Talking With Your Child About Cancer

When you have cancer, talking with your children about it is never easy. You may wish to protect your child from upsettinginformation. However, children often overhear people talking, and they are very good at picking up on changes in the behavior of their parents. Trying to hide cancer from them will likely make them more worried. Talk with your children directly so you can control the way that they get the information. You can also follow these guidelines if the person with cancer is a family member.

How should I talk with my child about my cancer?

• Prepare to talk with your child by writing down key points in a notebook.
• Be open but as gentle as possible.
• Consider your child’s age and maturity level when preparing for the discussion.
• Use words that are appropriate for your child’s age.
• Be honest and specific. Answer your child’s questions truthfully.
• Avoid giving too many details beyond the questions that your child asks. Too much information may overwhelm and confuse your child.
• Talking with the entire family at once is often the best plan. That way, questions that your child might have are more likely to get answered.

How can I use age-appropriate words when talking with my child about cancer?

• Think of how to describe cancer and treatment in ways that your child will understand:
  • Preschoolers will probably not understand many cancer-related words. Many children will understand the concept of sickness from their own experience.
  • Older children can understand most cancer-related words if you explain them as simply and accurately as you can. There are books and resources designed for children that you can use to help your child understand cancer better.
  • Teenagers may need certain words to be defined. Your health care team can help, and many online sources offer simple definitions for cancer-related words and phrases.
• For younger children, use simple words that you know your child has heard. An example might be “Mommy is sick, so she is going to the hospital so the doctors can help her feel better” or “Daddy is sick, and he is taking medicine that makes him tired.”
• When possible, replace medical terms with simple, common terms.
  • A tumor might be described as a “lump.”
  • Instead of “chemotherapy,” you might say, “a special medicine that fights cancer.”
  • Instead of “radiation,” you might say, “a machine that sends a special beam to get rid of the lump.”
• For older children, ask them what they have heard about cancer. Most will have access to information from the Internet. Provide resources that you know are accurate. Make sure they feel comfortable talking with you about what they have read. This will also give you the chance to correct any myths or wrong information.

How much information should I share with my child about my cancer and treatment?

How much you should share depends on the child’s age. Let your child know it is okay to ask questions and that you will be honest with him or her. Prepare your child for changes in how you will look and feel during treatment. Keep in mind that you do not have to tell a child everything at once, but make sure to tell your child:

• The type of cancer, such as breast cancer, lung cancer, or sarcoma.
• How it will be treated, in simple but optimistic terms.
• How the treatment might affect you, such as making you grouchy, sad, sick to your stomach, or very tired.
• How your child’s life will be affected.
• How your child can help, such as doing chores around the house when you are not feeling well.

Young children, up to 8 years old, will not need a lot of details. They need to be told that:

• Nothing they did or said caused the cancer.
• No one can catch cancer or give it to another person, so it is okay to hug and kiss.
• They will still be loved and cared for.

Older children may want to know more and have a voice in family discussions. They may want to see pictures of cancer cells and learn more about how the cancer will be treated.

What should I tell my child about my prognosis?

A prognosis is the outlook or chance of recovery from the type of cancer you have. You need to be honest with your child, but you do not have to tell everything as soon as you know it.

• Let your child know that having cancer does not mean you are going to die, and that many people are treated and get well.
• If your future is uncertain, try to keep the focus on the present. Let your child know you are taking your treatment one day at a time.
• If you know that your cancer is terminal, tell your child as gently as you can. Spending time together to make memories and being able to say goodbye are important. Let your child know who will take care of her or him, and that the child will still be loved. You may want to talk with a social worker, child life specialist, or others for help and support.

How should I expect my child to react to my cancer diagnosis?

Children may react in many ways. For example, they may:

• Be scared and confused.
• Feel guilty and think they somehow caused the cancer.
• Feel angry at changes around the home, or upset because they are not getting as much attention as usual.
• Become clingy and act as if they are much younger.
• Act out at school or at home.
• Use denial by retreating to their bedroom when you talk about your cancer, or by not paying attention.
• Say hurtful things such as blaming you for your illness or saying it would not have happened if you had only taken better care of yourself.

What behaviors might indicate that my child is not coping well?

Any major changes in mood or behavior could mean that your child needs help. The social worker or counseling staff at the hospital where you are being treated might be able to help or might know of other resources.

Your child may need extra help to cope if she or he:

• Is constantly sad and cannot be comforted.
• Becomes angry easily.
• Withdraws from friends and family.
• Eats more or less than usual.
• Has less energy or less interest in usual activities.
• Has trouble focusing or thinking.
• Cries more than usual.
• Sleeps more or less than usual.
• Develops behaviors such as bed-wetting or thumb-sucking.
• Acts out or gets into more trouble than usual.

If your child admits to thinking of suicide or of self-harm, get help right away.

How can I help my child cope with my cancer diagnosis?

Keep in mind that children take their cues from the adults in their life. Try to remain calm when talking with your child.

• For children of any age, the most important issues are their own safety and security. Let them know that you love them and that they will always be cared for, no matter what happens.
• Like adults, children may feel stressed, angry, or afraid when they learn of your cancer or about changes in their routine. Let them know it is okay to express such feelings, and that you are having some of the same feelings.
• Try to find things that children have a choice about. For instance, let them choose who will care for them after school or what to take with them when they go to stay with a friend or relative.
• Try to keep your usual daily routines. Do your best to support your child’s daily needs and commitments with school, sports, and friends.
• Help your child find support networks with others who have a family member with cancer.
• Encourage older children to express their feelings through journaling or special time set aside with you.
• Consider having older children join you for your medical appointments, and encourage them to ask any questions that they have. This will help them see what you are experiencing and help them avoid imagining things that go beyond reality.

Where to find support

• After talking with your child, share information about your diagnosis with other people who interact with your child, such as child care providers, teachers, or coaches. This will help you build a support system for your child outside the home.
• Consider reaching out to other trusted adults, such as a child life specialist, a school counselor, or a social worker.
• Ask your cancer care team for information, support, and resources to help you talk with your child about cancer.

Seek Additional Information

For more information about resources and how to talk with your child about cancer, turn to:

• American Cancer Society: www.cancer.org  
• National Cancer Institute: www.cancer.gov  
• Cancer.Net: www.cancer.net  

Summary

• Tailor your message to the age of the child. Young children will need fewer details and more reassurance about their own safety and security.
• Be honest, and focus on the present rather than the future.
• Encourage children to express their feelings, and let them know it is okay to have them.
• Watch for signs that your child needs more help to cope. Signs may include major changes in behavior or the child becoming angry or withdrawn.