Helping Your Children Understand Cancer

(Adapted from "Cancer Care Briefs" of the Cancer Resource Center in New York)

When someone has cancer, it affects the entire family, particularly children. Cancer is a complicated disease to understand, even for adults. There are many types of cancers and no easy way to describe them in simple terms. But if you, your child, or someone in your family has cancer, discussing it with your children may be the most important thing you can do.

Protecting Children Can Make Things Worse:
When someone in the family is diagnosed with cancer, children can sense that something is wrong, even if they don't know what it is. Talking it over with them, in words they can understand, is always better than hiding it. If you keep things from them, children may think that things are worse than they really are, particularly because there are many myths about cancer, such as the myth that cancer is contagious.

Many psychologists and psychiatrists have agreed that young children tend to think their actions may have somehow caused a parent or sibling to get cancer. It is important to not only communicate with your children, but to listen to them, and make sure that they understand what the family is experiencing. No matter what their age, there are ways to communicate with children about cancer, treatment options, and, if necessary, life and death.

The following booklet discusses ways that you can talk to your children.

How to Tell Children That You or Someone in Your Family Has Cancer: When a child's life is touched by cancer, it can cause a great deal of emotions, mostly because any kind of serious illness is scary to a child. Fortunately, as a parent, you can help your child overcome many of his or her fears by simply explaining the situation in a calm, reassuring way. The following are tips on how to talk to your child about a family member who has cancer.

Tell them about the illness. Although cancer is complicated, there are appropriate ways of discussing it with children of any age. This does not mean that you have to give them a detailed description about treatment process and/or alternative therapies. However, the more you talk to them and include them in things that are occurring, the less helpless and afraid they will feel.

Practice your explanation beforehand. It will be a great help to your child if you can be as calm and objective as possible when you discuss cancer, especially if you are the one who is ill. You should practice the conversation with your spouse or a friend; this may help you feel more comfortable talking about what is going on, and it may also help you focus on what your child's fears might be.

Avoid blame. The younger children are, the more they think the world revolves around them, and the more likely they are to feel responsible for a parent or sibling's illness. Assure them by saying that they did nothing to contribute to the development of cancer.

Explain to them that cancer is not contagious. Most children first experience sickness when they get a cold, the measles, or some other childhood disease that might have been fairly contagious. It is important that you explain to them that cancer is not contagious. They will probably already be afraid that someone else in the family will get cancer and it may comfort them if they are assured that this is not true.

Try to balance optimism with pessimism. Telling your child that someone will be "all better" will only make him or her more confused and upset if it is not true. On the other hand, being very pessimistic can scare them. It is usually best to try to offer a realistic but hopeful assessment of the situation.

Keep in touch with your children. If you are in the hospital for any extended period of time, your children may think that things are going badly. Staying in touch with them can often help reassure them that the best place for you to be may be at the hospital. Remember your being away from home is a big adjustment for children.

Take your children's feelings seriously. It is common for children to have many different reactions when they learn that a parent or sibling has cancer. These can include anger, sadness, guilt, fear, confusion, and even frustration. All of these responses are normal. Let them know that it is okay for them to have lots of different feelings and that you have many of them, too.

Answer questions honestly. Discussing cancer with a child can be difficult, especially when there are so many questions that adults or even doctors cannot answer. It is best for you to be as honest as you can with your child, and not be afraid to say, "I don't know" if you don't. For children, the amount of information you give them is usually less important than making them feel comfortable with what you say.

Help children understand treatment. Children often fear the unknown. They can think that a situation is worse than it really is. Explain the treatment process in a way that is appropriate for their age, but don't forget, it is easy for a child to imagine something like chemotherapy or radiation therapy as “bad” because it can cause hair loss, nausea, and other unpleasant side effects.

Prepare your children for the effects of treatment. Cancer and cancer treatment can often dramatically affect someone's appearance. A physical change such as hair or weight loss can sometimes frighten them, or make them think a person has changed or is different. It is best to explain this to them beforehand so they are prepared. For example, you can say, "When mommy was sick in the hospital, she lost weight, and her hair fell out - but don't worry, it will grow back. She is still the same mommy on the inside."

Let children help but don't burden them with responsibility. It is important to let children know that they can help their parent feel better; it will make them feel less helpless if you let them run an errand, fetch a glass of orange juice, or perform some other task that is appropriate for their age. Be careful not to burden them with too much. The stress of having someone ill in the family can be great. They will need lots of time to just play, relax, and be children.

Be prepared to discuss death. This is a complicated topic, but if you or your family member is very ill with cancer, you should be prepared to discuss death with your children. Given the limitations of this information, it is impossible to suggest ways to discuss this with your child. You may want to consult a trained counselor or clergy first.

One of the most important things to remember is to take your child's age into account when discussing death. Preschoolers, for instance, may not understand that death is final. School-age children tend to know that dead things don't eat, breathe, or sleep. Remember it takes time for children to begin to understand that death is the end of life, so be patient if they have lots of questions or seem confused. There are helpful books and other resources available to you to help facilitate the discussion of death with children. Many of these can be found on the Internet, in local libraries, and bookstores.

A great site to refer to on the internet is called Kids Cope and you can access it through the following web address: www.kidscope.org

In Conclusion: Remember that when cancer strikes a family, children know something is wrong. Trying to protect them will only make them imagine the worst, and will prevent you from helping them to understand and eventually accept what is happening. If you need help in talking to your children, don't be afraid to ask for it. As a parent, you may not always be prepared for every situation. Being unsure of what to say is no reason to be ashamed, or to not talk to you children about cancer.

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