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Psychologists comment on issues raised by Kate Middleton’s cancer diagnosis.
Professor Nazanin Derakhshan, Professor of Experimental Psychopathology & Founder of The BRiC Centre, University of Reading, said:
“The impact of cancer on younger women is more than meets the eye. Younger women are often in full-time work, have younger children, may be a sole provider for their families, or may be wanting to have a family of their own, all of these can be impacted by cancer adversely. These ‘costs’ of cancer can increase risk of emotional vulnerability to anxiety and depression which have shown to affect clinical outcomes of cancer. In breast cancer, younger age is associated with greater distress, poorer self-esteem and self-confidence (which can also impair workability), feelings of guilt and fear of recurrence and progression of disease. Many younger women worry about having to leave their younger children behind should the cancer progress. They worry about their abilities upon return to work after cancer treatment. They can experience radical menopausal symptoms due to cancer treatment. Recent research shows that age is a risk factor for increased levels of anxiety and depression in women with breast cancer. Younger women who can be at the prime of their lives can lose much more to cancer. Worryingly, there has been no systematic attempt to study the psychological and societal effects of cancer in younger women and this needs to be addressed.”
Professor Louise Dalton and Professor Elizabeth Rapa from the Department of Psychiatry at the University of Oxford lead a programme of work focussed on the importance of communicating with children about a loved one’s serious illness such as cancer.
Professor Dalton says:
“Adults understandably want to protect children from difficult or emotionally painful situations and often underestimate how much even very young children notice and understand about what is happening within the family. Research shows that children want to know about what is happening when an adult they love is ill and that effective communication with children about illness is associated with better psychological functioning.”
“Research consistently shows that when children are given an explanation of what is happening in their family this leads to better family functioning and mental health outcomes for everyone”
Professor Rapa says:
“Effective communication includes talking to children not only about the facts of what is happening, but also sharing and exploring some of the emotional impact of the news. It’s important to include children in conversations about illness in the family as soon as possible (e.g. after a diagnosis) so that they have time to understand and make sense of the situation and they are not left to worry alone.”
“Adults need to be authentic about some of the uncertainty and psychological challenges when someone is unwell. This honesty not only offers a coherent explanation for what children are observing, but also provides them with a model of how to talk about feelings and gives children permission to share how they are feeling. Normalising their emotional reactions and reassuring children about how the family will look after each other helps to contain anxiety and provides a shared focus.”
*Talking about Serious Illness: Making Impossible Conversations Possible
The powerful and personal announcement by the Princess of Wales today highlights the unenviable task facing millions of adults around the globe when they are diagnosed with a serious illness. Should we tell the children about what is happening? How do you explain something like cancer to a young child?
Despite adults’ understandable desire to protect children from upsetting or worrying news, it is important to talk honestly to children and young people. Even very young children notice when the adults around them are more stressed or start taking telephone calls behind closed doors. Research shows that when children are not told about what is happening, they reach their own conclusions. This can lead to children mistakenly feeling they are in some way responsible or to blame for these changes e.g. when a parent can’t play in the same way as before.
They have also created films to help the public understand the importance of these conversations with children:
Professor Dalton and Rapa have made evidence-based step by step guides for families on how to have these conversations including words and phrases to use, as well as children’s common reactions to being told about a serious illness https://www.psych.ox.ac.uk/talkingtochildren
Adult patients report wanting help from their healthcare team to think about what, how and when to share their diagnosis. Healthcare professionals have described feeling uncertain about asking patients about their relationships with children so this sensitive topic can be avoided during medical appointments. Healthcare professionals can play a crucial role in supporting patients in talking to children; Professors Dalton and Rapa have made a guide and animation for healthcare professionals in every area of medicine to help have these conversations with their patients: https://youtu.be/0esY5bsLM84
Declared interests
The nature of this story means everyone quoted above could be perceived to have a stake in it. As such, our policy is not to ask for interests to be declared – instead, they are implicit in each person’s affiliation.