Kids' different views of cancer

Possible reactions

Suggested approaches

• newborns and infants: becoming unsettled, especially if they need to be weaned suddenly
• newborns and infants: wanting to breastfeed more frequently for emotional comfort
• becoming fussy and cranky
• becoming clingy
• change in sleeping or eating habits
• colic
• toddlers: tantrums, more negativity (saying “no”)
• return to, or more frequent, thumb sucking, bedwetting, baby talk, etc.

• maintain routines: ask any carers to follow the established schedules for your baby or toddler as much as possible
• give plenty of physical contact (e.g. hugging, holding, extra breastfeeds) to help them feel secure
• watch play for clues to how a child is coping
• use relaxation tapes, calming music or baby massage

Possible reactions

Suggested approaches

• return to behaviour that is developmentally younger, e.g. sucking their thumb
• comfort-seeking behaviours, such as using a security blanket or special toy
• fear of the dark, monsters, animals, strangers and the unknown
• trouble falling asleep or sleeping through the night, refusal to sleep
• nightmares, sleepwalking or sleeptalking
• bedwetting
• stuttering or baby talk
• hyperactivity or apathy
• fear of separation from parents or other significant people, especially at bedtime and when going to preschool
• aggression (e.g. hitting or biting), saying hurtful things or rejecting the parent with the cancer diagnosis
• repeated questions about the same topic, even if it has been discussed several times

• provide brief and simple explanations about cancer; repeat or paraphrase when necessary
• use picture books, dolls or stuffed animals to talk about cancer
• read a story about issues such as nightmares or separation anxiety
• assure them that they have not caused the illness by their behaviour or thoughts, nor will they catch cancer
• explain what they can expect; describe how schedules may change
• reassure them that they will be taken care of and will not be forgotten
• encourage them to have fun
• listen and be alert to their feelings, which they may express through speech or play
• arrange opportunities for children to be physically active every day to use up excess energy, anxiety or aggression
• continue usual discipline and limit-setting

Possible reactions

Suggested approaches

• irritability, anxiety, guilt, envy
• sadness, crying
• physical complaints, e.g. headaches, stomach-aches
• trouble sleeping
• sudden worry about the well parent’s health
• school refusal
• separation anxiety when going to school or away to camp
• returning to behaviours that may be developmentally younger
• hostile reactions, e.g. yelling or fighting, including towards the sick parent
• poor concentration, daydreaming, lack of attention
• unexplained change in school marks
• withdrawal from family and friends
• difficulty adapting to changes
• fear of new situations
• sensitivity to shame and embarrassment
• trying to be extra good
• nailbiting

• use sport, art or music to help children express and manage their feelings
• assure them that they did not cause the cancer by their behaviour or thoughts, and that they cannot catch it
• reassure them that they will be taken care of and tell them that it’s okay to have fun
• let them know their other parent and relatives are healthy
• give them age-appropriate tasks to do around the house
• tell them you won’t keep secrets and will always let them know what is happening
• suggest letting school know
• help them understand that what their schoolfriends say may not always be right – encourage them to check with you
• try to continue after-school activities to maintain routine and to encourage fun
• discuss the issue of dying if your kids bring up the topic
• see also ideas for preschoolers

Possible reactions

Suggested approaches

• wanting to be more independent and treated like an adult
• becoming very insecure and dependent on parents, or lapsing into previous behaviours, such as watching children’s TV shows
• criticising support offered by adults
• preferring to confide in friends, and acting as if friends are more important than family
• depression or anxiety
• worry about being different and not fitting in
• anger and rebellion
• poor judgement and risk-taking behaviour, e.g. binge drinking, smoking, staying out late, unsafe sex
• withdrawal
• apathy
• physical symptoms caused by stress, e.g. stomach-aches, headaches
• hiding feelings – adults are less likely to see true reactions
• changes in academic performance
• worrying they will also get cancer (e.g. daughter of a woman with breast cancer or son of a man with prostate cancer)

• notice any changes in their behaviour and ask them about it – this can lead to a conversation about their concerns
• encourage them to talk about their feelings, but realise they may prefer to talk to friends or other trusted people
• use words and gentle touches to the arm or back to let them know you love them
• talk about role changes in the family
• provide privacy, as needed; highlight the importance of respecting privacy and using social media appropriately
• encourage them to keep up activities and friendships; talk about finding a balance between going out and staying at home
• set appropriate boundaries
• arrange opportunities for counselling
• don’t expect them to take on too many extra responsibilities
• let them know of resources for learning more about cancer and getting support
• reassure them that you don’t always need to talk about cancer – you still want to chat about things like homework, sport and friends
• see also ideas for younger children above