How you answer questions depends on the nature of the cancer and the effects of treatment. It’s a good idea to 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 questions over and over again, you are helping to ease your children’s worries. Sometimes children may test you to see if your answers stay the same.
Q: Why is this happening?
At some stage, children are likely to ask why such a terrible thing is happening in their family. This may be a question that you are grappling with yourself. How you respond will depend on your culture and 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?
A: “It’s no-one’s fault. Nothing you, or anyone else, did or said made me ill. And being kind and well-behaved can’t stop someone from dying either.”
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. For younger children, it may be helpful to talk about time in relation to upcoming events (e.g. school holidays, a birthday). Older children may want some idea of how long a parent is likely to live. 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 hope to be well enough to go to your kindy concert.”
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.”
“No-one can answer that, but we hope 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.”
For some children, the death of a parent from cancer will mean a substantial change in the child’s living arrangements. For example, if they are living with only one parent and that parent dies, they may have to move to a different house to live with their other parent. In these situations, it’s important to discuss this before the sick parent dies, and to include the other parent or guardian in discussions.
Q: What happens if Mum/Dad dies too?
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, loved and well cared for.”
Q: Am I going to die as well?
A: “You can’t catch cancer. When someone you love dies, it’s normal to think ‘Am I going to die too?’. It’s very unusual and unlikely for someone young like you to die or be so ill that the doctors can’t make you better.”
Q: What happens to people when they die?
How you answer this question depends on your personal or spiritual beliefs. You may need to probe further to work out 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. They may be asking what the physical process of dying involves or what happens to the body after death.
Keep your explanations simple and straightforward and follow the child’s lead to work out how much information 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.” (This example can be adapted if a cremation is planned.)
Questions about what happens after death may also 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. What do you believe?”
How to supporting grieving children
Each child will react to loss in their own way. Do not underestimate the impact of a bereavement, even if a child is very young or does not seem sad. Their grief may be expressed through play or other behaviour.
Children often work through feelings slowly, facing them in bearable doses. Allow children space to grieve – you do not need to “fix” their sorrow. Let them know that it is natural for people to express sadness in various ways, just as they express other emotions.
For bereavement information and support, call Cancer Council 13 11 20 or contact one of these organisations or services:
- Grief Australia – 1800 642 066
- Canteen – 1800 835 932
- GriefLine – 1300 845 745
- Parenting Through Cancer – 1800 226 833
- Redkite – 1800 733 548
→ READ MORE: How children understand death
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Prof Jane Turner AM, International Psycho-Oncology Society President Emeritus,The University of Queensland, QLD; Taylor Baker, Consumer; Dr Ben Britton, Principal Clinical and Health Psychologist, Head of Psychology, Hunter New England Mental Health, NSW; Camp Quality; Dr Lisa Cuddeford, Head of Department, WA Paediatric Palliative Care Service, Perth Children’s Hospital, WA; A/Prof Peter Downie, Head, Paediatric Haematology–Oncology and Director, Children’s Cancer Centre, Monash Children’s Hospital, VIC; Dr Sarah Ellis, Clinical Psychologist, Kids Cancer Centre, Sydney Children’s Hospital, NSW; Malia Emberson-Lafoa’i, Consumer; Kate Fernandez, 13 11 20 Consultant, Cancer Council SA; Jane Gillard, Consumer; Mary McGowan OAM, International Childhood Cancer Advocate, VIC; Annette Polizois, Senior Social Worker, Women, Family and Emergency Care Team, Royal North Shore Hospital, NSW; Rhondda Rytmeister, Clinical Psychologist, HeadWayHealth (formerly Snr Clinical Psychologist, The Cancer Centre for Children, Westmead, NSW); Nadine Street, Head of Social Work and Social Welfare, HNE Mental Health Service, NSW; Warren Summers, Online Counsellor, Canteen, NSW.
We would also like to thank the health professionals, consumers, organisations and editorial teams who have worked on previous editions of this title, and we are grateful to the parents and young people whose real-life stories have added to the richness and relevance of this book.
We thank and acknowledge Dr Paula K. Rauch, MD, Founder and Director, Marjorie E. Korff PACT (Parenting At a Challenging Time) Program and Associate Professor of Psychiatry, Harvard Medical School, whose research and writing on helping parents talk to their children about cancer was used as source material for this book and has been adapted in several sections: pages 8–11, How children understand cancer; page 22, Answering key questions: Are you going to die?; page 26, Involving the school or preschool; pages 30–31, Hospital visits; and pages 36–37, Encouraging family time. We also thank the American Cancer Society for permission to use and adapt material on pages 8-11 from its book Cancer in Our Family: Helping children cope with a parent’s illness (2013); Macmillan Cancer Support for permission to use its book Talking to Children and Teenagers When an Adult Has Cancer (2013) as a source of information; Jessica Watt, Oncology Social Worker, The Children’s Hospital at Westmead, for her contribution on page 20, When another child has cancer; and Diane McGeachy, Hobart Counselling Centre, for contributing material for page 37, Spending one-on-one time.
View the Cancer Council NSW editorial policy.
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