TIME

How Teens Cope With Cancer: The Fault Is in Their Brains

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Ansel Elgort, left, and Shailene Woodley appear in a scene from "The Fault In Our Stars." James Bridges—AP

The disease’s effect on teenagers is the subject of a summer blockbuster. Here's what it's like when their parent is the cancer patient

The movie “The Fault In Our Stars” is a reminder that cancer does not care how old you are. Some 70,000 teenagers and young adults are diagnosed each year.

The film is based on a young adult novel dedicated to one of those cancer-stricken teens.

Cancer affects teens in other ways as well. “Parental Cancer and the Family,” published in the journal Cancer in 2010, estimates that nearly a million U.S. teens live with a parent who is a cancer survivor.

If you ask those parents how their teenage children responded, some might say, “They hardly seemed to notice.”

The fault isn’t in their stars. It’s in their teenage brains.

Teens are in the developmental stage when they create their own sense of self and separate from the family. The news that a parent has cancer is exactly what they don’t want to hear. That news pulls them back into the family orbit that they’re trying to escape. That can lead to unexpected reactions—general anger, anger at the parent and sometimes a seeming sense of detachment from the family cancer crisis.

When my wife was diagnosed with breast cancer, our daughters were 12 and 15. They seemed concerned about mom, but they seemed more concerned about hanging out with friends and keeping up with school. Sometimes it seemed as if they were hardly around the house.

Years later, my older daughter and I collaborated on a book about teens facing a parent’s cancer. It was only then that I learned how deeply the experience affected Maya and her younger sister Daniela.

Marsha’s chemo-bald head was an uncomfortable sight for Maya, who just wanted to be with her buddies so she could feel like a normal teen. Now she wishes she had done more to help out during the months of treatment.

Daniela confessed that each morning at her Jewish day school, she and her friends would say a silent prayer for mom. She kept that to herself at the time. It was her way of trying to create a feeling of control in a situation that was out of control, she says, of trying to do something that could help.

I remember being puzzled when Daniela was supposed to spend the night at a friend’s house when Marsha had her lumpectomy surgery, and I got a call that night at home: “Dad, can you come get me?” What I didn’t grasp was that even though a sleepover can be a lot of fun, sometimes, when a family’s life has been disrupted by a crisis like cancer, a teenager just wants to be home, in her own bed.

So there you have it: outer teenage cool, inner worries, all mixed up in a confusing package.

And if teens do seem to be avoiding the parent with cancer, that doesn’t mean a lack of empathy. “Sometimes you want to preserve the picture of the parent as they were at the top of their game. For that reason, some children may stay away. They love their parent so much they can’t bear to see them sick and not all the way themselves,” says psychiatrist Paula Rauch, director of the Marjorie E. Korff PACT Program (Parenting At a Challenging Time) at Massachusetts General Hospital.

Other teens are “parentified”—that’s a term for kids who take on parental responsibilities. Interviewing kids for the book, Maya and I met teens who cared for younger siblings and handled new household chores.

Avoidance and parentification: “Those are two equally loving ways” to react to a parent suffering from cancer, Rauch says.

Rauch also notes that not every teen wants to talk about it, and that’s okay. Although sometimes, in the confines of a car during a round of errands, miracles can happen and even a reticent teen might answer a parent’s question: “How are you doing?”

For teens who are able to put their feelings into words, life lessons can be learned: How much cancer sucks, and that one way to cope is by drawing strength from your family.

Tyler, who was 11 when his dad was diagnosed with cancer, did the unthinkable for a boy: He shared his feelings with his mom. “We would tell each other things we couldn’t tell anyone else,” Tyler says. “I remember her saying that we were the only ones who understood what we were going through. Everyone else understood but they didn’t quite understand the way we did.”

That close relationship with his mom helped Tyler get through his father’s cancer treatments. And it was helpful for his mom, too. Sometimes he’d give his mom a hug or a kiss on the cheek, or hold her hand, and that little gesture meant the world to her. “We were really there for each other,” she says. “We were each other’s rock. I don’t know what I would have done without Tyler.”

Marc Silver and his daughter, Maya, are co-authors of “My Parent Has Cancer and It Really Sucks: Real-Life Advice from Real-Life Teens.”

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