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When a child finishes treatment and gets back to life within the family, the school and the community, many families find that the relationships have changed. Some relationships become stronger from the shared experience of cancer. But others may become strained because of the challenges of cancer.
Relationships with parents and siblings
Relationships within a family may be tested during the transition to life after treatment. Parents and childhood survivors often have different opinions of what life after cancer should look like. The entire family is changed by the cancer experience, but they may not recognize these changes. Open and honest communication is important to adapt to your new life and shifting relationships after treatment is finished. Family therapy can help in sharing feelings, opening communication and supporting one another.
After treatment is finished, some families struggle to think of the childhood cancer survivor as being well again. Or they may think of the child as being well, but forget that the child may still feel tired or have long-term side effects or physical problems as a result of treatment. Sometimes family members want to help the survivor too much, or they may not offer as much help as the survivor needs or wants. Again, talking and listening to each other will help to reduce some of these frustrations.
Family rules and routines often change during treatment. Adjusting to life after treatment then becomes a challenge. Sometimes getting back to former rules and routines means that parents now have to stop themselves from being overly protective. They have to let their young cancer survivor get back to being as normal as possible. This may mean letting the teen survivor go out with friends and come home at the usual curfew time. Or, it may mean letting their child participate in sports again. Before the diagnosis, these activities were allowed and encouraged, but now all the parents want to do is protect their child. This can be equally frustrating for the child who only wants to get back to normal as much and as soon as possible. Parents and children need to talk about their wants, needs, worries and fears to understand each other’s viewpoints. With time and good communication, this will work itself out.
Re-establishing responsibilities is another change that occurs once a child is finished treatment. During treatment, the child with cancer and the parents are away from home a lot. Other children at home often take on the added responsibility of cooking, cleaning, yard work and other household chores. They may also be responsible for getting themselves ready for school or extracurricular activities. Some children get used to these added responsibilities and may actually start to enjoy and take pride doing them. When treatment is over and everyone is home again, some children may resent having those responsibilities taken away from them. Parents need to be sensitive to these feelings. Open communication and planning with all siblings will help them to feel recognized and valued for all their help, while at the same time, the cancer survivor can become a contributing member of the family again.
Cancer in teens can change the normal developmental process. At a time when teens are usually becoming more independent from the family, teens being treated for cancer are instead dependent on parents for emotional and physical support. After cancer treatment, parents often still feel protective and may find it hard to let their teens get back to what they should be doing, which is getting back to normal routines, growing up and becoming more independent.
Cancer can teach everyone in the family about compassion, sharing and coping. You may come out with increased empathy, responsibility, self-esteem, maturity and family closeness. This can help your relationships and help you work through any challenges as you adjust to life after treatment.
Relationships with friends
Many children with cancer say relationships with their family and friends are never the same as they were before they had cancer. This is often true because the experience of having cancer may change the way a person looks at everything and everyone around them. Some friendships remain strong and others may end.
There may be differences depending on if you are diagnosed in elementary school or high school. Friendship in younger children is often based on who is in their class at school. Friendships can frequently change if you are away from school for a long time. When you are young, it may be easier to come back to school and pick up with new friends as friendships change more often. As an older elementary school child, there are more social groups forming and peer pressure is higher. It can be harder to maintain friendships and make new friends when returning to school. At high school age, older teens are often more mature. This can make them more understanding of what a friend with cancer is going through and they may be more likely to make the effort to keep friendships going. But for teens just entering high school, which is usually a time of making new friendships and leaving other ones, things may be harder because they haven’t had the chance to make those friendships.
You may find that you have lost touch with some friends over the course of diagnosis and treatment. Those friendships may seem less important now. Friends who did stay close and new friends that were made during treatment often stay close after treatment. These are friends who understand what you have been through. But at the same time, there may be times when you feel that even these friends don’t understand what you have been through or what you are feeling.
It’s normal for kids who have been treated for cancer to feel different from their friends. They’ve missed out on many experiences while going through treatment. Some children say that they feel out of the loop and can’t relate to the experiences or conversations of their friends. At the same time, you may feel more mature than your friends because your cancer experience made you grow up and redefine your priorities much faster than your friends. Some topics that friends talk about now may not seem important anymore compared to what you have been through.
Some children may feel angry at friends because they don’t understand what they have been through. You may even feel jealous of friends because they didn’t have to go through it.
Some children may want to get back to activities and social events that they did before the cancer diagnosis. You may feel shy or awkward because of side effects or you may feel uncomfortable or out of practice because you have been away from these activities for so long. Some children may feel guilty about getting back to their usual activities when they know that some friends they made during treatment can’t do so.
Talk with your parents, other family members, teachers or counsellors to help you figure out how to deal with situations that may come up with friends or classmates at school. You may find it helpful to join a survivor support group. Social workers, child life specialists and other healthcare professionals at the treatment center can also help you.
Making new friends and talking to friends
Making new friends as a cancer survivor can be difficult. You may feel different than other people your age or you may have late side effects that make it hard to be social. You may be scared that if cancer comes back this will hurt old or new friends.
Don’t feel the need to tell everyone about your cancer experience. Choose a few friends who you know will listen and be supportive. Help them understand what you are feeling, and then they can help others understand.
Some friends will find it difficult as they will not know what to say or are afraid they will say the wrong thing. Be aware that some people’s reactions and comments may be thoughtless or hurtful. This is usually because they don’t know what to say, not because they want to make you feel bad.
Try to be realistic about how much your friends will understand. They won’t understand unless you tell them, and they may not fully understand unless they have been through the same experience. Many childhood cancer survivors form lasting relationships with other childhood cancer survivors because they have that shared experience.
When to tell a friend that you are a cancer survivor
It’s up to you to decide when to tell someone you are a cancer survivor. You may want to get to know someone better before you tell them or you may want to tell them right away. If you have obvious scarring or a disability from cancer treatment, you may not have a choice.
Take each situation as it comes and do what feels right for you. As you think about when to do this, remember that many people find honesty to be a very important part of a friendship, especially a friendship that becomes long term.
Some survivors tell people right away to get it out in the open and to see how the person reacts. Others wait a while so that you know and trust them a bit better before sharing your experience with them. You may decide not to talk about it at all if you think that it won’t affect your new friendship.
It’s hard to know how a person may react to your cancer experience. Some people may be supportive and understanding right away, while others may be shocked at first but not put off. Others may be uncomfortable with your news and may reject you because of it. Often this reflects the person’s fear about cancer, rather than something about you. Don’t let this stop you from making new friends.
Dating after cancer
Some survivors find it hard to start romantic relationships. If you missed out on years in high school, returning to school and dating can be hard. It can be even harder if you have physical side effects of cancer treatment such as baldness, scarring, weight gain or a physical or learning disability.
Cancer can change not only your physical appearance but also how you feel about yourself. You may have scars on your face that anyone can see or scars on your abdomen that are usually hidden. If cancer has changed your appearance, it’s normal to be uncomfortable or self-conscious about it. You can still feel differently about yourself, even if you don’t look any different.
Try to remember that many people – whether or not they’ve had cancer – are unsure of themselves when dating and starting new relationships. Everyone worries about how their date will react as they find out new things about them. It’s normal to feel different about yourself and uncertain about your future or where a new relationship will fit into your life. But cancer shouldn’t be an excuse for not trying to meet new people and make new friends. Not every date has to be a success. If someone doesn’t want to see you again, you haven’t failed. After all, not all dates work out for people who haven’t had cancer, either.
If you have worries or difficulties with dating after cancer, talking with a counsellor may help. You can also find cancer survivor support groups where you can talk with others about dating and new relationships.
Marriage and life partners
Some survivors can be so afraid of cancer coming back that they are afraid to get seriously involved with another person. They may feel they don’t want to impact someone else’s future or put someone else through that.
Others rush in to a serious relationship or marriage even though they are not sure of what they want. They may feel vulnerable or very dependent upon others and want a relationship because it seems stable or normal.
Some may feel that they now know exactly what they want in a spouse. You may find that going through cancer treatment has made you feel stronger and wiser. You know yourself and your priorities better and feel that you have more to offer in a relationship.