Talking to children about cancer

You may worry a lot about children who are still at home and how cancer affects them. You might be tempted to avoid talking about cancer, especially with younger children. But children often sense something is wrong and may imagine the worst if they’re not told the truth. They may be angry if they hear the news or updates from someone else. By talking honestly and helping them share how they feel, you make it easier for them to feel safe and secure.

These strategies can help you talk to your child or teen.

Prepare in advance. Think about what you want to say and practise saying it or write it down. Simple, direct words are best. Choose a time to talk when you’re feeling calm.

Be clear and direct and open to talking about cancer. Don’t create a feeling that cancer should be a secret. Talk about how you are feeling and share how you work through your feelings.

Ask what they know about cancer. You can then talk about any information that’s incorrect.

Don’t overload them with information. Provide the basics such as the name of the cancer, where it is in your body and the treatment and side effects you might have. You can ask what else they want to know. How much information you provide will depend on the age and understanding of your children.

Give children plenty of time to ask questions and share their feelings. Try to answer questions honestly. If you don’t know the answer to a question, that’s OK. Tell them you’ll look for answers and then share what you find. Let them know that you’re available to talk and answer questions.

Comfort and reassure your children. Tell them they will be loved and looked after. Encourage them to talk about how they’re feeling. Tell younger children over and over that they didn’t cause your illness.

And try to be patient. Children of all ages will need time to adjust.

You can also ask your healthcare team for help with this. They may have some useful books, videos or websites to recommend or can refer you to someone who can help.

You’re the best judge of how much your child or teen will understand about the situation. Explain cancer with words that your child will understand. What your child understands about cancer will depend mostly on their age. You may want to talk to each child alone if your children are far apart in age or have very different personalities.

Infants and children up to 3 years don’t understand cancer as a disease. They may understand that someone doesn’t feel well or needs to have medicine because that person is sick.

Preschool children between 3 and 5 years of age can understand cancer when it is explained in very simple words.

School-age children between 5 and 12 years of age can understand a more detailed explanation of cancer. Children this age may hear a lot about cancer from friends, at school, on TV or online.

Teenagers from 13 to 18 years of age can understand complex information about cancer, and they may have many questions about it. They can understand explanations about diagnosis, treatment and prognosis. Much of their knowledge about cancer comes from friends, through school, on TV or on social media.

It’s not unusual for your child to ask if you are going to die when you tell them that you have cancer. Even if you tell them that you have a good chance of getting better again, they may still be afraid of losing you. Talking about death is not easy, and many of us avoid talking about it. You may want to prepare yourself by looking at your own feelings and beliefs about death. This can help you be more open and natural when you have to talk to them.

The most important thing is to be honest with your answers. Children can often sense if we aren’t being completely truthful. Honesty helps build trust and safety for children. Let your children know that you’re willing to tell them the truth and that you’ll keep talking to them as you get more information.

Don’t use words like “passed away” or “gone to sleep.” They can confuse your child and even make them afraid to go to sleep. Research has shown that using the words death, dying and dead give children a better understanding of what happens.

Here are some suggestions on what you might say if your child asks if you are going to die:

• The doctors are going to give me some medicines to make me better, and these will help stop me from dying.
• The doctors are going to try to make me better, but it’s going to take a while to see if I do. But we are going to do everything we can to make sure I don’t die.
• I wasn’t expecting my cancer to come back, but the doctor is going to try some new things to make me better. We will have to wait to see if it will work.
• We are going to do everything we can to make sure I don’t die. In the meantime, I am going to make sure that someone will always be here to take care of you.