Explaining Cancer Recurrence to a Child and Helping Them Cope

When cancer comes back after treatment and after a period when the cancer couldn’t be detected or found, it is called recurrence. Learning that the cancer is back can be overwhelming. It can make a person feel sadness, grief, upset, or that their future is uncertain.

Explaining cancer recurrence to children can be overwhelming, especially when you are their parent and you have cancer, it might help to process your feelings first and talk to your cancer care team as you think about letting the children know about the recurrence. You could also reach out to your support system to help you talk to your children.

Some people might not want to tell their children that the cancer is back out of fear that this will upset the child or cause them to worry more. Even though it is true that children are likely to be upset when they learn the cancer has come back, keeping them informed of what is going on might help them worry less and build trust.

Here are some things to consider before or when telling children that a loved one’s cancer is back:

When thinking about helping children cope with this news, remember:

• Children can’t always tell you in words but may show you how they feel. You might notice your child being more dependent, worrying more, or being out of character. They might also express themselves through drawing, coloring, or playing. It is important that the parents or guardians pay close attention to how and what the children are doing
• Ask the children frequently how they are doing and what can be done to help them feel better.
• Children might regress (act younger) when they are under stress. For example, a child who had just become toilet trained might start having accidents. Other children might begin to have separation anxiety or difficulty paying attention in school.
• Children might worry about their loved one dying. When talking to a child about dying, be honest and let them know that sometimes people do die from cancer and while there is no way to know what’s going to happen, let the child know about the outlook of the person’s cancer in a way that is appropriate for their age, and let them know that if you find out something new or different, you will let them know. This does not mean that parents should tell their kids everything they know as soon as they know it. It means that children should be given truthful information when they need it to cope well from day to day. If the loved one is a parent or guardian, they might need to seek help from a professional to help them process their own feelings and discuss ideas to and tips for talking with their children.
• Children thrive on routine and predictability. If the person whose cancer has come back lives in the same household as the child, try to keep their routine and way of life as close to normal as possible. Communicate with the child any expected changes. This will help increase their sense of security.
• Children should be told that although no one knows for sure why some people get cancer, it’s certain that the child did nothing to cause the loved one’s cancer to come back.
• Tell the children that it is OK for them to refuse to talk about their loved one’s cancer coming back with others.
• Find out as much information as possible about how the child is doing. This could mean talking to the child’s teacher, guidance counselor, pediatrician, a coach, or a professional counselor. This will help you help the child cope better.
• Consider using a children or teen's book about cancer to guide discussion. Your local librarian can help you find one.

Some children might have more trouble than others coping with the news that a loved one has cancer. Extra help, most times professional help, might be needed if a child:

• Is unable to handle the feelings of sadness
• Feels sad all the time
• Cannot be comforted
• Admits to thinking of suicide or of hurting themselves
• Feels extra irritable
• Becomes very angry very quickly
• Has declining grades
• Withdraws or isolates themselves
• Acts very differently from usual
• Has appetite changes
• Has low energy
• Shows less interest in activities
• Has trouble concentrating
• Cries more than usual
• Has trouble sleeping

You might find it useful to talk with the child’s health care team, school counselor, a child psychologist or psychiatrist, or social worker or counseling staff at the hospital where the loved one is being treated. Get help immediately if a child admits to thinking of suicide or hurting themselves.