When someone is diagnosed with advanced cancer, it can be challenging to explain the situation to children, especially if you are experiencing your own distress. However, it is important that children feel included and can start to prepare themselves for the future. The suggestions below may help you answer some of their questions.
If you don’t know the answer to a question, it’s okay to explain that you will need to find out. You can ask your treatment team, call Cancer Council 13 11 20, or read more about advanced cancer.
What words should I use?
If you need to prepare a child for the death of someone they care about, it can be confronting to find the right words to use. See also the Answering key questions section below.
When advanced cancer is diagnosed
Younger children – “Some people with this sort of cancer get better, but some don’t. I am going to do everything I can to get better.”
Older children – “Some people with this sort of cancer recover, but most don’t. I’m planning to do everything I can to keep the cancer under control, and I will always let you know how the treatments are going.”
When end of life is near
Younger children – “Daddy is very sick now. The doctors say there isn’t any medicine that can make him better. We think that means he is going to die soon. We will try to spend some special quiet time together.”
Older children – “The doctors say that the treatments haven’t worked for Dad. There isn’t anything else they can do. We think that means Dad will die soon. We want to make the most of the time he has left.”
To explain death
Younger children – “When Grandma died, her body stopped working – she stopped breathing and her heart stopped beating. A dead body can’t move or talk and it can’t feel anything. It also can’t come back to life. We won’t be able to see Grandma again, but we will always know she loved us.”
Older children – “I have some very sad news. Grandma died last night … Is there anything you’d like to know about how Grandma died?”
Answering key questions
How you answer your children’s questions depends on the nature of the cancer and the effects of treatment. Work out in advance what your children might ask and think about how you want to respond.
Asking the same question repeatedly is normal for children. By answering your children’s questions over and over again, you are helping to ease their worries. Sometimes children may test you to see if your answers stay the same.
At some stage, children are likely to ask why such a terrible thing is happening. This may be a question that you are grappling with yourself and how you respond will depend on your belief system, but there are no easy answers. The important thing is to let children know it is okay to talk about it.
A. “I don’t know. Life feels unfair sometimes and we don’t always know why sad things happen. Why do you think sad things happen?”
Q. Is it my fault?
Some children may ask you directly if they are to blame for the cancer getting worse. Even if they don’t say anything, they may worry in silence, so it is best to address the issue and reassure them.
A. “It’s no-one’s fault. Nothing you, or anyone else, did or said made me ill.”
Q. When will you/they die
Time is a difficult concept for young children, so it may not help to give even vague time frames. Older children may want some idea. It is still important to balance hope with reality.
A. “Nobody knows for sure when anyone will die. The doctors have said I will probably live for at least X months/years. Whatever happens, we want to make the most of that time. I will be trying to live for as long as possible.”
When death is near, you may need to give a different answer.
A. “I honestly don’t know, but I will probably get a little weaker each day now.”
“No-one can answer that, but we are hoping that there will still be
some good days.”
“Pop is very ill now because the treatment hasn’t made him better. He’s not having any more treatment and will probably die soon.”
Q. Who will look after me?
Many children will still be worried about who will look after them, so it’s best to tackle the question early on.
A. “It’s very important to me that you will always be safe and looked after. Dad will be there for you, and your aunty will help all of you.”
“You might be worried about what will happen if the treatment doesn’t work and I’m not around. I’ve already talked to Grandma and Grandpa, and they will be there for you and will look after you.”
Q. What happens if Mum/Dad dies too?
When one parent is gravely ill, it is natural for their child to worry about the health of the other parent.
A. “When someone you love is very sick, it can make you feel very scared. But Mum/Dad is well and healthy now and they will be around to look after you. Whatever happens, we’ll make sure you are safe and loved.”
Q. Am I going to die as well?
Children may start thinking about their own mortality and need honest reassurance.
A. “You can’t catch cancer. Most people die when they’re old and their bodies get worn out. It’s very unusual and sad for someone young like you to be so ill that the doctors can’t make them better.”
Q. What happens to people when they die?
You may need to probe further to check what the child means by this question. Responding with an open-ended question such as “What do you think happens?” can help you work out what the child really wants to know.
The child may be asking what the physical process of dying involves or what happens to the body after death. Keep your explanations simple, concrete and honest. If there will be a cremation, adapt the following example – follow the child’s lead to work out how much detail to give.
A. “The body goes to a funeral home until it’s time for the funeral. Then they will put the body in a big box called a coffin, which will be carried into the funeral service. After the funeral is over, the coffin is buried in the ground in the cemetery.”
However, the question may be prompted by more spiritual concerns, such as whether there is an afterlife. How you explain the spiritual aspects will vary depending on your own culture and belief system. You may want to explore what the child already believes before explaining your own view.
A. “People believe different things about whether a person’s soul lives on after death. What do you believe?”