Talking To Teens: Expert Tips for Parenting Teenagers

Introduction to Talking to Teens
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Andy Earle: You're listening to Talking to Teens, where we speak with leading experts from a variety of disciplines about the art and science of parenting teenagers. I'm your host, Andy Earle.

We're looking today at everything you need to know to talk to your teenager about cancer.

Chances are your teen is going to encounter a friend at school whose parents or relatives or a teacher who's dealing with cancer.

How much should you tell your teenager? When do you talk to them about it? What do you leave out? What do they not need to know?

How do you equip them to say the right things and ask the right questions if a friend or someone at school is dealing with this?

Introducing Dr. Chadi Nabhan
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Andy Earle: Chadi Nabhan is a hematologist and medical oncologist. He has authored or co authored over 300 peer reviewed manuscripts and abstracts.

He's the host of the weekly Healthcare Unfiltered podcast, and he's the author of two books, Toxic Exposure, and his new book, The Cancer Journey.

Really excited to have Dr. Nabhan on the show today. Thank you so much for coming on the Talking to Teens podcast.

Chadi Nabhan: Thank you so much for having me, Andy.

Andy Earle: I am super excited. I've been reading through your book on The Cancer Journey. You really have packed a lot in here. I'm super interested to dive into this.

Not something we've covered on the show before. Really excited to have you here and would love to hear a little bit about how you got into doing this and what inspired you to write this book.

Chadi Nabhan: Yeah.

Understanding Cancer and Its Misconceptions
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Chadi Nabhan: I'm a cancer specialist. I'm a cancer doc, took care of patients for many years.

In the process you encounter situations where you realize there's an opportunity to educate patients, families, and all stakeholders about everything pertaining to cancer. Because some of the questions come on and on again, very often. What's important also, is that there's no scarcity of search engines or places that people could find to research things.

Despite the availability of all this information, there is still difficulty for people to process this and to understand this very well. So I decided to embark on writing a book that simplifies everything about cancer for everyone. It took me three years to write because I really wanted to perfect the ability to reach very general and broad audience that wherever you are in the spectrum, whether you are a caregiver, a friend, a colleague, the person involved, the child of a parent, the grandmother, whoever you are in this spectrum of the cancer journey, you will understand everything I'm going to say about this.

So I use storytelling. I use plain and simple language because I think this is the best way to reach a very broad audience. Currently, I am working at an artificial intelligence company. My role at this company is chief medical officer, where I'm working with a lot of engineers and entrepreneurs to bring artificial intelligence to the way we conduct clinical research and clinical trials.

My hope is that I'll have an impact on how fast new drugs come to market to help patients that need them. I also have a weekly podcast called Health Care Unfiltered. It airs every Tuesday. The one other thing I will say is that I had written a previous book called Toxic Exposure.

In that book, I write about the Monsanto trials and Roundup linked to cancer and how I was an expert witness in these trials. During these trials, I had to explain to the jury in the courtroom a very complex topic pertaining to cancer. I realized the importance of simplification to reach people. And that was also another sign for me that if I was able to simplify things to the jury in a very complex situation, maybe I have it in me to actually take that to the next level. That's how it all started. And I'm glad that we're having a conversation about it today.

Common Questions About Cancer
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Andy Earle: What do you think are the common things that people might get wrong about cancer or not understand? Or what do you find yourself often getting asked by people or explaining to people?

Chadi Nabhan: The most common one that I've encountered is if you are an individual diagnosed with cancer and you don't have a family history of cancer, you are shocked by this because there's the inherent belief that cancer is a hereditary disease. I've encountered situations where the patient tells me, "Well, I mean, I've done really well.

I don't smoke. I don't drink. I exercise. I don't have any family member who has cancer. Why did I get this cancer?" And that is not unusual because the minority of cancers are hereditary that are passed on from parents to children. That is a very common question.

The second question that I see a lot is, what caused it?

Okay, now I have cancer. Like, is there anything that caused it? Did I do anything wrong? And then there's the fear of passing it to children. If the person I'm dealing with have children, and how this is going to really affect my kids, my family members and things of that nature.

And lastly, I will say that it's not uncommon that people really want to ask about certain remedies that they can use that are not conventional.

Can I do anything with diet? Is there any acupuncture, cannabis? I mean, there's so many of these questions that come to mind that people ask about. And I think it's important. In my view, to never dismiss these questions or any questions we get and try to address them. Because if the person is asking you that question, it means that this is important to them.

One of the unfortunate things I've seen is sometimes physicians dismiss some of these questions if they don't have similar beliefs to that of the patients and families.

Andy Earle: Yeah, that's something that I've heard from a number of people that are going through chemo is that as soon as they let people know that they have cancer or that they're being treated, people start recommending all these things or sending them all these articles or saying, oh, you've gotta try this, or you've gotta try that.

Or I know somebody who was able to do this crazy diet and it cured their cancer or whatever. And you should really try that.

Chadi Nabhan: And they mean well. Hey, listen, I heard this guy that tried this and have you thought about it and things of that nature? People are trying to certainly help. But from a patient perspective, consider the source. Look at the information. Discuss this with the physician and the medical team. Because not everything you're going to hear from outside sources is going to be appropriate for you for that particular case.

HPV and Cancer Prevention
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Andy Earle: You talk in the book about HPV and cervical cancer screening. You say that HPV vaccinations are essential and recommended for all preteens, girls and boys starting 11 to 12 years old. What is that and how does that work?

Chadi Nabhan: So, there are certain cancers that occur because of viruses or bacterias, believe it or not.

There are some lymphomas, for example, caused by a virus called the Epstein Barr virus, which is the same virus that caused the mononucleosis and things of that nature. We've been able to discover certain viral associations with particular cancers. HPV stands for human papilloma virus.

It's a very ubiquitous virus and most of the strains are benign and resolve on their own. But there are a couple of strains known to be associated with cervical cancer. In other words, if the woman has the HPV virus, specifically 16 and 18, they are at high risk of developing cervical cancer.

When these vaccines became available, you really are preventing the HPV from occurring. So you're essentially taken away the reason why cervical cancer happens. And there's enough data out there today that in the countries or in populations where you have HPV vaccinations available and people are getting these vaccinations, the incidence of cervical cancers have gone drastically low and you can really eradicate that. And there are countries that don't have access to it or don't believe in the HPV vaccinations and that incidence remains high. We both know that there are certain diseases that thankfully we don't deal with today as before, like Polio is an example.

But from a cancer perspective, it is recommended by the authorities that you should get that because it prevents cancer. We know it just won't happen unless you have that virus. 20, 30 years ago, we did not know this is happening because of that virus, but now we do.

If we can get rid of the problem, we don't need to deal with the disease.

Talking to Teens About Cancer
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Andy Earle: What do you think are some of the wrong things to say when you hear that someone has cancer or that their aunt or parent is being treated for cancer? How can we prepare our kids to have those conversations in a way that's respectful?

Chadi Nabhan: Remember, the teens and the kids are going to know about the cancer diagnosis from their parents eventually. I'll take you through a couple of scenarios that are very practical. One scenario is that you are a teen and you are seeing your parent starting to have a decline in health.

So you could tell something is off. You just don't know what it is. You could just tell they're just not themselves. They go to the doctor and when they come back, you're asking "what did the doctor say?" And things like that. And we'll go over how the parent need to handle this, but that is one scenario.

The other scenario is the parent is doing well. Let's think a woman went and had a mammogram for screening. They found a mass or a lump in the mammogram. So she wasn't really complaining of anything and she was healthy. I think the first scenario, when you are seeing and witnessing with your own eyes that your parent is having some decline in health. There's no question that you have some sense of uneasiness and anxiety about what's happening. And you're probably going to demand answers because, you know, what is really going on and what's actually happening?

And I think that is where the parent is on the receiving end of the questions that are coming from the teens and they need to respond to that.

On the second scenario where the parent is doing well, they essentially don't have to say anything because there's no alarming signs. But some form of communication is absolutely needed and required.

So going back to your question, regardless of either scenario, teens and kids need not to be dismissive of the actual problem. We tend to depends on the personality of the teenager. It depends on the dynamic of the relationship between the teenager and the parent.

Sometimes an illness makes the relationship much closer and better, and they get both people tied together. And sometimes it could create a lot of problems.

Number one, not to be dismissive. Number two is it's okay to ask questions, but be respectful of how much the parent is willing to share because there may be a reason why they don't want to share everything right away.

Maybe they just don't know. Not knowing all of the information on day one happens a lot. And parents don't want to share incomplete information because it creates further anxiety. Number three is just ask a simple question.

What can I do and how can I help? Just be there, be available. Be present, because that is the most needed thing from a person diagnosed with cancer. They want to feel the love and the intimacy of their family. And just having that individual present is helpful.

I'll go through the other scenario if you want. I just don't want to take a long time to answer.

Andy Earle: I also feel like there's an extent to which you as a parent who's going through this. You don't want to burden your kids with having to be anxious about your condition, or it's like they have so much going on in their life.

Chadi Nabhan: That's the second scenario right? Because remember, that's why I differentiate scenarios, right? In the first scenario I described if you really having decline in health and it's very obvious to everyone and you went to the doctor, you can't just say, I'm not going to tell you what happened.

It's really going to create more problems. We can go over how this conversation should go. But in the scenario you're describing, yes, I mean, I'm going to the doctor for something completely irrelevant. Maybe a checkup. And they find something I was not expecting.

That is a tough thing because teenagers probably are in school, they're doing a lot of things and you really start thinking if I tell them right now and they have finals next week and there's a lot of things happening, I mean, you, you go through all of this emotional rollercoaster. So my advice to parents in that scenario, number one, do not rush to tell your teen right away what was just discovered. Because you don't know everything yet. There is no way you know everything from day one. I promise you that. I've done this for over 20 years. There's a lot of information that you need to gather from the doctors, from the nurses, from the medical team.

So when you get to the point that you want to tell your teen or your children, you have enough information that you can actually respond to that. Number one, my advice is, A, pick the right time. And yes, sometimes waiting a couple of days is okay. Nothing is going to happen in those two days.

Maybe you want your kid to finish their finals before you sit down and have a conversation with them. Nobody knows the right timing more than the parent. So we can't really teach that. Pick the right time. Timing is very critical.

Number two is there are situations where I had parents where they said, "I don't want to tell my child everything." And I think there are two schools of thoughts on that. One is tell everything because teens are more resilient than we give them credit for. They need to handle this kind of information because it's part of their personality development and eventually they're going to find out.

If you were going to the doctor once or twice a year, and now every week you're going to the doctor, it doesn't take a brain surgeon to realize, something is off with this scheduling. It's not the usual thing. "Are you going to doctor again tomorrow?" "Why are you having another CAT scan?"

So being transparent and picking the right time is very important. Try to answer everything you can, but also offer that they can come with you to the doctor's office next time. It's okay to ask these questions, that they actually have. I am from the school of thought that telling the teens at the right time, providing them with the information you have is critical. Then talk to the doctor and say, "Hey, is it okay the next time I'm going to bring my daughter or son with me? Or is it okay if I call you and have you on a speaker phone?" And I've had lots of family members that taped the conversation that I was having with them in clinic and that's totally fine.

As long as they ask permission. Sure. Why not? You could tape the conversation and listen to it with the family. I think the time when it's okay not to tell anything is there are situations where the disease is diagnosed, but nothing needs to be done.

In other words, there are some cancers that we diagnose, but there is no treatment needed right away, and we could just monitor and observe and watch. So essentially then it is the parent choice. Do I really want to tell them that I was diagnosed with something and create anxiety, but there's nothing I'm gonna do right now?

I think in this situation, you could go either way, and I think it depends on the personality of the teenager, the relationship with the parent, the type of disease, and things of that nature.

Andy Earle: Yeah, it feels like as a teenager, you get any of this information, you're going to have so many questions. How bad is it? What do you mean exactly? What caused this? Does that mean I could have cancer? How long is it going to take? What's the treatment going to be like?

What are the chances that it's going to be cured and go away? It makes sense what you're saying about making sure you have all the information first before you tell them. And I love the idea of bringing your kids with you to an appointment or to speak with the doctor.

Or getting on a call or something like that, so that they feel involved in the process.

Chadi Nabhan: And I think you're going to need that involvement. It is okay for them to know. They're going to find out. At the end of the day, if you are actively undergoing therapy for a particular cancer, they're going to find out.

It is better that they find out from you and to sit down and have this conversation. The time where I am like 50 50 is when you are diagnosed with something that requires nothing to do. And that is not unusual. There are many cancers where we tell the patient, "you have something, but there's nothing that you need to do immediately.

We're going to monitor you and watch you." In this situation, sometimes not saying anything is okay. If that's what you choose because you think it might create more anxiety to your teen, but sometimes you should. I'm okay with this either way, 50 50 on that one.

Handling Cancer-Related Anxiety in Teens
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Andy Earle: How would you handle a child who hears about someone having cancer on TV, or a friend at school whose parent has cancer and they're really worried or anxious about it? Could something like that happen to you? What if you get cancer, mom? Or something like that?

How will you talk them through that?

Chadi Nabhan: Yeah, it's not an uncommon scenario. I mean, they could have a kid at school that their parent had cancer or even the kid had cancer, their classmate or something like that. Number one is education, education, education. Let's talk about what happened, and let's try to understand the particular situation. And clarifying that just because it happened to one individual, it doesn't mean it's going to happen to you.

This is cancer and it could happen to a lot of people. But right now it is not happening to you. Try to spin a positive thinking on this. The second thing is explaining to the teen or the anxious kid that just because cancer was diagnosed does not mean we cannot get rid of it, does not mean we cannot cure it.

There are many treatments available. In fact, in my book, I talk about all of these therapies. We can treat it. We can cure it. Many cancers we cure. So, let's try to assume that this cancer diagnosis is like any other disease. And let's hope that there is a cure. And number three is, feel free to extend a hand to help.

Ask your friend if they need any help. Sometimes help is simple as let's bring him out for a play date, or let's take them out. Or simply is cooking a meal and you can take it to school and give it to them. Or let's give them a gift card because they can't really cook and their mom is sick or their dad is not available.

Maybe we can buy them a couple of meals. Making sure that the kid provides useful helping hand to their classmate would be helpful. So teach, educate, keep a positive outlook. It's really important. And there's a lot to be positive about.

And then see what else can you help with. Because then the kid and the teen feel very useful, and they really feel that they're providing a lot of meaningful aid to their classmate and their friend.

Conclusion and Resources
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Andy Earle: Thank you so much for coming on the show today and speaking with us about your book. I really appreciate you coming on. I hope people check out a copy of The Cancer Journey: Understanding Diagnosis, Treatment, Recovery, and Prevention.

Chadi Nabhan: Thank you so much for having me. It's been really awesome to be with you.

Andy Earle: I know you also host a podcast. Where else should we send people to follow what you're doing and learn more about your next book or whatever you're up to next?

Chadi Nabhan: I have a podcast called Healthcare Unfiltered.

It is weekly. It is every Tuesday and it's Available everywhere folks listen to podcasts from Apple to Spotify to Amazon. It's also on YouTube. They can check out my website, ChadiNabhan. com, and I'm active on Twitter, at ChadiNabhan, and on Instagram, Chadi underscore Healthcare Unfiltered. And I'm happy to address any questions, concerns, comments.

I'm always available.

Preview of the Full Episode
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Andy Earle: We're here today with Chadi Nabhan, covering everything you need to know to talk to your teenager about cancer. And we're not done yet. Here's a look at what's coming up in the second half of the show.

Chadi Nabhan: Target therapy is all about going after the target that is leading to the cancer development, to the cancer growth, and to the cancer going elsewhere. The common perception is that cancer is one disease. The reality is, cancer is not one disease. It's the most unfair question but people ask it all the time. "How come you guys can't cure cancer?" And I always say we actually cure a lot of cancers, but we don't cure all, unfortunately. I've always told the parents, children are more resilient than we give them credit for. And sometimes the reason these cells are growing in an uncontrollable fashion is because there's a mutation in the DNA that is not being repaired by our body. That mutation leads to the development of cancer.

Andy Earle: Want to hear the full interview? Sign up for a subscription today. It's completely affordable and your membership supports the work we do here at Talking to Teens. You can now sign up directly through Apple Podcasts.

Thanks for listening and we'll see you next time.