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HOLLY MAIRENA understands the mixed emotions Elizabeth Edwards, wife of Sen. John Edwards, must have felt when she told her children she had breast cancer.
Mairena experienced similar feelings when she gave her four children the same news more than a year ago.
She still tears up when she recalls that day.
The family, including her husband, Mario, had just returned from a vacation in Colorado. Before she left, doctors had performed a biopsy after a routine mammogram showed something suspicious.
The test confirmed her worst fears.
Mairena never considered sheltering her children from the cancer diagnosis. As a kindergarten teacher, she knew the bits and pieces of information they might hear from others could do more harm than the truth.
She talked to them in simple, honest terms.
"We pulled them into the living room and told them," said Mairena. "They knew I had been to the doctor before we left for vacation and after we got back."
Their reactions were varied.
Collin, then 11, kept his eyes locked on his mother, while the two middle children, 9-year-old Connor and 7-year-old Alison, started to cry. The youngest, Liam, who hadn't turned 5, shifted closer to his mom and echoed the cries of two of his siblings.
But the hardest question was yet to come.
Connor asked his mother: "Are you going to die?"
The heartfelt query hit her like a jab in the stomach, but she carefully gave her candid response.
"I told him I don't have plans to do that," said Mairena, 40, who lives in southern Spotsylvania County. "I'm going to do everything in my power to fight this."
She told them that she needed their support to battle the disease.
Looking back, Mairena said she wouldn't do things differently.
"I was glad that I did it that way," said Mairena, who is now cancer-free after a mastectomy and chemotherapy. "We do everything as a family. I thought it was important to tell them together."
How to talk to children about a family member's illness is one of the most difficult dilemmas a parent can face. But counselors agree that parents should be truthful.
"Don't try to keep a secret to keep them from worrying," writes Elaine Fantle Shimberg, author of 19 health-related books including her latest "Blending Families." "Children sense the tension in a family and if you don't tell them, they'll think they did something wrong."
Shimberg, who lives in Florida, recommends that parents explain to children what is happening. They should describe how the parent will feel during treatment so the children know what to expect.
That's similar advice given by Michigan children's therapist Chick Moorman, who has been writing and speaking about parenting issues for 40 years. He recently co-authored "The 10 Commitments, Parenting with Purpose."
Moorman said parents should strike a balance between providing truthful information and burdening children more than they can handle.
"I'm in favor of being honest with younger children, explaining in language they can understand," Moorman said. "I don't tell them any more than they ask for. I try not to give information that would scare them."
Moorman, 62, heeded his own advice after he was diagnosed with cancer last November. He takes care of his two grandchildren, now ages 13 and 16. The children came to live with Moorman after their mother's death three years ago.
"I told them I had been to the doctor and had a serious illness called cancer," he said.
One grandchild asked if he was scared and he answered truthfully.
"I told them 'yes,'" he said. "I told them I don't know what the future brings, but I know we'll be able to handle it."
Moorman said parents make a big mistake by shutting kids out.
"They feel it going on, but no one tells them," he said. "They'll feel they're not important enough for you to talk to them."
Annie Mason of Spotsylvania said she was prepared for questions her daughter, then 11, had when she told her she had breast cancer in March of 2003.
She wasn't prepared when her daughter asked if she would have to worry about getting the disease herself one day.
"I told her 'I don't think so,'" said Mason, who is 54.
She talked about the strides that are being made in cancer research.
She mentioned names of famous women and local women she knew who had breast cancer and were doing well. She talked about the strength she draws from her faith that would help her through the trauma.
"I saw her relax," Mason said.
Three months after her lumpectomy, Mason and her daughter attended a cancer survivors' gathering.
"She saw survivors who had gone eight years, 15 years, 22 years," Mason said. "It really helped her to see that."
Another Spotsylvania resident, Tina Rebennack believes it's important to consider the personalities of the children when talking to them about a family member's illness.
She did just that.
Megan was 7 years old, Joshua, 4, when Rebennack, then 38, learned that she had breast cancer in June of 2002. She considered not telling them.
"They were so young," she said. "I didn't want to scare them. I'm scared enough myself without frightening them."
She and her husband, Karl, waited until after her a lumpectomy. The children stayed with her mother, who regularly watches them while she's at work.
She told them that she was sick and had surgery to make her better. She told them that she would take treatments called chemotherapy that would make her hair fall out.
She let them know that they could talk to her whenever they wanted.
Megan is reserved and tends to worry, while Joshua is "all-boy" and curious.
Rebennack said she answered their questions one-on-one as they came up.
She got different reactions from each when her hair began falling out. Rebennack had cut her long hair short so the change wouldn't be a shock to the children. She wore a hat inside and outside the house.
At one point, she took Megan aside and asked if she would like her to take off her hat.
Megan said "No."
She posed the question to Joshua when the two were alone.
He wanted to see.
His reply: "Wow, you really are bald."
Polly Franks, 45, of Richmond knows all too well what it's like being burdened with too much information.
Her father suffered from congestive heart failure, diagnosed when she was 14. He underwent a heart transplant when she was 19 and died two years later.
Her mother told her every detail, but no one outside the family was to know what was going on. She spent her adolescence helping take care of her father and making repeated trips to the hospital.
"A 14-year-old doesn't need to be dealing with that," said Franks, a crime victim's advocate. "I felt I had to be the adult. I felt disenfranchised from people my own age."
Her childhood experience helped her relate better to her three children while Franks cared for her stepfather who had terminal cancer.
Like others, she explained the illness and invited questions. She let them know that their grandfather needed lots of hugs.
She said parents should instill a hope for the future in their children.
"Let them know there are still good times to be had, and that no matter what happens they will have someone to take care of them."
She recommends that family routines and the children's activities be kept intact as much as possible.
"These are anchors that keep you together," she said. "It's important for children to have that continuity."
That stability also helped the Mairena children while their mother underwent chemotherapy treatments.
Family and friends took Collin and Connor to ice hockey practice; Alison, to soccer and dance; and Liam, to T-ball.
"Their lives as they knew it didn't change," Mairena said.
More than a year after the family's trauma, the Mairena children are well adjusted.
Mairena said that her children still think about their mother's health, but they share her positive attitude.
Earlier this month for her birthday, they presented her with a homemade card, showing her at the 40th rung of a ladder.
Across the card, they wrote the phrase: Cancer survivor.
To reach MARTY MORRISON: 540/374-5423 mmorrison@freelancestar.com
