Telling people

A significant step after your breast cancer diagnosis is communicating the news to others. Who and what you want to tell – and when - are up to you.
Some women choose not to tell many people at all, maybe family and friends but not colleagues. Others tell everything to everyone. It is completely your decision. In this section you'll find tips on:

Here are some communication tips:
• Write a 'high to low' priority list to ensure those closest to you hear first
• Decide on how you will tell different sets of people eg emails may be appropriate for some but face to face for close friends and family
• Give people just a few key facts so they can process the most important information
• Give people guidance on what support you would like from them eg meals, company at hospital appointments
• Have someone be your ‘communication link’ person - it can be exhausting repeating the same information over and over – so ask your partner, a relative or friend to communicate with others on your behalf

Breaking the news to your children
The way you communicate information to your children depends on their age, but being honest and telling them as soon as possible is the best way forward. You may want to shield them but even very young children can sense when there is stress within the family or changes to the daily routine.
Young children don't need as much information as adolescents. Being truthful and building trust from the outset will help everyone in the family face the situation and cope better with challenges ahead. Here are some tips that may help, especially for younger children:
• Plan what you want to say, and where you want to say it, ahead of time. This will give you a structure for the conversation. Have your partner present, or another adult the children trust if their presence will help. Choose a comfortable and safe place where you won't be interrupted
• Don't be afraid to use the word 'cancer'. Explain cancer in simplistic terms like 'cells that sometimes go wrong', that doctors will remove all or part of your breast and then use medicines over long periods of time to make you better. Encourage them to ask questions at any time. If you don't know the answer, say 'I'll find out' and be sure to follow through on that
• Make sure young children know that cancer cannot be caught from someone else!
• Prepare children for treatment side effects.  Let them know you may feel unwell and tired, there may be changes in how you look, and that you'll have more hospital appointments. You could be away from home for periods of time.
• Reassure children that their needs will be met. Stay consistent with routines as this reassures and helps to keep things normal. Let children know if other people they trust will be helping to care for them. Try to make time for your children, even if you're not feeling too well. Simple activities like reading a book or watching a DVD can help them feel secure
• Keep usual limits and routines in place. You may be tempted to give your children more treats but maintaining 'the usual' can be more reassuring.  Older children may be asked to take on extra domestic responsibilities. Be sure the reasons why are clearly explained
• Teenagers may feel the greatest stress especially when asked to take on more household chores. There is also the stigma of a mother who 'isn't cool' and this can cause embarrassment and anger, even long term problems (timely professional intervention may be needed). Talk, negotiate tasks, encourage their participation in normal activities (sport, social interactions with friends) and reassure them that none of this is their fault
• Let others help out with the children.  Picking up from school, taking to sports practice
• Let teachers at school know what is going on. Ask them to advise any change in your child's behaviour (anger, withdrawal, loss of concentration or falling productivity)

Skylight provides online resources for helping families cope with stressful and traumatic situations
Kenzie's Gift provides psychosocial support for young children coping with a diagnosis of serious illness within the family

The Cancer Society provides a booklet: 'Cancer in the Family: Talking to your Children'

Letting work know
Reactions to your news at work will vary. Some colleagues may be very supportive and helpful and others may not be comfortable with your news. Talk to you partner, friends and family about the approach you would like to take. Here are some ideas that might help:
• Your manager should be one of the first people to know so they don't hear it second-hand.  Explain how cancer treatments may affect you at work and your need for time off for appointments. Confirm arrangements for paid and unpaid sick leave. Get approval for your sick leave from your manager.
• Talk to you manager about what you would like your colleagues to know or not know. If you are comfortable talking to colleagues, keep messages simple about the treatments you'll be having and how they may affect you and your appearance (e.g. hair loss and fatigue). Encourage them to ask questions if you are comfortable with that but if you are not comfortable, it’s okay to say that you don’t want to discuss it
• Depending on how you want to approach this, keep your manager updated as needed on your health and progress
• If necessary, ask your manager for assistance and flexibility with regard to deadlines and projects, hours worked during treatment. If your role enables, ask if you can work from home. 
Many women choose to keep working through their treatment. Discuss this with your specialist team as they may be able to schedule appointments to suit your working hours and can also advise on side effects that may impact your ability to be productive such as nausea, fatigue and cognitive effects (poor concentration and memory loss). Here are some tips that might help if you are working through:
• Keep a 'work diary' showing the days you work, work meetings and appointments, project deadlines, and notes from meetings
• Make daily 'to do' lists to help you keep track of jobs
• Talk to your manager about some extra help or job-sharing when needed 

Handling the reactions of others
Reactions will vary. Others’ reactions are not your responsibility but they may have some impact on you. Some people will;
• feel emotional and in shock
• share an opinion about cancer or treatment eg I would never do chemo....
• share a positive or negative cancer story eg my Aunt died…
• give advice to you eg that you should feel grateful that you are still here or to stay positive
• want to help but aren't sure how
• say unhelpful things though they want to be supportive
• not be there for you when you thought they would be and
• be incredibly supportive when you didn’t expect them to be.
Some people may be very supportive and helpful while others may withdraw following your news. Be prepared for all types of advice, some of which may not be helpful but mostly well-intentioned! 

Whatever the reaction, it’s vital to have a supportive team around you - surround yourself with people who make you feel comfortable and safe.

You need to put your needs first. It's not about you being the support for your friends and family.