How do I tell my children I have HER2-Positive Breast Cancer

Talking to Your Children About Your HER2-Positive Breast Cancer Diagnosis

This is one of the most difficult conversations you'll have, and your instinct to think carefully about it shows real wisdom. Let me share some guidance based on what other parents with HER2-positive breast cancer have learned.

Key Principles for the Conversation

Be honest but age-appropriate. Children sense when something is wrong, and honesty—delivered in a way they can understand—actually reduces anxiety more than silence does. You don't need to explain every medical detail; you need to help them understand what's happening in their world.

Emphasize three core messages:

1. This is not their fault - Children often blame themselves for a parent's illness
2. You're getting treatment - This is crucial. HER2-positive breast cancer has targeted treatments (like Herceptin) that specifically work against this type of cancer
3. You will still be their parent - Reassure them about routines, care, and your role in their life

What One Parent Learned

Sandra Balladares, PhD, who was diagnosed with HER2-positive breast cancer at age 36 with two young children (ages 2 and 4), shared valuable insights about this journey. She organized a birthday party for her son just two days before her mastectomy surgery—not to hide what was happening, but to create positive memories and maintain normalcy during a difficult time.

Her advice to newly diagnosed parents: "It's important to get psychological support very early. When you get diagnosed, before going to find an oncologist, it's super important that you find a psychiatrist." This support isn't just for you—it helps you be more present and grounded when talking with your children.

She also noted something important about what children remember: "I feel lucky they were very young. Obviously it was so difficult, but there are things that they don't remember." What they DO remember is how you handled it and the love around them.

Age-Specific Guidance

For young children (ages 2-5):

• Use simple, concrete language: "Mommy has a sickness in my body called cancer. The doctors are going to help me get better."
• Explain changes they'll notice: "I might lose my hair, but it will grow back" or "I'll need to go to the hospital for treatments"
• Reassure about daily care: "Grandma will pick you up from school" or "Dad will still make your lunch"
• Let them see your prosthetic or reconstruction if age-appropriate (Balladares' children played with her prosthetic breast like a ball—turning something scary into something normal)

For school-age children (ages 6-12):

• Provide more detail about what cancer is: "My body has some cells that aren't working right. The doctors have medicine to fix them."
• Explain HER2-positive specifically: "My cancer is a type that doctors know how to treat really well. There's a special medicine called Herceptin that targets exactly this kind of cancer."
• Be honest about side effects: "I might feel tired" or "My hair might fall out, but it will grow back"
• Give them a role: "You can help by being patient when I'm tired" or "Your hugs help me feel better"

For teenagers:

• They can handle more medical detail and appreciate being treated as more mature
• Discuss your prognosis honestly: "HER2-positive breast cancer has much better treatment options now than it did years ago"
• Acknowledge their feelings: "This is scary for you too, and that's okay"
• Involve them in appropriate ways: "Would you like to come to one of my appointments?" or "I need help with..."

The Good News to Share

This is important: HER2-positive breast cancer, while historically aggressive, now has excellent targeted treatment options. According to the medical literature your doctors follow, Herceptin (trastuzumab) and other HER2-targeted therapies have significantly improved survival rates for patients with this diagnosis.

You can tell your children: "The doctors found that my cancer is a type they know how to treat. There's special medicine that works really well for this kind of cancer."

Practical Tips

Before the conversation:

• Have your own support in place (therapist, support group, trusted friend)
• Know what you want to say, but don't script it perfectly
• Choose a calm, private time—not rushed before school
• Have tissues available

During the conversation:

• Let them ask questions and answer honestly
• Don't over-explain—answer what they ask
• It's okay to say "I don't know" or "Let me find out and tell you"
• Validate their feelings: "It's okay to feel scared/sad/angry"

After the conversation:

• Keep communication open—they may have questions days or weeks later
• Maintain routines as much as possible
• Consider age-appropriate books about cancer
• Watch for behavioral changes (regression, acting out, withdrawal) that might signal they need more support

Questions to Ask Your Healthcare Team

To help you explain your situation to your children, ask your oncologist:

1. "What is my prognosis with HER2-positive breast cancer and the treatments I'm receiving?" (This helps you speak truthfully about your outlook)
2. "What side effects should I prepare my children to see?" (Hair loss, fatigue, port placement, etc.)
3. "Are there resources or counselors who work with children of cancer patients?" (Many cancer centers have these)
4. "How long will my treatment take, and what will my schedule look like?" (Helps you explain what to expect)
5. "What support groups exist for families dealing with parental cancer?" (Helps children know they're not alone)

Final Thought

Balladares reflected on her survivorship journey: "I feel safe. I feel fine and I feel healthy." She's now 15+ years into survivorship. Your children need to know that while this is serious and real, you're getting treatment, you have hope, and you're still their parent.

The conversation won't be perfect, and that's okay. What matters is that you're honest, present, and connected to them through this.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.