Qualitative interview study of communication between parents and children about maternal breast cancer

Objective To examine parents' communication with their children about die d iagnosis and initial treatment of breast cancer in the mother. Design Qualitative interview study within cross sectional cohort. Setting Two breast cancer treatment centres. Participants 32 women with stage I or stage II breast cancer with a total o f 56 school aged children. Main outcome measures Semistructured interview regarding timing and extent of communication with children about the diagnosis and initial treatment of the mother's illness, reasons for talking to children or witholding inform ation, and help available and requested from health professionals. Results Women were most likely to begin talking to their children after the ir diagnosis had been confirmed by biopsy, but a minority waited until afte r surgery or said nothing at all. Family discussion did not necessarily inc lude mention of cancer. There was considerable consistency in die reasons g iven for either discussing or not discussing the diagnosis. The most common reason for not communicating was avoidance of children's questions and par ticularly those about death, While most mothers experienced helpful discuss ion with a doctor concerning their illness, few were offered help with talk ing to children; many would have liked help, particularly the opportunity f or both parents to talk to a health professional with experience in underst anding and talking to children. Conclusions Parents diagnosed with cancer or other serious illnesses should be offered help to think about whether, what, and how to tell their childr en and about what children can understand, especially as they may well be s truggling themselves to come to terms with their illness.