Psychiatrists working with cancer teams should help raise the team's awareness of the needs of children and their fathers when the mother is affected by cancer.

There is increasing interest in the key role that fathers play in families, particularly when the mother is ill. About 1 in 9 women develop breast cancer, and over a quarter of them have children living in at home.

Studies so far have tended to focus on fathers as spouses or partners, rather than as parents. This study explored the impact of the mother's diagnosis of breast cancer on father-child communication, and on the paternal role. It also examined the differences between the fathers' and children's perspectives.

24 fathers whose partners had early breast cancer, and 31 of their children aged between 6 and 18, were interviewed at home, separately, as part of a larger study of family communication.

Fathers described their reaction to news of their partner's breast cancer, and their attempts to maintain normal family life and provide support for their partners by taking over housework and childcare.

Keen to protect their children from stress, fathers sometimes did not recognise, or underestimated, their children's distress and concerns. Some misinterpreted behavioural reactions to the diagnosis as 'bad behaviour' or 'rudeness'.

Children were often acutely aware of their father's emotions, and expressed a wish to protect him, too.

Fathers wanted more information about different aspects of breast cancer and treatment, and teenagers also expressed a need for more information.

The researchers concluded that following a mother's diagnosis with breast cancer, fathers take on many key roles whilst dealing with emotional stress themselves.

They often attempt to protect children from stress, but sometimes the children's distress goes unrecognised or misinterpreted.

Royal College of Psychiatrists