Talking With Your Child About Cancer

By Les Friedman, CEO and Mikey’s dad

Photo by National Cancer Institute

“Your child has cancer.”  These words are probably the most frightening words a parent will ever hear. And amidst our own fears, is the equally daunting thought of talking with your child about cancer.

Talking with your child about cancer: why they need to know

It’s only natural to want to protect our children from the cancer and the fear that comes along with it. For this reason, it may be tempting to consider holding off talking with your child about cancer or even not telling him at all. But not telling the truth will only lead to problems later.

Kids usually know when something is wrong. They may not be feeling well or may wonder why they have so many medical visits.  In fact, some children will create their own idea as to what they think is wrong.  Not knowing what is wrong or what to expect may cause your child even more anxiety, stress, and fear.  For this reason, being honest tends to lessen a child’s stress, guilt, and confusion.

Another key point is recognizing that children frequently have a tendency to blame themselves when bad things happen.  For instance, they might feel guilty, as if being sick is somehow their fault. With this in mind, it’s important to let your child know that nothing she did caused the cancer. 

When to talk about cancer

The National Cancer Institute’s publication, “Children with Cancer: A Guide for Parents” offers guidance on what to say when.  They recommend telling your child as soon as possible. This will help build trust between you and your child. But, it doesn’t mean that your child needs to hear everything all at once.

If you’re not sure when and how to tell your child they have cancer, talk with your child’s health care provider. They can help you decide what to say and how to answer your child’s questions. They may work together with you to give the news to your child if you would feel more comfortable having their support.

Age appropriate conversations

What you tell your child about his cancer depends on his age and what he can understand. But, according to The National Cancer Institute, children of all ages need clear, simple information that makes sense to them. As much as possible, help your child know what to expect by using ideas and words that he understands. For example, very young children only need to know basic information, while a teenage will want to know more details about treatments and side effects.  Regardless of a child’s age however, the goal is to prevent fear and misunderstanding.

What to tell children up to age 4

In general, children under the age of 4 cannot understand cancer. Telling them that they are “sick” and need “medicine” to get better is usually enough of an explanation. 

At this age, children are most afraid that the medical staff will take them away from their parents. So, it’s important to reassure your child that this isn’t the case.  In like manner, very young children might think they did something to cause cancer. So, it’s equally important to reassure your child that he did nothing wrong to cause his illness.

What to tell children ages 4 to 7 years old

Children ages 4 to 7 are more aware of their illness, and can understand explanations about their cancer in simple terms. They may look for a specific cause for the cancer, such as something they did or thought.  So, it’s important to reassure them that they did not cause the cancer. At this age, children are afraid that their parents might abandon them at the hospital. It’s also essential to reassure your child that you will be there for them.

What to tell children ages 7 to 13 years old

Children of this age group are able to understand a more detailed explanation of their cancer.  The National Cancer Institute suggests explaining cancer in terms they can understand. You might for example describe cancer cells as “troublemakers” that get in the way of the work of the good cells. Treatment helps to get rid of the troublemakers so that other cells can work well together.

What to tell a teenager

Teenagers can understand a complex explanation when you tell them about their cancer. They may also have detailed questions and be interested in learning about their diagnosis.  In general, teenagers are most likely to focus on cancer in terms of its symptoms.  They will be thinking about how cancer changes their lives such as their friendships, their appearance, and their activities.  

Your teen may feel that she has lost a lot of her freedom and privacy. Try to give her the space and freedom that she had before treatment and encourage her independence.  

Teens understand the relationship between their cancer, the symptoms, and the role of their treatment. Make sure that your teen is included in treatment planning and other choices. They may even want to play a role in making decisions about their treatment.

It’s important to tell teens the truth.  If they think that you might not be telling the whole truth, they may begin to imagine a different reality.

Start with small amounts of information

It may be hard for many children to process too many details or information given too far in advance.  With this in mind, start with small amounts of information that your child can understand. You can share more information over time, as long as your child will be able to understand and cope with the information.

A single conversation with your child will not be enough. Frequent, brief conversations with your child will help to keep the lines of communication open.

Tips on how to tell your child about their cancer

  • Practice what you are going to say before you tell your child they have cancer. Ask for advice from your child’s health care team or another parent who has been in a similar position.
  • When you first tell your child they have cancer, consider asking another person to be with you if you feel uneasy about talking alone. This might be another family member who can provide support. It could also be a doctor or nurse who can help describe cancer in more detail.
  • Your child may hear words related to cancer at the doctor’s office or hospital. Explain the meaning of the words in a way they can understand. For example, a tumor is “a lump inside the body” and chemotherapy is “special drugs to get rid of cancer.” You can learn more about cancer terms by visiting our blog post, What Did the Doctor Just Say?

Encourage your child to ask questions

  • Encourage your child to ask questions. Try to answer his questions as honestly and openly as you can. If you don’t know the answer, it’s okay to say so.  But, let your child know that you will find the answer.
  • Some children may be afraid to ask certain questions. Be on the lookout if it appears that your child has something on her mind but is afraid to talk about it. For example, if she seems upset after seeing a child who lost his hair, talk about what symptoms she man have from her treatment.
  • Keep in mind that your child may have heard things about cancer from other sources, such as TV, the movies, or other kids. It’s a good idea to ask what he has heard, so you can make sure he has the right information.

Don’t be afraid to ask for help

Having a child who is being treated for cancer can feel overwhelming for any family. But you’re not alone. Don’t be afraid to ask for help. Talking about cancer is not easy for anyone. If you need help with certain topics, ask your child’s provider or cancer care team. Lots of resources are available online, too. 

Helpful resources

Note:  All information on Mikey’s Way Foundation, is for educational purpose only. For specific, medical advice, diagnoses, and treatment, consult your child’s physician.