Wendy Schlessel Harpham, is an internist in Dallas, Texas, where she lives with her husband and three children. She is the author of After Cancer: A Guide to Your New Life and Diagnosis Cancer: Your Guide Through the First Few Months.

When a Parent Has Cancer

Perennial

Chapter One

Meeting Your Children's Fundamental Needs

Turning Problems into Strengths

Cancer has entered your life. You may be recovering from a biopsy or surgery, in which case you are probably feeling the pain, grief, anxiety, and fear that make time seem to stand still just when you need to be moving quickly to gather information and make vital medical decisions. Or you may be in the middle of treatment or recovering, in remission or facing recurrence. Many of you feel totally overwhelmed by what is happening. Standing in the wings of the cancer drama are your children. Parenting instincts urge you to shield your precious children from the crisis, just as you would cover their eyes if a horrible crime were to unfold in front of them.

The problem with this approach is that there is no way to protect your children from the fact that cancer has entered their lives. Even though the cancerous cells reside in your body alone, the cancer experience is happening to your entire family. Your children sense that something major has happened; they are trying to understand what is going on and find ways to cope. But they are just children, lacking the maturity, skills, and experience to deal with your illness. If you exclude them, they may draw inaccurate conclusions or find maladaptive ways of dealing with your illness. If they are included in the crisis, they can be guided toward accurate, healthy, and hopeful interpretations of the events and learn adaptive coping skills.

Childhood experiences mold the adults that children become. As a medical doctor, I cared for adults with health-related phobias, unresolved anger, or the inability to trust, all stemming from unpleasant childhood events. I also cared for, people who were able to overcome illness and loss effectively and enjoy fulfilling lives owing to valuable lessons learned from similar childhood crises. As a mother, I have watched my children grow through the challenge of my illness.

Your illness will affect your children. Whether the impact of your illness is positive or negative will be shaped by you -- your words, actions, and love. Recognize the powerful role you play in molding your children. Just as important, understand that you can only affect, not control, how your children turn out. Many factors that are beyond your control will also influence your children's reactions and ability to cope. A parent whose child has attention deficit disorder (ADD) or diabetes isn't to blame for the problem. In the same way, don't accept blame for problems that arise due to your illness or your handling of it. Try to do your best, and then gear yourself up to deal with whatever happens down the line.

You can learn from others how to handle common issues that arise when a parent has cancer. Sometimes the best answers are hidden deep inside your heart. Providing healthy responses to your children's questions and difficulties can prevent or minimize problems for them in the short and long term. Fewer problems with them means less stress for you. And in your soul-searching for wise answers for your children, you may discover handles that bring you comfort, nourish your hope, and encourage you to have a positive attitude.

You may feel that the enormous demands of your illness are an insurmountable obstacle to instilling values and beliefs in your children or providing them with adequate love. Your heightened physical and emotional needs may lead you to see parenting as something that will just have to wait until you are healthy again. Your children can't wait. This is the only childhood they will ever have, a crucial time of development. Choose to see your illness not as an obstacle but as a powerful platform from which your messages are amplified, helping your children understand and believe you and feel your love in a powerful way.

Rearing children challenges your sense of control over your world. Innumerable parents are made to feel powerless by a baby who won't stop crying, a toddler who won't stay in bed at night, or a teen who refuses to clean his room. Cancer, especially during the tumultuous time of a new diagnosis, disrupts this sense of control even further. Your parenting job does not have to represent one more area of powerlessness. Regain a sense of control over your parenting and your life by tackling the issues of raising your children while fighting cancer.

Cancer can direct all your attention and energy inward, toward yourself. Only if you put aside your own worries and feelings when you are with your children can you empathize with their concerns and needs and recognize how to help them. This requires that you look at survivorship issues from two different points of view -- yours and your children's -- and separate your experiences from theirs. Helping them understand their emotions will give you added perspective that will help you with your own feelings. And tending to their needs will help you escape the role of victim.

During this family crisis, you may be highly sensitive to all of your children's moods and behaviors. What other parents may brush off as "just a phase" may seem to you a serious psychological problem. Remember that children grow in fits and spurts. Sometimes they are happy and easy to please, other times they can be moody and impossible to satisfy. Trying on different behaviors and attitudes is a normal part of growing up, and will happen whether or not a parent is ill. You will be facing the challenge of distinguishing children's difficulties that would have occurred anyway from those that are related directly to the strain of cancer. You will sort out when to intervene and when to leave the problem to resolve itself. In learning how to do this you will become well equipped to deal with the normal ups and downs of raising kids.