Diagnosis is a hugely emotional time for cancer patients. While there are the understandable worries for your own health, treatment and survival, there is also the challenge of how to disclose the news to loved ones.

The Breast Unit at King Edward VII’s Hospital works closely with patients to manage these challenging conversations. This Breast Cancer Awareness Month, Dr Vishakha Tripathi, Consultant Genetic Counsellor, and Amelia Cook, Breast Unit Manager answer the most common questions they’re asked.

What should I say?

Sharing the news of a cancer diagnosis can be nerve wracking for so many reasons; for many it can make the situation feel more real, and can add to the enormous stress they’re already under considering their prognosis and treatment options.

We always advise patients to take their time and broach the subject in a way that feels right to them, this may be in our clinic, or in private. Each relationship dynamic is different and this will influence how patients wish to communicate with their families.

If you have younger children this may feel particularly challenging. We’ve worked with a number of families broaching what can be an incredibly painful experience for parents and the key premise to managing every discussion is keeping it open, honest and simple.

Children are intuitive and will sense something isn’t right; being up front about a diagnosis in an age-appropriate way can help to strengthen bonds, and give children the confidence to ask questions and talk about their own feelings.

Who can come to my appointments with me?

Having a loved one come to appointments with you can help to inform decision making, and keep on top of treatments. Patients can understandably feel distressed when they first learn of their cancer status, and keeping track of appointments and next steps can feel daunting.

Inviting a spouse, sibling, friend or older child can not only provide emotional support, but also be a useful second voice in the room, for asking questions or remembering details on your behalf.

You may want to have your son or daughter in the room with you, and in some instances this can be beneficial. We’ve seen patients bring children as young as 16 into their appointments to a positive effect. Being able to be involved can prevent your children imagining the worst, and giving them a helpful role in the treatment process allows them to feel useful.

How can I juggle my treatment around my family and keep things positive?

Focusing on your holistic health can help to make treatment feel less consuming. At King Edward VII’s our patients can receive support in all areas of their wellbeing whilst undergoing breast cancer treatment, from a clinical psychologist to a reiki instructor.

It’s also important to make time to enjoy yourself with loved ones, to give you all something to look forward to and take your minds off more serious concerns. We always recommend patients have something nice planned for after a round of treatment, like an outing or holiday. Continuing to function as a family and do things you love can prevent becoming consumed by treatment.

What about their health? Should they be worried what my cancer diagnosis means for them?

While cancer diagnosis of a loved one can be hugely worrying, some relatives may wonder what that means for them and their health. There have been several high profile individuals who have publicly spoken about their genetic predisposition to cancer and the decisions that they’ve made as a result. But not every cancer patient will be carrying a genetic strain.

BRCA1 and BRCA are two of several genes that come with an inherited breast cancer risk, but only between 5% and 10% of cancer patients will have an alteration in a high-risk gene.

It’s also important to remember that even if your cancer is inherited, that there’s no guarantee that your relatives will develop the disease. Each child of a BRCA carrier would have a 50% chance of carrying the gene, and cancer would more likely only develop in adulthood, giving them time to consider whether they’d opt to be tested themselves, if they’re eligible.

After your diagnosis you may be invited to consider genetic testing to identify whether your cancer is inherited, on the NHS this happens if there is a 10% probability that something significant would be found through genetic testing.

Genetic testing can be done through blood or saliva but having the right support through the process is essential.

We offer genetic counselling to families undergoing genetic testing, as it can understandably be a nerve wracking experience at what is already an emotional time.

Whatever the outcome, or however you manage the genetic element and overall cancer journey, making decisions based on what’s right for you and your family and keeping them involved in your journey can help both you and them to process your diagnosis.