How can I overcome my father's refusal to ask for help with his cancer care?

A fellow caregiver asked...

My 64-year-old father has been diagnosed with colon cancer and doesn't want to tell anyone. The doctor recommended surgery and radiation therapy, and Dad's going to need a lot of care, but keeping his illness a secret makes it impossible to get other people involved in helping out. How do I handle this?

Expert Answer

Michele Francis is a clinical social worker at the University of California, San Francisco, Comprehensive Cancer Center.

Such secretiveness is not at all uncommon, and it's almost always a generational issue. Your father grew up in a very different era: 50 years ago, there was a great deal of fear and secrecy surrounding cancer, and people rarely talked about it.But they also didn't have much hope of a cure; a diagnosis of cancer usually meant a long, slow decline. So your first job is to talk to your father and try to find out if fear and pessimism are at the root of his secretiveness. Make sure he understands that today he has a good chance of recovery and that a proactive approach to cancer treatment requires a <link>support team</link> to make it easier.

It's true that you can't involve others in your father's care giving without telling them about his diagnosis, and you need to make this clear to him. You may need to be very firm in letting him know that although he prefers to keep his cancer diagnosis a private matter, doing so puts you in a difficult position. People of his generation didn't ask for help with illnesses, so your father may not understand that you're overwhelmed and that it's not fair to expect you to do this alone. Discuss the treatment regimen the doctor has recommended and explain in as much detail as possible the number of appointments this will involve and the issues that may arise, such as problems with appetite and nausea, pain, and mobility. Tell your father that you'll be caring for him every step of the way but that you can't do it without the help and support of others. 

If your father dreads telling people himself, ask him if he'd prefer that you be the one to deliver the news. You might offer to send an email to family and friends so that you aren't inundated with phone calls and questions. If your father is particularly uncomfortable talking to certain people, you can offer to run interference and shield him from having to deal with friends and family members he prefers to avoid. One thing you can count on: once you begin sharing the news and your father starts to receive love and support, his resistance to telling others will begin to fade.