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My mom and I have a difficult relationship, and now she has been diagnosed with cancer. How do I cope emotionally as I help care for her?


​Roberta Satow, Psychotherapist in New York City and Author of Doing the Right Thing: Taking Care of Your Elderly Parents Even If They Didn’t Take Care of You and the Psychology Today blog Life After 50 | Photo courtesy of Roberta Satow​
ROBERTA SATOW: You certainly aren’t alone. Many people feel ambivalence toward their parents. It’s important to accept how you feel about whatever your experience with your mother has been. You will need to accept that you still have these feelings, and you aren’t going to be able to simply put them in the past. In fact, when adult children find themselves in a caregiving role, those old feelings often come back to the surface.
 
For some lucky people, caregiving can be an opportunity to work through and resolve past resentments. You might find you are finally able to connect with your mother in a way you never have before. More likely, you’ll need to work through your feelings about the past without your mother’s involvement. It’s important to find another person who can help. Talk to a spouse, sibling or close friend about your experiences with your mother and how they make you feel about caring for her now. A therapist, social worker or support group can also be helpful.
 
As you work through your emotions, it’s important to set reasonable limits on how much help you can provide without sacrificing your own health or unduly disrupting your own life and family. Keep in mind that there are different ways to make sure your mother is receiving quality medical care and that her other daily needs are being met.
 
You might feel strongly that you are going to take care of mom yourself no matter what. Or it might be enough for you to make sure that your mother is well cared for even if you aren’t acting as the primary caregiver yourself. In either case, look to family members and loved ones for help with specific tasks or financial assistance if needed. If you can afford it, consider getting professional help to address some of your mother’s needs.
 
Remember, it’s important to take care of yourself too. Reach out to others who can help share the load. 
 
TAKE CARE OF YOU // Family Caregiver Alliance has tools to help you reduce the stress of caregiv-ing. // The National Cancer Institute offers a booklet on managing a new role as caregiver. // WebMD​ has tips for working together as a family to care for parents. 
 
Do my partner or I need to take any special precautions while having sex during my cancer treatment? 
 

​Dale Shepard, Medical Oncologist at the Cleveland Clinic Cancer Center | Photo courtesy of the Cleveland Clinic
DALE SHEPARD: For couples who are able to have children, the first and foremost consideration in having sex is the risk that you or your partner may become pregnant during cancer treatment. Chemotherapy, radiation and other cancer treatments might present a risk to the fetus. Chemotherapy can also cause damage to sperm or eggs, which may increase the risk for birth defects. Use of birth control is therefore recommended when having sex during your treatment. Hormonal birth control is not recommended for certain women with hormone-sensitive cancers. Copper intrauterine devices or barrier methods like condoms are nonhormonal options.
   
The other reason to think about using barrier methods is that chemotherapy drugs can be secreted in bodily fluids. There’s a chance that these low levels of chemotherapy drugs could cause irritation to your partner, particularly in the days immediately following your treatment. Use condoms or dental dams to prevent your partner from coming into contact with semen or vaginal fluid.
 
Some chemotherapeutic drugs can cause blood counts to drop, sometimes significantly and for periods of days to weeks. They can also dry mucous membranes. These factors can lead to an increased risk for irritation or bleeding associated with sex. If you have a low white blood cell count, you and your partner may need to take extra precautions, such as using lubrication and condoms during sexual intercourse, or limit your sexual activities for a time to protect yourself against an infection.
 
In most cases, there is no medical reason to forgo sex during treatment. However, when you have cancer and are undergoing treatment, you may find you don’t feel as much like having sex. You may experience treatment side effects—including anxiety, nausea and fatigue—that leave you feeling unwell. Other side effects, such as hair loss and weight gain or loss, can negatively affect body image. It’s a good idea for you and your partner to discuss and appreciate the fact that there may be a period of time that you don’t feel like being intimate.
 
With that in mind, if the opportunity does present itself and you feel like having sex, that’s a good problem to have. If you have sex and you do it safely, that’s perfect.

SEX DURING TREATMENT // The American Cancer Society has advice on navigating sexual activity during cancer treatment. // Dana-Farber Cancer Institute offers tips on how your partner can support you during treatment. // The University of Texas M. D. Anderson Cancer Center​ provides information on changes to your sexuality that may occur with treatment. 
 
I am a survivor of an inheritable cancer. When and how should I tell my children about this history?
 

​Melody Perpich, Genetic Counselor in Pediatric Oncology at the University of Chicago Medical Center | Photo by John Eatinger​
MELODY PERPICH:
The first thing I encourage survivors and families concerned about hereditary risk to do is to talk with a trained professional, such as a genetic counselor or a doctor with expertise in genetics and inherited cancer syndromes. You’ll want to make sure you have the best information available on the nature of your cancer and its connection to genetic mutations that could be passed down from one generation to the next. Many people who have experienced cancer are surprised to learn that only 5 to 10 percent of cancers are inherited.
 
Once you’ve established that cancer does run in your family, you’ll need to consider the risk to other family members. When a syndrome increases childhood cancer risk, genetic testing and cancer screening in children is appropriate. More often, inherited cancer syndromes only increase cancer risk in adulthood. In such cases, genetic testing or cancer screening is typically not recommended for children and can be postponed until they are old enough to be involved in decision making.
 
In either case, I recommend that parents and families be as open and honest with their children as possible. You may be hesitant to share this information with your children out of a desire to protect them from worry. However, even young children might have questions and concerns, particularly if they’ve witnessed you and perhaps other family members undergo cancer treatment.
 
Of course, every child is different, and you’ll want to take the personalities and learning styles of your children into account. It’s OK to take it slow. In fact, it’s often easier for children to process this kind of information gradually, rather than be surprised with it as an unexpected burden later in life.
 
In having these conversations about cancer-related genes and cancer risk with children, it helps to stay positive. Explain to your kids how knowing that cancer runs in the family is a good thing. With this information in hand, they can be proactive in taking steps to reduce their cancer risk through healthy living, earlier cancer screening and consideration of risk reduction strategies. 

UNDERSTANDING GENES AND CANCER // Cancer.Net offers a basic primer on genetics and cancer. // The American Cancer Society lists and discusses signs that cancer might run in your family. // The National Society of Genetic Counselors​ has a directory to help you find a genetic counselor in your area. 
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12/30/2016
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