Hester ​Hill Schnipper​ ​

​Photo courtesy of Beth Israel Deaconess Medical Center​

I AM A FIRM BEL​​​IEVER IN TELLING THE TRUTH. ​It seems inarguably necessary to share news about a cancer diagnosis with one’s family and friends. However, after years of counseling patients with cancer, I have learned there are exceptions to the rule.

Most often, these exceptions come into play with patients who decide to withhold news of their cancer diagnosis from aging parents who are sick or frail. What if, for example, a cancer patient’s 98-year-old mother is in poor health and lives a thousand miles away? Perhaps the patient’s 80-year-old father has dementia and lives in a nursing home. Maybe a parent suffers from debilitating anxiety and requires a great deal of professional care and attention.

I’ve learned lies of omission in these circumstances can be both loving and responsible. If you find yourself grappling with whether to tell a frail or ill parent about your diagnosis, the following considerations may help you determine the best course of action.

1) First, do no harm. Of course, learning about your cancer diagnosis can be painful for people who love you. In most cases, they can manage their emotions and support you. In other cases, due to life circumstances, age or illness, they may be unduly burdened by the news.

2) It’s not always possible to keep cancer a secret. If you regularly see your mother, she may notice lapses in visits or ​treatment-related appearance changes, such as hair loss. If, on the other hand, you see a parent only a few times a year, you may be able to keep your own counsel.

3) Consider visiting a parent who lives far away before you start treatment to gauge whether to share information about your diagnosis. Remember that older people’s attitudes may be rooted in a time when the “C word” was whispered, and cancer meant sure death.

4) Think about delaying news of your diagnosis until after surgery or other treatment has been completed. In this way, you can emphasize your recovery, and your presence will offer reassurance.

5) Determine whether it’s likely that your cancer news will remain a secret. Could others who you choose to tell let the information slip? It would be worse for your parent to hear of your diagnosis from someone else.

6) If you must break the news over the phone, arrange for someone to be with your parent for the call.

7) Focus on the positive. You don’t need to share dire news with an elderly or ill parent. Talk about hopeful information or the excellent care you are receiving. 

8) If your prognosis is poor, consider breaking information down bit by bit for your parent. Divulge negative information only when it is necessary.

It is devastating for parents to hear that their child has a serious or life-threatening illness. But you don’t need to shoulder the burden of helping a parent deal with these emotions. Enlist the help of family members or close friends to support your parent so you can focus on your own needs.​

Hester Hill Schnipper, a licensed independent clinical social worker, is a breast cancer survivor who served as the manager of oncology social work at Beth Israel Deaconess Medical Center in Boston.