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 should work for your child's age and what they can understand; 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 your children before talking to them.
• Use the word 'cancer' because they will hear others use the word.
• Tell them where the cancer is. For example, "the cancer is in my breast" or "the cancer is in my blood."
• Tell them how the cancer will be treated.
• Describe what will happen during treatment. Be direct and honest. For example, "I will lose my hair" or "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 children (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 (ages 13-18) usually can 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?

• Be honest, even when it is hard, and try not to keep secrets.
• 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.

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.
• Talk with them about how much information you want shared and with whom. You can ask that certain details stay between you, the teacher, and the school counselor/administration to help protect you and your family's privacy.

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 through behavior, not words. You may see them being more irritable or angry. Sometimes this shows up before sadness does.
• Your child may have trouble sleeping, eating, or paying attention at school.
• Younger children may act younger than their actual age. This is called regression. They can also worry that they did something to cause the cancer. It is important to reassure them they are not to blame for what is happening.
• School-age children may start taking on adult responsibilities like checking on you or managing their younger siblings. While their help is well-intentioned, it isn't their job. Remind them they get to be "the kid."
• Adolescents often hide their struggles to avoid "burdening" you. A teen who says, "I'm fine," may really not be fine. Give them space and time to be.

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.
• Hospice and child-life specialists can also provide support with grief and bereavement.

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, like FaceTime, Zoom, or other video calling apps.

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

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

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.