with the naked eye but can be seen with a microscope.
Cancer is an illness that affects some of the cells in our bodies. (These can be called the bad cells and depicted with grumpy faces in contrast to the happy smiley face healthy cells.) Sometimes these cells join together and form a lump which is called a tumor. These tumors can, at times, stop our bodies from working properly.
12-14 year olds
Healthy cells in our bodies divide in a controlled way to help us grow, to repair wounds and to replace damaged cells. Tumors occur when cancer cells divide in uncontrolled way. These cancer cells then crowd out healthy cells and may even spread to other parts of our bodies; this is known as a secondary cancer or metastasis.
Tumors can be benign or malignant.
Benign tumors are not cancer. They can be removed and do not spread to other parts of our body.
Malignant tumors are cancer. The cancer cells can invade and damage nearby tissue and spread to other parts of our bodies.
Metastasis is the spread of cancer tumors from one part of the body to another.
Male cancers such as testicular, prostate and penile cancer are called “solid tumor cancers” because the cancer cells have formed a lump which can sometimes be felt and can be detected by medical scans.
What are the tests for cancer and how is it diagnosed?
7 to 11 year olds
When someone notices a lump, feels unwell over a long period of time, or has unusual aches and pains, they should visit their GP to discuss their symptoms. The GP will then refer them on for specific tests.
12-14 year olds
There are specific test that are used to diagnosis cancer. These include blood tests, scans and even having a minor procedure (a biopsy) to remove a piece of the tumor to see if the cells are cancerous.
If the doctors suspect cancer and/or want to find out if it has spread, they will make referrals for additional tests or scans which include: Blood tests which test for chemicals in the bloodstream, X-rays, Computerized Tomography (CT Scans) or even Magnetic Resonance Imaging (MRI Scans).
What are the treatments?
7 to 11 year olds
The doctors plan a very specific treatment plan or “regime” designed for each person. There are three main ways that doctors can treat cancer, sometimes the patient may receive one, both or all of the types of treatments including:
Surgery – where a specialist doctor called a surgeon cuts out the cancer tumor.
Radiotherapy – where high energy rays are targeted to destroy the cancer cells.
Chemotherapy – where very strong anti-cancer drugs are taken to destroy the cancer cells.
12-14 year olds
Surgery – in male cancers, removing the cancer tumor can often cure the disease.
Radiotherapy – involves exposing the tumor to radioactive rays over a short period of time. These radioactive rays can kill cancer cells which will reduce the size of the tumor. Unfortunately, sometimes even good cells may be destroyed causing a patient to have side effects including tiredness.
Chemotherapy – these powerful drugs can be swallowed or given directly into a vein. In some cases, cancer patients only receive one dose of chemotherapy and other times they receive the drug slowly over a longer period of time. Chemotherapy will also destroy the good cells and may cause side effects such as sickness and hair loss. Luckily, these side effects are usually temporary.
Surgery – in the case of male cancers, the doctors will perform specific types of surgery. For prostate cancer, the surgeons may remove part or all of the prostate gland. For testicular cancer, the surgeons will usually perform an Orchidectomy which is the removal of a testicle.
Radiotherapy – if the cancer has spread (metastasized) to other parts of the body such as the lymph nodes, radiotherapy can be used to treat this area as well.
Chemotherapy – is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells by disrupting the growth of cancer cells as they circulate in the blood stream. Often chemotherapy is given as a drip into a vein in the arm or neck. The side effects including sickness can also be treated with drugs through these tubes. The treatment regime may last over several weeks.
What are the myths about Cancer? Getting the facts right.
7-11 year olds
- Cancer is contagious and can be spread from someone else. FALSE – You can’t catch cancer.
- Only bad people get cancer – it is a punishment. FALSE – Doctors and scientists are still trying to discover the precise reasons some people get cancer and others do not. But it is definitely not the person’s fault.
- People always die from cancer. FALSE – Now days many people recover and live long and healthy lives after being treated for cancer.
12-14 year olds
- Cancer is only for old people. FALSE – although nearly 2/3 of people who are diagnosed with cancer are over the age of 65, cancer can affect anyone. But early detection and effective treatments have ensured that many more people are cured from male cancers.
- Cancer makes your hair fall out. FALSE –radiotherapy and chemotherapy can cause hair loss. Usually when the treatment is finished the hair will grow back.
- All tumors are cancer. FALSE – some tumors, called benign tumors, are not cancerous and may be surgically removed. Tumors that are cancerous are called malignant
- All cancers are the same. FALSE – there are more than 200 different types of cancers which can occur in any part of the body.
- Cancers are always named by the organ they are in. FALSE- cancers are named by the primary site of the diagnosis. For example, if the first tumor grew in the testicle and then some cancer cells spread (metastasized) to the lungs than it would be called testicular cancer with secondary metastasis in the lungs, not lung cancer.
Can cancer come back? What is recurrence?
7-11 year olds
In many cases cancer treatments are successful in getting all the cancer cells. However, sometimes it can return. If that happens, then the doctors will continue to take care of your father and try and develop new ways of treating the cancer.
12-14 year olds
When the doctors cannot find any sign of cancer cells the patient is said to be in remission. Cancer recurrence is defined as the return of cancer after treatment and after a period of time. The same cancer may come back where it first started or somewhere else in the body. Additional treatment options will then be discussed.
Sometimes cancer returns to the first place it started (localized disease) or it may spread to an organ close to the original one (regional recurrence) or it may come back in another part of the body, some distance (distant recurrence) from where it started (often the lungs, liver, bone marrow, or brain). For example, prostate cancer may return in the area of the prostate gland (even if the gland was removed), or it may come back in the bones. In either case it’s a prostate cancer recurrence.
How can children help when someone they care about has cancer?
When a child knows that someone they care about is ill, they often like to help. Children this age can be encouraged to engage in concrete simple tasks such as taking on simple chores, for example, unloading the dishwasher or setting the table. Or they can be asked to draw pictures and download photos that their fathers can take to the hospital.
12-14 year olds
Children in this age bracket are beginning to break away from the family and look to their peers for company. However, they too benefit from being encouraged to help in an age appropriate manner. They may even want to be involved in simple tasks of caring for the patient by bringing cups of tea or sitting with them during treatment.
Developmentally, most teenagers are maturing and becoming increasingly independent from their parents. Therefore, it is important that they are not overly burdened with the care of patient but are given appropriate responsibilities. They may be asked to babysit younger siblings during hospital visits or assist in meal preparations. However, it is important to ensure that they are also encouraged to maintain their peer friendships and allowed time, if possible, to socialize. If this balance is kept, then the teenage child will feel he has been helpful without being overly weighed down.
Children may wonder: Will I also get cancer?
7-11 year olds
You cannot get cancer from someone else. It is not contagious.
12-14 year olds
If your father or brothers have had testicular cancer you may have an increased risk of getting the disease. However, testicular cancer is a VERY treatable disease. If it is found in the early stages there is cure rate of 98%.
If your father, brother, grandfather or uncle had testicular cancer it is particularly important that you start performing testicular self-examination (TSE) on a regular basis, at least once a month. Remember Testicular Cancer has a very high cure rate but it is important to catch it early. For information and video advice on testicular self-examination visit: http://www.orchid-cancer.org.uk/451/Check -em-out.
When visiting your GP it is always important to tell them if there is a history of cancer in your family. In all likelihood the symptoms are not cancer but it is helpful for the GP to rule cancer out.
For boys’ eyes only – How can I check myself?
The easiest way to identify potential testicular problems is to perform a testicular self-examination. It only takes a few minutes and is best performed monthly after a bath or shower. For video advice on testicular self-examination visit: http://www.orchid-cancer.org.uk/451/Check -em-out.
Orchid provides information on male specific cancers. Please visit www.orchid-cancer.org.uk
Your Privates is a testicular cancer microsite and includes interviews with patients and healthcare professionals. Please visit www.yourprivates.org.uk
The Orchid Male Cancer Helpline is a freephone services providing information and support. It is staffed by dedicated Nurses. Tel 0808 802 0010
www.riprap.org.uk . They provide information and support for young people aged 12-16 years old who have a parent with cancer.
www.winstonswish.org.uk. They provide information and support for bereaved children and their families.
In addition you may wish to read:
Helping your children cope with cancer: A guide for parents and families by Peter Van Dernoot (2006).
The Secret C – Straight talk about cancer. Provided by Winston’s Wish.
When your mum or dad has cancer by Ann Couldrick and Graham Jeffrey
Glossary of terms
Benign –Noncancerous. Benign tumors can often be removed and do not spread to other parts of the body.
Biopsy – A medical procedure where a sample of tissue is removed from the area where cancer is suspected and looked at under a microscope to determine if it is benign or malignant.
Cancer – Cancer is the name given to group of many related diseases that start in the cells and can occur in any organ in the body. All cancers involve the abnormal and uncontrollable growth of cells.
Chemotherapy – The use of medicines to destroy cancer cells. The medicine can be taken as a pill, an injection or through a drip.
Malignant – Cancerous. In malignant tumors the abnormal cells divide and grow without control or order. They can spread to nearby tissues and also have the capacity to spread to other organs in the body.
Metastasis – The spread of cancer tumors from one part of the body to another. The cancer cells in the new area go on dividing to form a new tumor.
Radiotherapy – The use of high-energy rays or high energy particles to kill cancer cells and shrink tumors.
Recurrence – Cancer treatment may cause a remission but sometimes the cancer comes back. This is called a relapse or recurrence.
Remission – When the doctors cannot find any signs of cancer.
Scan – A medical procedure which uses machines to build up images of internal organs. X-rays and CT scan (computerized tomography) are the most common.
Side effects – Cancer treatments destroy cancer cells and may also harm healthy cells in the process. This may lead to unwanted effects. Side effects for Chemotherapy and Radiotherapy include hair loss, nausea and tiredness. Side effects vary from person to person.
Testicular self-examination (TSE) – From puberty onwards it is important that men check their testicles regularly (once a month). It is the easiest way to identify any potential testicular problems such as a lump or swelling.
Last reviewed 04/06/2018. Next review 04/12/2018.
References available on request.