Women will be flooded with new concerns when they receive a breast cancer diagnosis, but one thing they may not have to worry about is their children’s ability to cope with the fact of their mother’s illness, according to a new study.

"This study did not find evidence that children of mothers in the initial diagnostic and treatment phases of breast cancer had increased adjustment problems when compared with children whose mothers were not seriously ill," says study author Lizbeth A. Hoke, Ph.D., of Beth Israel Deaconess Medical Center in Boston.

While children may not have serious adjustment problems, it is still important for parents to address their children’s emotional needs, says Hoke. This research suggests children can handle the bad news.

Hoke’s earlier research showed that children carry a heavy burden of worry when a parent is sick. Children whose parents try to protect them from knowledge of a mother’s illness may instead develop harmful misperceptions.

"Children often have questions and worries when a parent is ill, and they may feel confused and unable to talk about their feelings. Parents need to be aware of their children’s responses and talk with them about their experiences, in order to help them cope with the effects of the illness on the family," Hoke says

In this study, children of mothers with breast cancer experienced fewer behavior problems and anxiety symptoms than even the average child. The children’s adjustment decreased only slightly in response to the severity of their mother’s illness, an effect that did not reach statistical significance in this sample.

"Children in the breast cancer group appeared to be doing well, even though their mothers reported significantly more distress and adjustment problems than mothers with benign biopsies," Hoke says.

The study is published in the September issue of Psycho-Oncology.

The study included 52 families, 28 of which had a mother with breast cancer and 24 with mothers who had had a benign finding on breast biopsy. The women with breast cancer had a total of 35 children and the women without breast cancer had a total of 34 children. The children ranged in age from 8 to 16.

Hoke also found a paradoxical effect in children of mothers with breast cancer who reported greater psychological problems. Those children actually performed better socially and in school compared with children of mothers without breast cancer who reported being distressed.

"Adolescents of mothers with breast cancer may have looked to outside activities to help them cope with the situation at home, or they may be trying to help their mothers when they were distressed by doing better in school and social activities," she says. An alternative explanation is that they "may have been able to attribute their mother’s distress to her medical illness, thereby lessening the likelihood that they felt confused or responsible for her negative feelings."

The study was funded by the Trustees Under the Will of Herman Dana and the American Cancer Society’s Massachusetts Division, Inc.

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Psycho-Oncology is a bimonthly international journal devoted to the psychological, social and behavioral dimensions of cancer. Published by John Wiley, it is the official journal of the American, British and International Psycho-Oncology Societies. Contact Jimmie Holland, MD, Co-Editor, at (212) 739-7051 for information.