Children as young as 6 years old often realize the gravity of the situation when their mother is diagnosed with breast cancer, but most still need to talk more with their parents - or even with the doctors involved - in order to understand what is happening and what to expect, British investigators report.

Approximately one out of every four women diagnosed with breast cancer has children living at home, Dr. Gillian Forrest and colleagues at the University of Oxford point out in their report, published in BMJ Online First.

“We were building on work done earlier, in which women with early breast cancer were interviewed, and it was discovered that talking to their children about their disease contributed to their distress,” Forrest told Reuters Health.

Forrest’s team interviewed 37 mothers with breast cancer and 31 of their children between 6 and 18 years old.

“The most striking thing that came out was how much more children these days know about cancer from an earlier age than parents realized,” the researcher said. “Some parents were unaware that the kids knew it was a serious illness that could kill you.”

So she recommends first off that parents find out how much their children understand, and if they had previously observed cancer in friends’ families, and how those acquaintances had fared.

“If their child saw that cancer had killed someone they knew, they would most likely believe that their own mom would die, and should be reassured that that is probably not the case,” she continued.

Her team found that children who visited their mother too soon after surgery could be quite frightened by seeing blood on the sheets, or even believing that she had died because she was so pale and still, so she recommends waiting at least a day after surgery before taking the child in to visit.

In addition, the youngsters need to be prepared for their mother’s hair loss, and to be told that it would grow back, and that she may not feel well while undergoing chemotherapy

Forrest also explained that it can be difficult to predict how children will react. “Some may be surprised by the strength of the reaction, with tears and anxiety or even anger, while others may be shocked and dismayed by the apparent lack of reaction.” She noted that these children may be very distressed internally, even though outwardly they appear to be uncaring.

Doctors can play a key role in helping parents talk to their children about cancer, she added. “Even asking the parent how things are going with their children and if they are finding it difficult to talk and need help, can enormously enhance their care.”

SOURCE: BMJ Online First April 14, 2006.