Telling a Child Someone They Love Has Cancer

Children will likely be upset when they learn that a family member or someone they know has cancer. When the person with cancer is a sibling, the child might feel even more stress and anxiety. Some parents might want to protect their children from fear, or they might be afraid that their children will worry more if they are told. 

Children can usually see that others are acting differently and sense that something is wrong. If they think something important is being kept from them, they might feel confused and afraid. Some kids will even look for ways to listen without being noticed. When they overhear these conversations, they might worry more, and even feel more confused and afraid.

Be honest and open

It is important to be honest and open with children. If they think something important is being kept from them, children might feel confused and afraid. Some kids will even look for ways to listen without being noticed and what they overhear might make them worry more.

Use words they will understand 

Children need to know enough to be prepared for what’s about to happen and how it will affect them. Younger children usually need less detail than older kids. However, if it is someone in the family, most kids of all ages need to know these basics:

• The type of cancer (for example, colon cancer or lymphoma)
• Where the cancer is in the body
• What will happen with treatment?
• How treatment might change how the person looks and feels
• How their lives are expected to be changed by the cancer and its treatment

 Find a balance between too much information and too little

How much children are told depends on things like the child’s age, personality, and ability to understand the information without being overwhelmed. The goal is to tell the truth in such a way that children can understand and prepare themselves for the changes that will happen. Consider using a children or teen’s book about cancer to guide discussion.  Your local librarian might be able to help you find one. It might be helpful to give children information in little bits and periodically check in with them to see if they understand the information or have any questions. 

Explain the physical changes they might see

Cancer can be a difficult secret to keep. Once treatment starts, the child may see side effects like tiredness, weight changes, hair loss, or vomiting. Seeing these physical changes can be scary for a child.

• They see that their loved one is sick and might assume that he or she is going to die.
• They may think that others in the family will get the same illness, or the child might fear they will catch the illness.
• They may think that life as they know it will end.

Not knowing what’s happening or how to cope with it can be terrifying to a child. To help avoid this, children need to be told about the illness. They should know in advance the kinds of side effects that cancer treatment might cause and the ways their daily lives and how the family works together may change. Reassure children that it is OK to feel angry, scared, or anxious, and that it is important to talk about these feelings with a trusted adult.

Explain cancer is a serious illness

When telling a child that a someone they love has cancer, it is important to talk about the difference between being sick with a non-serious illness (like the common cold or a headache) and a serious disease which could be incurable and lead to death (like cancer). It is important to give them information about the cancer and what to expect in a way that is appropriate for their ages.

Let them ask questions and express their feelings

Speaking truthfully builds trust and gives the child a chance to adjust to changes. Telling the truth is especially important with teens. Levels of anxiety in children who are told about a loved one’s cancer diagnosis have been found to be lower than in those who are not told. It is also important to give children space and time to ask questions and express their feelings. This will help them understand what’s going on and help them worry less. 

When telling children about a cancer diagnosis, it is helpful to let them know that in the future, the family member or loved will be letting the child know if anything changes (for example: a different treatment which  affects the family schedule, when treatment is over and how it worked, or if cancer treatment is stopped). Tell the child they can call a family meeting or just ask questions at anytime during treatment.  A parent can also plan quiet times to check in with the children and ask if they have questions or concerns. A nurse, counselor, clergy, or social worker can be asked to help plan these talks or to find out how to best support the child.

Children of different ages will have different concerns. For example, teens, who are testing their independence and limits, will have very different concerns from a 5-year-old who needs parents for basic caregiving. Young children (up to 8 years old) might not need a lot of detailed information like older children (8 to 12 years) or teens.

First, set up a quiet time when you won’t be disturbed. You might talk to each child alone so that information can be tailored to each child’s age and understanding. Be sure you have time to answer questions and let your child express their feelings.

Choose a time when you are feeling calm to talk to children. If you are feeling upset or unsure about what to say, it might be better to wait until your emotions are a bit more controlled. You might want to write down what you think you want to say before you talk with each child. It might help to have another trusted adult, like the other parent, or a trusted friend or relative present.

• Think about what you want to say and how to answer questions on a level each child can understand, but in a serious and thoughtful way.
• Children are perceptive. They may have noted changes in you and suspect something is wrong. They may have pieces of information, so it is important to ask the child what they know about the loved one’s illness to help see what they understand.  
• It is also helpful to ask the child if they have ever heard of or known anyone else who has had cancer. If the person the child knew with cancer had a different experience or result of cancer treatment, explain this experience might be different. 
• For all children, especially younger ones, it is best to give out information in small doses and periodically ask them if they have questions, and then answer the questions.
• If you are unsure about treatment outcome (prognosis), telling the child in stages may be helpful. The first stage could cover telling the child about the cancer and the planned treatment.  During this talk, the child could be told “we are not sure how well this treatment will work, but we will let you know how it is going"
• Think of possible questions they may ask ahead of time, and you will be less likely to be caught off guard. When questions arise, answer them honestly, but don’t feel like you must have all the answers right away. Try to lay the groundwork for an open line of communication with the child—a way for the child to come to you with their concerns, needs, and fears. Assure them they will not upset you by asking questions. 
• Plan to check in with each child regularly before, during, and after cancer treatment. This can be a great comfort to them. 
• If a parent or loved is sharing this information with the child alone without a another trusted adult present, suggest to the child someone they can talk to in the future if questions arise.  
• When checking in with a child, avoid general questions like “How are you?” Ask more specific questions like, “What is it like for you when I don’t spend as much time with you?”

Children might blame themselves

Besides the illness itself, children can have other worries about the cancer. A common worry that children have is that something they did or didn’t do might have caused a parent’s or loved one’s illness. Reassure children that they couldn't cause the cancer.

Children of certain ages, like teenagers, might benefit from joining a support group and/or talking to other trusted adults. There are local and national camps or support groups for children whose parents have a cancer diagnosis. Camp Kesem is a national camp that has local chapters. Other support groups might also be available in your area.