Maya Silver, left, with her mother, Marsha, pose while on a family trip to Maine after Mom completed her final chemotherapy treatment to eliminate a malignant tumor in her breast. Maya, now 26, along with her father, Marc, wrote "My Parent Has Cancer and It Really Sucks: Real-life Advice from Real-life Teens."
STATEN ISLAND, N.Y. -- Dealing with a parent’s cancer diagnosis is traumatic at any age, but there is something about being punched with this reality as a teenager that makes it all a bit messier. No longer protected like a child, a teen is expected to be resilient and take on more responsibility, all while navigating the vicissitudes of adolescence.
Knowing how difficult it can be for the estimated one million teens who have a parent with cancer (as reported in a study published in the journal Cancer in 2010), the daughter-father team Maya and Marc Silver of Chevy Chase, Md., have written “My Parent Has Cancer and It Really Sucks: Real-life Advice from Real-life Teens” (Sourcebooks 2013), a comprehensive how-to-get-through-it guide that includes insight from dozens of medical professionals and 100 teens.
Fifteen years old when her mother developed breast cancer, Ms. Silver says she struggled coming to terms with a prognosis that flipped her adolescent universe upside-down. Like any teen in this developmental stage, she says, she was “self-conscious” about how her peers would perceive her in light of her mom’s diagnosis.
“I really had difficulties talking about it with others and was ashamed of the situation. I was nervous others would view me differently,” the now 26-year-old confides. “As a result, I never wanted to talk about it or deal with it.”
Perhaps the most challenging part, though, was seeing her mom, who went on to beat cancer through chemotherapy/radiation treatments, in a debilitated state. As Ms. Silver explains, “I perceive her as a strong role model — she’s the one who raised me,” so to see her “weak and suffering” was “hard to see.”
“The loss of hair,” she adds, “is a sticking point for a lot of teens. It’s a visual symbol of what’s happening, how sick their parent is.”
COMMUNICATION IS CRUCIAL
As the Silvers point out in the book, when dealing with a serious illness in the family, the “C” word — in this case “communication” — becomes incredibly important.
Marc Silver, who also is the author of “Breast Cancer Husband” (Rodale Books 2004), says he and his wife, Marsha, promptly told Maya and their other daughter, Daniella, then 12, about the diagnosis while traveling by car, a trick many parenting experts suggest when communicating with kids, as they have nowhere to go.
Silver points out that having the talk in the car also made the conversation “less daunting” than if they all had been sitting around the dinner table, staring at each other glumly.
According to Terri Gianfagna, a licensed clinical social worker with the Nalitt Cancer Institute at Staten Island University Hospital, many parents try to overprotect their teenage children by not telling them at all or presenting a rosier prognosis, tactics that often backfire.
As she’s heard from members in the support groups she runs at the hospital, sometimes children are blindsided when a parent dies because they didn’t know how dire the situation was, making the grieving process even harder.
When informing a child about a life-threatening illness and ongoing updates, Ms. Gianfagna says, “You don’t want to sugarcoat information,” nor cause him/her to panic.
Silver agrees, adding that minute-by-minute reports about the pain you’re in or how nauseous you’re feeling are details more suited for a spouse.
In figuring out how much or little to say, Silver suggests considering your teen’s personality. “Some kids want to know it all,” he observes, while others prefer few details.
Because one-on-one conversations with adolescents often go nowhere, especially when tackling a sensitive subject, Silver says writing a note or e-mail the teen can read in private works better for some.
And just because they aren’t asking questions, he warns, don’t assume they are not interested in knowing more. As she informed him while writing the book, Maya felt he didn’t check in enough at the time.
Although, at that age, Ms. Silver admits, she might not have been so receptive to his overtures, especially when all she wanted to do was escape her reality — which she did by running track, hanging out with friends, basically anything that got her out the house.
As Silver points out, having an ill parent whose needs come first can clash with a teenager’s “agenda.”
“Developmentally, teens are pulling away, and this yanks them back into the family,” he says, noting, “There can be a lot of tension and resentment over that.”
“Teens are in that stage where everything revolves around them. They are going to want to do their own things,” Ms. Gianfagna echoes, counseling, “It’s important they are involved in their own activities. It keeps them centered and more focused.”
The social worker warns some teens may begin to engage in risky behavior. Angry outbursts, falling grades, problems with friends and bullying are some red flags parents should look out for. To help ensure your teen stays on track, Ms. Gianfagna advises notifying a counselor or trusted teacher at school of the situation so they can be attuned to any developing problems.
Parents also should be aware of a phenomenon known as “parentification,” in which children feel obliged to take on duties Mom and Dad typically handle, such as running errands, doing chores and taking care of younger siblings.
While it’s important that teens pitch in during this ordeal that tests the entire family, Silver believes parents also should try to give them space to act their age, hanging out with friends, going to the mall and the like.