It's tough to talk about cancer, but kids need to know what's going on.
Parents don't want to freak out their children. It's our job to make their world safe. Doing something that will absolutely scare them, shake up their security and alter their lives is unthinkable. Yet thousands of parents do just that when they tell their children they have cancer. For many, telling the kids is the toughest step in their cancer journey.
Saying nothing is not good
Some parents try to keep it from the kids, figuring what they don't know won't hurt them. But kids are smarter than that, and cancer is too big to keep secret. Nothing's louder than a whispered phone call or a hushed conversation. Word gets around, and hearing the news from a relative or friend might frighten children more than getting the information straight from their parents.
Dr. Nathalie Johnson, a surgical oncologist at Good Samaritan Hospital in Portland, Oregon, and author of "Mommy Found a Lump" says, "Kids always know there's something wrong. It's more fear-inducing if they're not told. In a kid's mind, it means something's really bad. Most of the time, the news isn't as bad as they've imagined. It's far less scary to be honest and make them part of the process."
Tailor the words with their age
What to tell children depends on their age and maturity. Give facts on a basic level with the least drama, and then wait for their questions. It may not happen immediately, but those questions will come. Let them know you want to talk about it. If it's too difficult for the person with cancer to talk, have another close family member or friend be their go-to source for information.
Use simple words for children under 8: "medicine" instead of "chemotherapy"; "surgery" instead of "mastectomy." Tell them where the cancer is, for example: breast, blood or lung. The American Cancer Society offers a great explanation: "The body is made of lots of parts. When someone has cancer, something's gone wrong with these parts, and they've stopped doing what they're supposed to. Part of the body is no longer normal. Over time, a tumor or lump develops that shouldn't be there. Tumors can grow in other parts of the body. Treatment will either take out the tumor or stop it from spreading to other places."
If surgery will leave scars, tell them what to expect. Reassure them you'll take medicine to make pain better.
Older kids might be more frightened than young ones if they know someone who's had cancer. They might try to protect you from their worries by acting like "it's no big deal." Don't be fooled. It's a very big deal. Tailor information to their maturity level by giving more advanced explanations. Give them as much reassurance as possible without being dishonest.
Kids are excellent truth detectors. Answer questions to the best of your knowledge. It's OK to say, "I don't know, but when I find out, I'll tell you."
Give time frames children can relate to
Children may have trouble understanding how much time treatment will take. They may expect their parent to get over cancer like a cold. If you'll be hospitalized, tell them how long. Use time frames they understand. For example, "Daddy will take medicine until summertime, when school's out. He'll start feeling tired and yucky next week and won't feel good for a long time. We think he'll be all better by Halloween."
Worries are often "me-oriented"
Little kids worry about who'll take care of them. Reassure them that they'll be well cared for. Let them know who'll be helping out and that you'll still be there for them, even if you're sick in bed.
Most children are naturally "me-oriented" and may think something they did made Mommy or Daddy sick. They may try to be extra good or they may act out. Reassure them that there are lots of feelings that go along with having a sick parent, and that all of those feelings are normal, and it's brave to share them with family and friends.
"Are you going to die?"
Then there's the big question: "Mama? Are you going to die?" Even if they don't ask out loud, they're worried. Some never ask directly but need the answer anyway.
The American Cancer Society offers a variety of suggested answers based on the fact that most people, even if the projected course of their disease is poor, live for a while after diagnosis. Every day, new cures and treatments increase the likelihood of survival, even from cancers that were previously considered untreatable. It's reassuring that nowadays, more people live long, healthy lives with cancer than ever before.
The ACS suggests saying something like this: "Sometimes people do die from cancer. I'm not expecting that to happen to me, because the doctors have told me they have very good treatments these days, and my type of cancer usually goes away with treatment."
Or this: "My cancer is a hard one to treat, but I'm going to do everything I can to get better. It's impossible to know right now what will happen down the road. What you can be sure of is that I'll be honest with you about what is going on."
Lean on resources to help
The ACS also recommends a variety of books and resources to guide parents and children through this difficult discussion. Experts recommend support groups for children or various therapies to provide more information and support. Cancer is a big journey, but there are guideposts along the way to help families get through it.
Published on April 4, 2008; updated on May 22, 2014.