Talking to Your Young Children about Your Cancer

Tips for Important Conversations

Any cancer patient who is a parent worries about her children. For most of us, these concerns are the most painful and frightening part of our illness. When we hear our diagnosis, our first two thoughts are probably: Am I going to die? and What will happen to my children?

There is nothing to say that is very reassuring about this fear. It may help a little to remember that children who are given age-appropriate information and whose routines are not too disrupted generally do well. If, as a parent, you are worried about getting through a time-limited period of treatment and disruption, this is some solace. It does not help much, however, if you are a parent facing a life-ending diagnosis. In any situation, the keys are open communication, love and a promise that your children will be watched over and beloved.

You know your children best. It can be overwhelming to manage your own intense feelings and figuring out what to say to them may seem impossible. Consider talking about your strategy with your spouse, a clergy member or a friend before you share the news with your kids. In most cases, you can take time to process your diagnosis, but don’t put off sharing the news with children too long. The atmosphere in your home will change immediately after you’re diagnosed, and your children may sense the shift.

Secrecy may only fan your children's fears. I remember one woman who was determined to never tell her young daughters about her breast cancer. She never removed her wig in their presence, never told them about her appointments or treatments, closed the bathroom door when she was ill, and thought that she fooled them. I seriously doubted that they were ignorant of something scary happening in their home, and I was and am sure that the silence was much more damaging then honesty would have been.

Over the years, I have worked with many women who lost a mother to breast cancer when they were young. Obviously, they all suffered, but almost all went on to develop healthy and happy lives. The exceptions, the women who were always tormented, were the ones who had been shut out. They were the ones who were never told, never included and came home after school one day to find that Mom had vanished.

There are some excellent resources available:

Telling Kids About Cancer provides advice for sharing news about your cancer diagnosis with children of all ages.

CancerCare for Kids features podcasts, educational workshops and free counseling for parents, children and adolescents.

Raising an Emotionally Healthy Child When a Parent Is Sick is a thoughtful resource written by psychiatrists Paula K. Rauch and Anna C. Muriel. Available at bookstores and online.

And here are some suggestions as you consider these important conversations. Note the plural. This is never a one-time discussion.

1) Always be honest. Resist the temptation to lie about sensitive matters.

2) Avoid euphemisms. Your children may overhear words such as “cancer” or “chemotherapy.” Be sure they know what these words mean. Avoid the childish words like "boo boo."

3) Give them information gradually. You don’t need to overwhelm them in a single conversation. Think of it like sex education; bring up the subject, tell them what they need to know immediately and be prepared to revisit the topic.

4) Don't be surprised if your children seem uninterested or unfazed by your news. This does not mean that they didn't listen.

5) Find additional helpers. Talk to your family members, close friends and your children’s teachers about what is happening at home. Ask them to be an extra set of eyes and ears and to be ready to provide additional support to your kids.

6) If your children are struggling, connect them with a counselor at school, or ask your health care team or pediatrician for recommendations. Make sure that you let your child's teacher/school know what is going on at home. If they don't know, they can't help.

7) Prepare your children for big changes and events, such as hair loss, hospitalizations and surgeries, before they happen. Some women involve their children in shaving their heads. If you will have hospital stays, think about how to stay in close touch. FaceTime or Skype help a lot, and very small children appreciate a calendar where the days can be marked off in anticipation of your return home.

8) Consider taking your children to visit your treatment center and meet your caregivers. This is almost always reassuring to them. If you would like to do this, pick a time when the center will be uncrowded and, ideally, arrange for one of your providers to be available for at least a short talk.

9) Have an answer ready if your children ask if you are going to die. Unless your death is imminent, it’s OK to say “no.” You’ll have an opportunity to prepare your children if the time comes. Here is one possible response: “This is not the time to worry. If that time ever comes, I promise that I will tell you.” This promise, that you will let them know when and if the time comes to worry, may be the single most important sentence you can utter.