Learning that a loved one has cancer is challenging in any circumstance, yet this news can be particularly difficult for children. Depending on their age, children may not understand what cancer is or what this diagnosis means for their families. Instinctually, some adults may wish to protect young ones from this hardship by not telling them. However, including children in the caregiving process helps them learn and grow, strengthens family connections, and can be immensely healing. This article offers suggestions on how to talk to children about cancer and support one’s family throughout this troubling time.
First, talk with your children about the cancer diagnosis.
Provide an honest and clear explanation about what is happening and how it will impact the cancer patient and family rather than trying to “protect them” by not telling them. Children will notice changes in the household even if they are not told by you directly. They will overhear snippets of conversations, observe when a loved one is upset or sad, or may learn the truth from someone else, which can feel like a betrayal. They need to understand why these changes are happening, or they may come up with their own interpretation of the situation. They may be fearful about catching the illness, think they will be left parentless, or assume they made the sickness occur. Children adapt best to new situations when they are given the truth.
Talk to the children before treatment starts in language appropriate to their age.
Young children, around 5 years or younger, do not need many details. They likely will not understand what is happening inside the body, focusing instead on the symptoms they can see, such as hair loss. Keep the discussion direct, simple, short, and supportive. Let them know that cancer is not contagious and that they did not cause it. Younger children in school may be similar – keep things simple and be prepared to return to the conversation later. They may not register this news right away.
The American Cancer Society suggests giving young children reassurance. For example, “We’ll always love you, and we’ll always be sure that you are cared for” (Bucher et al., 2011, p. 22). Tell them the diagnosis in simple language, such as “Grandma is sick. She has a disease called cancer.”
Describe the treatment that the patient will have and what that will mean for them and the child. You or the patient might say:
- “I’m going to have surgery, which means removing the part of me that’s not healthy. I won’t be able to pick you up or hug you for a while, but you’ll still be able to sit close to me” (Bucher et al., 2011, p. 22).
- “Grandpa has to take strong medicine that will make his hair fall out. He’ll look different for a while, but he’ll still be Grandpa” (p.22)
- “Dad is going to have less energy for a while. He’ll need to rest more. We’ll need to pick quiet times to do things together” (p. 22).
If you feel comfortable or the child asks about it, you can describe the prognosis. If the chance of a cure is high, you may say, “The treatment should get rid of the cancer, and the doctors expect that Mom will make a full recovery.” If the outcome is uncertain, you may say something like, “The surgery and medicine will fight the disease, and we hope she will get better.”
Older school children likely will have a better idea of what cancer is, so you may provide them with more details. Teens will know more about cancer and be more worried but may feel like they should not ask questions in case it upsets you. Encourage them to ask you questions. If they feel more comfortable talking to someone else, connect them to a trusted friend, teacher, or counselor. The article, “Talking with Children about Cancer” has additional information on how to talk to children according to their age.
Ask children what they want to know & be a good listener.
You do not want to overwhelm them, but make them feel comfortable knowing they can ask you about what is happening. If your children seem hesitant about opening up, normalize their emotions. Say, “Lots of kids feel angry or scared, and it’s okay. It’s important that we talk about how we feel.” Understand that when children ask about a loved one dying, they may actually be inquiring about something else, such as what will happen to them if their parent dies.
Include children in the caregiving.
Provide children with an opportunity to help the family in this time of crisis. Even a young child can be responsible for giving Grandpa a hug before each trip to the clinic, and a teen may take on new household tasks. If a child is older, you can involve them in trips to the clinic or hospital, so they can meet with the doctors and nurses. If the patient is hospitalized, prepare children in advance for what kinds of things they may experience.
Create and maintain rituals.
Set aside time on a daily or weekly basis to check in with your children. Ask how they are doing regarding their feelings about the loved one’s condition but also in other areas of their lives. Establish how the patient will communicate with the children when the patient is not home, such as through phone calls, texts, email, recorded messages, letters, etc. Sit down as a family periodically to discuss changes in routines and update them on what is happening. Maintain traditions where possible and create new ones, such as a weekly pizza night or an after-dinner walk. These can help to provide stability and familiarity during this difficult time.
Pay attention to behavioral changes.
While children often will have some behavioral changes after learning about a diagnosis or adjusting to a new routine as their family navigates their new normal. However, if these changes are disruptive and last longer than a week or two, you may need professional assistance.
These changes could include:
- New negative behaviors
- Sleep disturbances
- Problems at school
- Increased withdrawal from others
- Extreme compliance
- Physical ailments without a discernible medical cause
- Loss of interest in previously enjoyable activities
- Loss of appetite
- Needing constant reassurance, despite support from caregivers
- Suicidal ideation
If you notice any of these traits, reach out to your doctor, a counselor, or a clergy member. Dealing with this diagnosis is likely the most stressful event your family has faced – seeking professional assistance is nothing to be embarrassed about and is extremely common.
Remember, there is no exact right or wrong way to talk to your children about cancer. The most important thing is for them to feel supported and know that they can come to you if they have worries or questions. You can return to this topic repeatedly. Include your children in these discussions. Remain open to questions and answer them truthfully. With parental support, children are often resilient in the face of a cancer diagnosis and become stronger people as a result.
Bucher, J. A., Houts, P. S., & Ades, T. (2011). American Cancer Society: Complete guide to family caregiving (2nd ed.). American Cancer Society.
Dana-Faber Cancer Institute. (n.d.). For parents: Talking with children about cancer. https://www.dana-farber.org/for-patients-and-families/care-and-treatment/support-services-and-amenities/family-connections/for-the-patient/talking-with-children-about-cancer/#different-ages