Talking With Your Kids About Cancer

Kids are perceptive and can usually tell when something’s wrong. If you find out you have cancer, it's best to talk to your kids about it. Providing age-appropriate information helps ensure kids aren’t drawing their own conclusions, which can sometimes be scarier than the facts. When talking about it, don’t avoid the word “cancer” as this may unintentionally cause confusion and misunderstanding.

You should consider talking to your kids about cancer as soon after the diagnosis as possible, although an ideal time might be after your treatment plan is in place. You want to avoid your kids learning about it another way, such as overhearing conversations between parents or having other adults offer support before you’ve talked to them. If you’re having trouble starting the conversation, it may be helpful to include another family member or even professionals who can help share information and answer questions. And know that not everything needs to be discussed all at once. You can and should revisit the conversation multiple times.

Consider your child’s age. Even though babies are too young to understand a cancer diagnosis, they can instinctively sense stress, which can lead to restless sleep, longer bottle feeding and a need to be held more often. Once children are four, they can understand more than you may expect and need a straightforward conversation. Children aged four to ten in particular want to know how they can help you feel better, even if they don’t know how to express it. Ask them to draw pictures of happy scenes and explain their art cheers you up. If you have teenagers, keep them updated on your progress.

Focus the conversation on your kids’ questions and fears, and remain as calm as possible to allow them to express their feelings and observe how you’re coping. Practicing ahead of time may help you better control your tone and word choice. Also, be realistic. Making your kids believe you’re going to be just fine may confuse or scare them even more if you get sicker. It may also result in a distrust of adults that can be a lasting problem for years to come. Instead, tell them that you and the doctors are doing all you can to fight the cancer, and try to provide a timeline of what to expect.

Your children may react with several emotions, including anger, fear and guilt. Tell them it’s OK to feel these things. Sometimes children think they caused the cancer, so explain that they are not responsible in any way. Even if they don’t bring up these feelings, many children do feel a sense of guilt. It may be beneficial to let them know that cancer can happen to anyone and wasn't something that anybody made happen. Also consider that children often associate being sick with “catching it” from someone, so be sure to tell them cancer is not contagious and that it’s safe to be around someone with cancer.

Try to help them understand the treatments and side effects you may have. Let them know that even if the medicine seems to make you feel worse, it could just mean that it is working to fight the cancer. Also tell them that some side effects may change the way you look. Seeing a parent lose her hair or lose weight can be scary, so let them know ahead of time you’re still the same person on the inside.

If your treatment may cause hair loss, consider having a “coming out party” for your hair. Invite friends and family to bring head coverings (hats, turbans, scarves, etc.). Engage your children in helping with this party, and ask them to decorate a hat for you. If your children are young, explain that they will not lose their hair. Some children worry about this, especially if other family members shave their heads to support you.

Keep in mind that kids still need time to be kids. It’s a good idea to let them help out with age-appropriate chores and tasks, but don’t burden them with too much responsibility. Having someone sick in the family is stressful, so it’s especially important that your kids have the time they need to enjoy their childhood, pursue interests and maintain friendships. Make sure they know they can still come to you to talk about other things going on in their lives. And remind them that no matter what, cancer doesn’t affect how much you love them.

In some circumstances, you may need to talk to your kids about death. Try to be prepared for this conversation in case it becomes necessary. You may find it helpful to consult a member of the clergy or a counselor first. Some younger children may have trouble understanding that death is final. Avoid phrases such as “passing away” or references to “going to sleep” because children may believe that someone could wake up from death or that they themselves could die in their sleep. Use clear terms but know that it could take a while for a child to fully understand death. It’s hard to think about, but it’s important.

Remember that you’re the expert on your children. You know better than anyone how they may react, the needs they may have and how best to support them. How you deal with this cancer experience will leave a lasting impression on your children. Demonstrating your strength, patience and effort to continue to function as a loving parent is key to their emotional development.

Keep the routine

While often a challenge, maintaining a child’s routine is very important. Kids need to feel some sense of normalcy during a time of family stress. That means school activities need to happen as they normally would, regardless of cancer treatment. Recruit neighbors, family members or friends to help you with errands, picking your children up from school, etc. Just make sure your child is aware of any changes involving them in advance.

Regardless of your children’s age, their teachers need to know about your diagnosis and treatment. Tell them, as well as parents of any really close friends.

Also, remember that teens need to still be teens. While they may be very capable of picking up some of the slack — making dinners, doing laundry, babysitting — they need to be rewarded for their efforts. Teens still need their Friday nights at the movies with their friends.

Finding the right words

• The basic information all kids will likely need is the name of the cancer, the body part it affects, how it will be treated and how their lives will be affected.
• Use age-appropriate language. Younger children may only understand that you’re sick and need medicine to get better, whereas older children will likely want more information.
• Ask your kids what they know about cancer. This will help you address any misunderstandings.
• Encourage kids to share their feelings and ask questions. It’s OK not to have all the answers, but let them know their questions are important and that you’ll try to find out.
• After you’ve shared some information, ask your kids how they feel about what you’ve told them. By listening to their responses, including any fears they may have, you encourage open communication.
• For additional help, consult your family doctor, pediatrician or a child psychologist. Some organizations offer support for families affected by cancer.