How should we tell them about the diagnosis and treatment?

During and after treatment, children will likely be less anxious and feel more secure when they are included and told the truth. Your children will benefit from being told the news as soon as possible, as they may sense when something is wrong. Have the conversation as soon as you are able to and when you can be clear about what you want to share. Remember that it doesn’t have to be one big conversation. You can support and reassure your children that the initial conversation is the first of many. They do need to hear the truth in language they can understand.

Who should tell them?

Parents are the first line of support for their children. Both parents need to be involved in deciding how and what to tell their children. If either or both parents are unable to agree on what to say, it may be helpful to talk this over with a counsellor. If you feel unable to talk to your children, it is best to select someone who can, and to be present during that conversation. You may find it helpful to write down what you wish to say. If the parent with cancer is not able to be present, the other parent or close family member may take the lead. A family meeting can be one of the best ways to share the news.

How important is it for parents to be open and honest?

While you may want to avoid your children’s sadness, anger, or questions about death, children need the opportunity to ask questions and express fears. This is a time to role model that sometimes things happen that make you feel sad, or scared or mad. Talk with your children and answer their questions truthfully. If you are open, your children will realize they can count on you to be honest with them. They will have a better chance of handling whatever happens in the family and in their lives. It is inevitable that they will overhear something. It takes a lot of valuable energy to keep a secret.

Won’t they worry if we tell them the truth?

Worry is something we all do, including children. As a parent, you cannot protect your children from worry, but you can help to ease their anxieties by giving them accurate information and talking with them about their fears and worries. When they are excluded or told very little, children will sense that something is wrong and become anxious, but they will feel discouraged from asking about their parents’ health or seeking assurance.

Without the truth, your children are likely to imagine something far worse. Remember to give your children time to adjust. Provide more opportunities for them to come back and ask questions or share their feelings.

What do we say about the diagnosis?

Children need to understand basic information about their parent’s diagnosis, and basic facts about cancer. Remember, information needs to match your children’s level of understanding. To ensure this is happening, ask your children what they heard you tell them (or how they might explain it to someone else like a friend or an aunt).

How do we reassure them?

Children are reassured when you let them know that:

• you will continue to talk with them and answer their questions 

• you will let them know what will change and what will be the same 

• you want them to be involved - talk with them about how they can help 

• they will be looked after no matter what 

• you will get though this together as a family 

• everyone in the family needs to adjust to the news 

• you want them to continue their activities and will help them do this 

• it is important for them to play and see their friends
  

Tips for talking with your children about a cancer diagnosis

Use simple language, give a brief statement of what has occurred.

Tell your children:

• the name of the illness

• what part of the body is affected

• how it was discovered

• what will be done to treat your illness

Calling your illness a” boo-boo” may confuse children about common illnesses being as serious as cancer. Ask your children what they know about cancer, and what they want to know.

3 Steps...

1. Cancer is no one’s fault. Your children have not caused your cancer. Nothing that they have said, done, or thought can cause your cancer.
   

2. Your child cannot ‘catch’ your cancer. Cancer is not like a cold or flu.
   

3. It is not always clear why cancer develops. Children often need to hear the information again, or may ask the same questions. Remind your children that they can always ask questions if they don’t understand what is happening. Encourage your children’s questions, and reassure them there are no dumb questions. Accept their unwillingness to talk. Children will talk when they are ready.

Questions children and teens may ask

What if...?

Parents often worry about what to do if their children don’t ask any questions, or if they can’t answer their children’s questions. They may not have any questions (right now), they may have many questions and they may need to ask the same questions again and again. You do not have to have all the answers. You can tell your children that you don’t know the answer right now, but if you can, you will try to find out and get back to them.

What is cancer?

The following are some of the basic concepts about cancer that would be helpful in describing this disease to children. Remember, it may take time for children to understand these concepts.

• Cancer is an illness.
  

• Cancer is an unusual disease.
  

• It’s not like a cold, flu or like feeling bad for a few days.
  

• There are many different types of cancer.
  

• Some cancers are more serious than others.
  

• Some cancers grow very slowly, others grow fast.
  

• Cancer is not something that you can catch from someone else like you can a cold or the flu.
  

• You cannot cause cancer in someone else.
  

• Cancer is a group of over 200 diseases in which cells that are not normal grow and divide quickly, in an uncontrolled way. The cell is the building block of all parts of the body. Cells are tiny – you need a microscope to see them.
  

• The body usually controls the growth of cells into mature cells, but in cancer, the body’s control mechanism doesn’t work properly, and the cancer cells increase in number and can spread.
  

• Cancer cells may group together to form a tumour.
  

• Cancerous tumours are “malignant” and keep growing, crowding out normal cells. They can spread to other places in the body. There are also “benign” tumours that do not spread and are not cancer.
  

What causes cancer? Where did it come from?

Is it serious? Is there something that can be done?

Is my parent going to die?

Who else should we tell about the diagnosis?

It is your decision who you want to share information with. Telling others can be a longer process that allows you time to absorb the news as a family and make decisions about what information you want to share outside the family. Open communication can be one of the most important activities that support your family’s coping. It decreases the chance of confusion for those that support you. Friends and family can then offer support and understanding, and you can ask for their help.

Keep people informed on a regular basis, or select a spokesperson for this task. Inform your children’s school and after-school communities so that their teachers, guidance counsellor, or school principal can provide support and communicate concerns to you.

Other things to think about

Try to keep your family life as normal as possible. All children benefit from having a sense of stability and routine. Outside help is often necessary. You can help to meet your children’s everyday physical and emotional needs by enlisting people who can help with meals, laundry, carpooling, homework, sleepovers, play times, outings, and attending your children’s special events when needed.

In addition to family and friends, consider asking your health care team or other organizations (service, social services, and home health agencies) and communities (neighbourhood, school, religious) for support.

How is cancer treated? What are the different types of treatment?

What are “side effects” of treatment?

Why is my parent crying?

Offer reassurance: