Talking about the diagnosis

When you first learn of a cancer diagnosis, you may feel shocked and overwhelmed. Among the many decisions you need to make will be when, where and how to talk to the children and young people in your life. However you decide to approach the conversation, try to be open and honest and leave kids with a feeling of hope.

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When should I tell my children?

It’s common to feel unsure of the best time to tell your children; often there may be no right time. You may wonder if you should tell them soon after you’ve been told yourself, or wait until you have more details about test results and treatment.

Although it is tempting to delay talking to your kids, try to tell them as soon as you feel able. Keeping the diagnosis a secret can be stressful, and your children will probably sense that something is wrong.

It’s also a good idea to tell children if:

you think they may have overheard a conversation
they are scared by adults crying
they are shocked or confused by physical or emotional changes in the person who has cancer, especially if the person has symptoms such as frequent vomiting, weight loss or hair loss, or is admitted to hospital for immediate treatment
you notice changes in their behaviour.

It may be hard to decide how much information to share, particularly if you are waiting on test results. Your children don’t need to hear everything all at once. If you don’t know what treatment is required, just say so – but also assure your children that as soon as you have more information you will tell them. For example, “Dad is in hospital to have some tests. We’re not sure yet what’s wrong, but when we do know we will tell you.”

Let children and young people know it’s okay to have questions at different times, such as during treatment, when you are managing side effects and later during recovery, and to talk about how they feel at anytime.

Mum was driving us over to McDonald’s when she asked me about cancer and what I knew about it. Then she told me about Dad’s leukaemia – what it meant, what it was doing and how it would affect him. I was sitting in the car park feeling pretty overwhelmed.

— James, aged 12

Where should I tell my children?

Try to find some time when you won’t be interrupted or have to rush off without answering all their questions.

Many people find that bringing up the topic while doing something else – like walking the dog or washing dishes – can help reduce the tension. This approach may be less intimidating than sitting the family down for a formal discussion.

Talking to children before bedtime or before an important event may not be a good idea. Ideally, you should tell them at a time and in a place where they are more likely to listen and take in the news.

Should I tell them together?

Depending on the ages and temperaments of your children, you may decide to tell them individually or together. You may need to use different language because of their age. If you decide to tell them separately, try to tell them on the same day. Asking older children to keep the diagnosis a secret from younger siblings can add to their stress.

Who should tell my children?

Deciding on the person to tell the children is another thing to consider. In most cases, it is easier if the information comes from someone who is close to your children. Ideally, that will be the parent who has cancer, the other parent or both of you together.

However, this is not always possible. Another adult close to your children, such as a grandparent, aunt, uncle or friend, may be able to tell them or be there when you tell them. This may be particularly important if you’re a single parent. You may also decide to break the news with the support of a member of your health care team, such as your general practitioner (GP) or social worker.

Looking after yourself

Telling children and young people about a cancer diagnosis can be confronting and difficult. You may have trouble helping your kids deal with the news if you’re struggling yourself. You may be facing both emotional and physical challenges and you will have to make many decisions, but you don’t have to do this alone.

Wait until your initial feeling of shock has eased before attempting the conversation.
Talk to a few trusted adults beforehand – this will allow you to express your own feelings and start getting used to the news yourself.
Make a list of things that other people can do for you. Family and friends are often keen to help out, but usually need guidance on what to do.
Ask a friend to coordinate offers of help.

See Involving others for more information about involving others. There are also many support services for people who are newly diagnosed with cancer.

This information was last reviewed in December 2018. View who reviewed this content.

We thank the reviewers of this book: Professor Kate White, Chair of Nursing, The University of Sydney, NSW; Sarah Ellis, Psychologist, Behavioural Sciences Unit, Kids with Cancer Foundation, Sydney Children’s Hospital, NSW; Kate Fernandez, 13 11 20 Consultant, Cancer Council SA; Chandra Franken, Program Manager – NSW & ACT, Starlight Children’s Foundation, NSW; John Friedsam, General Manager of Divisions, CanTeen, NSW; Keely Gordon-King, Cancer Counselling Psychologist, Cancer Council Queensland; Stephanie Konings, Research Officer, CanTeen, NSW; Sally and Rosie Morgan, Consumers; Dr Pandora Patterson, General Manager, Research and Youth Cancer Services, Canteen, and Adjunct Associate Professor, Cancer Nursing Research Unit, The University of Sydney, NSW and Visiting Professor, Faculty of Health and Life Sciences, Coventry University, UK; Suzanne Rumi, Consumer; Michael Sieders, Primary School Program Manager, Camp Quality.

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, Founding 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, Different views of cancer; page 24, Answering key questions: Are you going to die?; pages 26 -27, Involving the school or preschool; pages 30 -31, Prepare for hospital and treatment centre visits; and page 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, Children’s Hospital Westmead, for her contribution on page 18, When another child has cancer; Diane McGeachy, Hobart Counselling Centre, for contributing material for page 38, Spending one-on-one time; and Dr Ranjana Srivastava, and The Guardian for permission to adapt €œHow do you tell your children you have cancer? €_x009d_, on pages 21 and 47 – full story is available at https://www.theguardian.com/society/2015/nov/29/how-do-you-tell-your-children-you-have-cancer.