A Personal Decision
- When Anna Sullivan was diagnosed with breast cancer in 2017 at age 37, she and her husband decided not to tell their kids, as they felt they were much too young to understand, the mental health therapist and writer wrote in her latest personal essay.
- It wasn’t until five years after her initial diagnosis that her kids, then 8 and 6, overheard her talking about her diagnosis and Sullivan finally decided it was the right time, as it was more age-appropriate.
- Choosing whether or not to share your cancer diagnosis with your kids is a highly personal decision. If you’re struggling with the decision, consult a child psychologist or another therapist with experience working with kids who could help you talk through it as a family.
Thankfully, she caught the disease early after finding a lump the size of a No. 2 pencil eraser. Sullivan then had to endure a mastectomy and reconstructive surgeries and seven years later, is still on treatment.
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Anna’s Cancer Diagnosis
Sullivan explained that her diagnosis was “early-onset and ER-positive,” which meant Sullivan was able to forego chemotherapy and instead, was prescribed “a five-year adjuvant endocrine therapy,” which is a hormone therapy given upfront to help reduce the risk of the cancer recurring, or coming back.Early-onset, according to Cleveland Clinic, means being diagnosed with breast cancer before 45 years old, which is the age most physicians recommend beginning routine mammograms, the primary screening method for breast cancer.
ER-positive refers to her cancer’s subtype, meaning it’s estrogen receptor-positive, or fueled by that specific hormone. It is one of the most common subtypes of breast cancer, and per the American Cancer Society, keeping the hormone “from attaching to the receptors can help keep the cancer from growing and spreading.”
Since there are treatment methods to block the hormone, Sullivan was put on Letrozole to “kill the estrogen” in her body and Lupron injections to “shut down my ovaries,” which put Sullivan into induced early menopause since the drug “is an ovarian suppression drug” used to reduce the risk of her cancer coming back.
With all the appointments and managing symptoms, cancer, as many survivors know, had become The New York Times-published writer’s “full-time job,” she said.
It wasn’t until five years after her initial diagnosis that her kids, then 8 and 6, overheard her talking about her diagnosis. “I still hadn’t told them. I was starting to think it might be better if they never found out,” she shared.
Extended Treatment
Sullivan and her husband, who are based in Santa Fe, New Mexico, were discussing how her oncologist wanted to extend her medication for another five years to be safe.
She let her kids ask her questions and she filled them in as best she could. “I’ve always tried to talk openly and honestly with my kids — when it’s age-appropriate to do so.”
Sullivan, who still continually goes to doctor’s appointments, explained that discussing her cancer and all that comes along with it has bonded them, but she doesn’t regret waiting.
“At times, I wish I’d told my kids sooner about what I went through. Being able to talk openly about my cancer diagnosis has brought us closer as a family. But the truth is, I didn’t need to tell them until I was ready. And I was lucky to be able to wait.”
Talking to Kids About Cancer
Discussing a cancer diagnosis with children can be really complicated. You want to be honest with them and you want them to be prepared for what might happen, but at the same time you want to protect them, and be as gentle as possible.
John Duberstein, who lost his wife Nina to cancer, previously explained to SurvivorNet that he and his wife tried to take a progressive approach – and were as open with their kids as possible. But as honest as they were, they ran into some issues with their kids understanding the disease.
Talking to Your Kids About Cancer
When Nina started to look healthier, for example, the kids assumed she was getting better … but that wasn’t the case.
“It was a real eye-opening moment for two people who felt like they were dealing really head-on with this stuff, talking to the kids,” John said
“So I think it’s important to be open with the kids as much as you can, as much as you feel like they can handle. But it’s also important to revisit it and not make assumptions.”
“At the end of the night, what Nina had to tell them was, ‘I’m not ever going to get better. My cancer is not ever going to go away,’ it was hard for them to hear even though they’d already been prepared.”
‘When it Comes to Your Kids, You Want to Protect Them’
Obviously, not every parent feels comfortable sharing so much about their diagnosis with their children, especially if they are very young like in Sullivan’s case. Some survivors have even told us that they were afraid to tell their family members – but in John and Nina’s case, honesty worked best for them.
If you’re struggling with the decision to open up to your kids, consult a child psychologist or another therapist with experience working with kids who could help you talk through it as a family.
Learning About Breast Cancer Subtypes
Estrogen and progesterone help cancerous cells grow, so healthcare providers must immediately find out if the cancer is fueled by either — or both, or neither. Here is an overview of subtypes:
- ER-positive (ER+) breast cancers have estrogen receptors.
- PR-positive (PR+) breast cancers have progesterone receptors.
- HR-positive (HR+) breast cancers have estrogen and progesterone receptors.
- HR-negative (HR-) breast cancers don’t have estrogen or progesterone receptors.
- HER2-positive (HER2+) breast cancers, which have higher than normal levels of the HER2 protein. This protein helps cancer cells to grow. About 15% to 20% of all breast cancers are HER2-positive.
Questions to Ask Your Doctor After a Diagnosis
If you have been diagnosed with breast cancer, it’s a good idea to make a list of questions for your doctor. Here are a few questions to help you begin the conversation:
- What type of breast cancer do I have? What subtype?
- What treatment will I be receiving and for how long?
- What side effects are associated with this treatment?
- Are there steps I can take daily to help minimize these side effects?
- What physical activity routine do you recommend for me during treatment?
- Do I need to have a mastectomy?
- What does my genetic testing show about my cancer risk?
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