Talking about cancer
Explaining a diagnosis of cancer to children or teenagers can feel difficult and overwhelming. This information is designed as a starting point for having a series of conversations about cancer. Talking sensitively and openly about the diagnosis can provide children with reassurance during a time of uncertainty and change.
Learn more about:
- Why talk to kids about cancer
- When you can’t talk about cancer
- Cancer in different cultures
- How children understand cancer
Talking with kids about cancer can feel overwhelming. Your first reaction may be to keep the news of the diagnosis from children or to delay telling them. Or you may feel an urgent need to tell them straightaway. Even though it can be difficult, research shows that being open helps children cope with the cancer diagnosis of someone close to them. We explore some of the issues you may like to consider as you approach these conversations.
This section focuses on when a parent has cancer, but much of the discussion will be relevant for anyone who needs to explain a cancer diagnosis to children or teenagers – for example, when a child’s sibling or friend has cancer, when their grandparent or another significant adult has cancer, or when the child has cancer.
We offer tips on talking with children throughout all stages of cancer, from sharing the news about a cancer diagnosis to adjusting to life after treatment or speaking about end of life.
This section includes quotes and stories from people who have been affected by cancer, along with examples of what a parent or carer might say. These are just ideas; you will need to adapt what you say to suit your children’s ages and their individual personalities. You know your children best and can judge their ability to understand things.
You may like to share this book with grandparents, teachers, school counsellors, family friends and neighbours – anyone who talks with your children – to ensure your children hear a consistent message about cancer and how it may affect your family.
If you or your family have any questions or concerns, call Cancer Council 13 11 20. We can send you more information and connect you with support services in your area. You can also visit your local Cancer Council website
A note about the language we use
We have used the terms “kids” and “children” interchangeably, and the term “teenagers” rather than “adolescents”, as this is how families tend to speak.
Mostly, this information is addressed to “you” as a parent with cancer, but it can be read by any adults supporting children and young people who have a family member with cancer.
When someone is diagnosed with cancer, adults are sometimes hesitant to discuss the situation with children. Parents and other adults can feel overwhelmed by their own anxiety and fear, and their first reaction may be to protect children from those same strong emotions.
They may be concerned about their children’s reactions or worry the diagnosis will disrupt their children’s school performance or friendships. However, there are many reasons why a straightforward and open discussion can help children.
You are the expert
As parents and carers, you are the experts on your children and what works for them. To help you discuss the difficult subject of cancer with children, this book offers evidence-based, practical strategies that can build upon your existing strengths and knowledge.
Sometimes it may take a few attempts before you find an approach that suits your family. Use your understanding of your children’s individual personalities and needs to guide you.
Secrecy can make things worse
Children who are told about the illness of someone important to them tend to cope better than children who are kept in the dark. Trying to keep the diagnosis secret can be difficult; it can add to your stress and can be confusing for children. For example, you may need to change your family’s daily routine to attend specialist appointments and your children may not understand why.
You can’t fool kids
Children are observant. No matter how hard you try to hide a cancer diagnosis, most children will suspect something is wrong. Even if it’s an aunt or grandparent who has cancer, rather than a parent, kids will usually pick up on any stress this causes in the family.
They may notice changes at home, such as your sadness, whispered conversations and closed doors. Or they may see that their family member looks different or cannot do certain things. These signs may be more obvious to older children and teenagers, but even young children can pick up on change. They will work out that a secret exists.
Not knowing the reason for the secret may leave them feeling powerless or left out of family matters. They may also feel that they have done something that has caused this change in the family, or imagine that the situation is worse than it actually is.
Being open can build trust with your child
Children can feel hurt if they suspect or discover they have not been told something important that affects their family. Sharing information shows you trust and value them, which can boost their self-esteem and ease their concerns.
The diagnosis may also be a chance for children to learn from their parents how to deal with complex feelings. Together, you can all find ways to cope with difficult situations (resilience).
How children hear about a diagnosis is important
Ideally, children should hear about a cancer diagnosis from their parents, guardian or a trusted family friend, particularly if it is the parent, a relative or close friend who has cancer.
If you tell friends and relatives about cancer in the family, but you don’t tell your children, there is a chance your kids will learn about the cancer from someone else or overhear a conversation. Children often listen to adult conversations even when it seems like they are busy with their own activity and not paying attention.
Overhearing the news can make your children feel upset and confused. They may think they are not important enough to be included in family discussions or that the topic is too terrible for you to talk about.
Children may make up their own explanation to fill in the gaps in their understanding. They may feel afraid to ask questions and worry in silence. Teenagers, and even younger children, may pick up on a few key words and search the internet for answers, which can lead them to unreliable websites. They may spread incorrect information to other children in the family.
Kids can cope
When a family is affected by cancer, it can be an unsettling time for kids. You may wonder how they will get through it, but with age-appropriate information and good support, most children can cope with this difficult situation.
Kids have surprising abilities to respond to life’s challenges. They learn about emotions and how to express them by watching others – especially their parents. Parents can role model how to recognise, talk about and manage a range of emotions. For example, you might say: “I’m feeling sad that Grandma is sick and I think I need to go for a walk.”
It’s okay to explain to your child that what you are telling them is upsetting and it’s natural to have strong feelings. We can’t stop kids from feeling sad, but if we share our feelings and give them information about what’s happening, we can support them in their sadness.
Children need a chance to talk
Talking to your children about cancer gives them the chance to ask questions (here are some suggested approaches). Encourage your kids to share their thoughts and feelings, but don’t be surprised if they don’t want to talk when you do, and don’t push your kids if they would prefer not to talk. Younger children may like to draw a picture, while older children may find it helpful to keep a journal to write down questions or thoughts as they come up.
Sometimes kids, particularly teenagers, may feel guilty about burdening a sick parent with their worries or taking up a healthy parent’s time.
Reassure them that their concerns are not a burden. They may also like to speak to an adult who is not their parent (e.g. a grandparent, an aunt or an uncle) or perhaps another trusted person in their lives, such as a school teacher, counsellor or coach.
Some parents don’t want to tell their children about the diagnosis at all and try to keep it secret. People have their own reasons for not sharing the diagnosis with their children, including cultural beliefs or an earlier death of a relative from cancer. Sometimes you may want to wait to find out more about the diagnosis before telling your kids.
If you want to share the diagnosis with your children but your fear of saying or doing the wrong thing is keeping you from having this difficult conversation, it may be helpful to talk with a psychologist or social worker. They can help you develop a strategy. Keep in mind that talking about cancer will change over time. Some discussions may become easier, others may become more challenging.
What to expect after telling children
How children react to hearing about a cancer diagnosis in their family will depend on their age, nature and family environment.
Cancer in different cultures
There are a wide range of beliefs and ideas about cancer. People from some cultures believe that cancer is caused by bad luck, that it is contagious or always fatal. Others may believe that the cancer has been sent to test them. It is important to respect different ways of coping with a cancer diagnosis.
You may be reading this book because you work with children who have been affected by a cancer diagnosis. Before talking to someone else’s child about cancer, it’s essential that you understand and respect the wishes of the parents.
If a family wants to keep a diagnosis private, organisations such as Cancer Council 13 11 20, Canteen, Camp Quality or Redkite may be able to suggest ways for children and other family members to discuss their feelings and concerns in a confidential setting.
Sooner or later they were going to find out. Why not tell them straightaway? I tell them frankly what is happening. I think they find it much easier to cope because they are ready for things.Susie, mother of three children, aged 12, 13 and 16
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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