Talking To Your Children About Your Cancer Diagnosis

Talking to your children about your cancer is very important. They may sense something is wrong and possibly imagine a worse situation. Also, if they hear about your cancer from someone else, they may be angry and not trust you when you do talk to them about it.

What should your child be told?

• Information you provide must be age-appropriate; ask for help in planning your discussion. Oncology social workers, school counselors, and clergy/religious leaders can be helpful.
• You should be comfortable with your diagnosis and the information you want to share with their children before talking to them.
• Use the word 'cancer' because they will hear others use the word.
• Where it is. "The cancer is in "my breast," "my blood", etc.
• Tell them how the cancer will be treated.
• Describe what will happen during treatment - 'I will lose my hair.' 'I will get tired.'
• Talk about how their daily lives may change. For example, who will cook their meals or drive them to soccer practice.
• Ask them how much or what they understand and what they want to know. Ask if there is anything they do not want to know or are afraid of hearing.

Important Things to Reassure Your Child About

• They did not do or say anything to cause your cancer.
• Cancer is not contagious. You can't catch it or give it to someone else.
• It is okay for them to have strong feelings, such as anger or fear about your cancer.
• You will do your best to keep things as normal as possible for them.
• People with cancer don't always die from it.
• You will let them know about any new information that comes up about your cancer.

How do I tell different-aged children?

• Young children (up to 8 years) do not need a lot of detailed information. Reassure them they will be safe and loved. Give them space to ask questions.
• Older school-age (8-12 years) can cope with more information and may have more questions. They usually worry about how the illness affects them socially. You commonly see anger before sadness. They may try to cover up feelings in front of friends.
• An adolescent is able to understand the significance of serious illness and the permanence of death. They may stay close to the sick parent or withdraw and show little emotion. Try to limit how much you increase their responsibilities and continue to maintain as much of their routine as possible.

What are some things you should not do?

• Try not to lie, even if the truth is difficult.
• Limit how much you share about frightening medical details or financial worries.
• Try not to make promises you can't keep.
• Do not be scared to say: 'I don't know.'
• Do not pressure children to talk if they don't want to.
• Try to avoid keeping secrets.

Involving the School

• It is important to tell teachers and administrators about what is going on with the parent.
• A cancer diagnosis and treatment can impact children's performance & behavior in the classroom.
• Get help from school staff (guidance counselors, teachers, etc.) to support the child.
• Include coordinators of any other activities the child is involved in - sports, scouts, extracurricular activities.

What other things help children cope?

• If possible, have you or another consistent adult, spend regular one-on-one time with each child.
• Keep each child's routine as normal as possible.
• Encourage questions.
• Give children permission to express any feelings.

Are there typical reactions I should look for?

• Reactions depend on the age of the child and their personality.
• Children usually express their feelings with their behavior.
• Children may 'regress' or act younger when they are under stress.
• Your child may have problems paying attention at school.

What if my child asks if I am going to die?

• The answer depends on how you understand your cancer and its diagnosis.
• The most important worry for children is who will look after them. You need to assure them that no matter what happens, they will be cared for.
• Tell them you are doing everything you can to get better. Reassure them that you will be honest with them along the way and that when they have concerns, they should talk to you.
• If the prognosis is poor, think about leaving a legacy through movies, letters, or cards for future important events.

How do I help my child get ready for hospital visits?

• Let your child know ahead of time what they will see and hear.
• Let the hospital staff know you are planning on bringing the children in for a visit. They can help you prepare physically and emotionally.
• Let younger children bring toys to play with.
• Bring another adult so that your child can leave early if they want to.
• Provide cards, drawings, etc. when visits are not possible.
• Utilize technology to stay connected including FaceTime or Skype.

Camp Kesem is a national program with local, free summer camps for kids with a parent who has or had cancer. This is a great opportunity for your kids to get away with other kids who have "been there", while still having professional support. Camps are offered across the country.

If you have any questions about talking to your children about your cancer diagnosis or need additional information, ask your care team for help.

Further Reading

Helpful resources from Cancer Care

Helping Children When a Family Member has Cancer from the American Cancer Society.

When Your Parent has Cancer: A Guide for Teens from the NIH

When Your Brother or Sister Has Cancer: A Guide for Teens from the NIH

The Children's Treehouse Foundation: Partners with and provides training/education to cancer providers around the country to offer support programs to kids with a parent with cancer.