Metastatic Breast Cancer

Supporting Teenage Children Whose Mothers Have Metastatic Breast Cancer

Two-time breast cancer survivor and breast cancer expert Lillie Shockney offers insightful advice to mothers with metastatic disease on how not to burden their teens with heavy expectations, and instead allow them to have “teenager time.”
June 2019 Vol 5 No 3
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
Editor-in-Chief, Journal of Oncology Navigation & Survivorship®; Co-Founder, Academy of Oncology Nurse & Patient Navigators® (AONN+); University Distinguished Service Professor of Breast Cancer, Professor of Surgery, Johns Hopkins University School of Medicine; Co-Developer, Work Stride-Managing Cancer at Work, Johns Hopkins Healthcare Solutions
Breast cancer survivor

Teenage years are challenging for everyone—the teen and his or her parents. With hormones pumping and facing the new opportunities that come with dating and getting their driver’s license, they are heading in the direction of young adulthood. But, they aren’t there yet. If you have been diagnosed with metastatic breast cancer, you need to delegate things you were doing before your diagnosis, and if you have teenagers, you may feel inclined to give them additional responsibilities. All of a sudden, you may even look at your teens as if they were young adults.

Let Your Teen Be a Teen

Some of the common duties assigned to teens include laundry, meal preparation and kitchen cleanup, babysitting, running errands, and housekeeping duties. Keep in mind that it is already difficult to get them to keep their own room clean, and now your expectation is for them to keep the whole house in some state of organization? That seems a bit much.

Don’t burden your teenagers too much. Just because they live in the same house doesn’t mean they need to become you now. They also still need to be teenagers and do the things that teenagers do.

Others Will Want to Help

So, make a list of what needs to get done, and don’t assign anyone to the various duties. There will be neighbors, friends, and other family members who are going to ask you how they can help, and rather than saying “thanks, but no thanks,” you can pull out that list and start discussing what they would feel comfortable to take on for you. Remember, they will have their own medical crisis at some point, and your family will be there to support them.

Honesty Is Key

Next, sit down with your teens and make sure you are being honest about what your medical situation is. That you do have stage IV breast cancer, where the cancer has spread to, and what treatments you are going to be receiving. Also include them in the discussions that you have with your spouse or partner after each doctor’s appointment and test results.

Don’t say that you are going to be fine. That is only fooling yourself and, frankly, not fooling them. They will have already gone online and read a lot of information about metastatic breast cancer. Honesty with your children is key.

Let Your Teen Choose

Now, discuss with your teens that you would like them to take on more responsibilities at home, doing things that you normally did, but for medical reasons cannot do at this time, or anymore. Don’t preassign any duties to them. Show them the list and ask if they are willing to do 3 tasks on that list. Let them choose what 3 things they will be.

You may want them to do 10 things, but that isn’t realistic; not because they aren’t capable of doing these tasks, but because they are very upset about your diagnosis, whether they are showing it or not.

Boys have a tendency to clam shut, sit in the bedroom, and not talk about their feelings and concerns. Girls may show emotion, but may even misdirect it, by having outbursts of yelling or being difficult to talk to. Remember, she just got her breasts in the past year or 2, and now is wondering if she will end up with breast cancer as well. It is an emotionally charged time, whether your teen is a boy or a girl.

“Teenager Time”

Teens taking on more duties, many adult duties, such as picking their little sister up from softball practice, still need to have “teenager time” built into their schedule. Friday nights need to be preserved for dating, going to a movie, or hanging out with friends. Saturday morning still needs to be the time to let them sleep in rather than fixing breakfast for the entire family. Saturday night could be date night or some other school activity, such as seeing a basketball game.

Praise and reward your teen for pitching in, too. Get them tickets to a rock band that is coming into town they have been wanting to see. Tell them how much you appreciate them helping out.

Tough on Everyone

Remember, this situation is very different from how it was when you might have had an earlier stage of breast cancer. That time, treatment had a beginning and an end. This time, you are being treated in a way that makes this a chronic illness, so there won’t be a time when you can tell your teen everything will go back to normal. That’s tough for everyone to accept, including yourself.

And again, always be honest with them about your clinical status. The worst thing a parent can do is to lie to his or her teens about their true health status, because teens are smart and see right through it. You are not sparing them anything. Instead, you are creating an environment of distrust, which is truly one of the worst things you could possibly do at this time.

Finally, be sure to set aside time for you to spend private time with your teens. These are challenging, but also precious, years. They will never stop being your children, and you will never stop being their mom.

Patient Resources

National Breast Cancer Foundation

Metastatic Breast Cancer Network

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Last modified: August 5, 2019

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