Harold C. Simmons Comprehensive Cancer Center

Tips for Talking to Your Children about Cancer

The news of a new cancer diagnosis can be devastating. While many questions and concerns can run through your mind, a common question we get asked is, “How do we tell the children?” While it can be scary to think about disclosing this difficult news to your children, telling them about your cancer diagnosis can help them feel included in your experience, help you maintain a trusting relationship with them, and promote more positive psychological outcomes long-term.

The following information can be helpful in beginning and continuing conversations with your children now and throughout your cancer experience.

Prepare for the Talk

Often patients find it helpful to process what, how, and where they want to communicate information about a new cancer diagnosis to their children. Some important considerations include what your children may already know and how much information you feel they want to know. Not all children want to know all of the details, so it can be helpful to prepare for this conversation by deciding the specific information you want to convey about your cancer and treatment plan. Many patients find it helpful to practice what they want to say ahead of time so they not only feel more comfortable saying the words but more prepared in the moment with their children.

When possible, offer your children a choice as to where they would like to have the conversation. This could be at the kitchen table or outside on the porch. Do not have these conversations before school or at bedside. It can leave children with many thoughts and feelings that could result in difficult focusing at school, behavioral responses, difficulty sleeping, or even nightmares.

How Chemotherapy Works

Dwight Powell sits down with an oncology nurse to walk through what happens while a parent is getting chemotherapy. This video can be useful when trying to explain a treatment that can be hard for children to understand since they are not typically allowed in infusion areas.

Open and Honest Communication

It is important to speak openly and honestly with your children about your new diagnosis and treatment plan as early as possible and to maintain this communication throughout your medical experience. Remember, open and honest communication does not mean you have to share every detail. It means providing simple, truthful, and developmentally appropriate explanations to help your child cope with all of the changes they will potentially witness now and in the days to come.

Part of truthful explanations means using the words. It’s OK to use the word “cancer,” and we encourage you to use it. Let your child know that cancer is a big sick, not a little sick like a cold or the flu. Address the three most common concerns children have when a parent has cancer:

Did I cause it? Can I fix it?
Can I catch it?
Who is going to take care of me while my person is going through cancer treatment?

In addition to these common concerns, your child may ask about death. It’s OK to let them know that even though cancer is a very serious illness, it does not necessarily mean you will die from it. It’s also OK to say “I don’t know” because there may be additional questions that you don’t necessarily have an answer to at that point in time or are unsure of how to answer in the moment. If it is a question you can speak to a member of your medical team about, let your child know you will try to get an answer to their question. Be prepared for them to also ask the same questions over and over again, and at various times throughout your treatment. This is how they are processing your medical situation and are seeking continuity in responses to know they are being told the truth. It can also be due to them not liking the answer they initially received and having a desire to see if the answer has changed. Consistency in your answers and the information communicated to your children from all involved is of utmost importance.

Ultimately, small amounts of information over time can help a child or teen process difficult news in a way where they are less likely to become overwhelmed. When children are not communicated with about a loved one’s cancer experience, their imaginations can take over, and they may create their own explanation of what is happening. They may also seek out inaccurate information from others, or the internet, and this information is often more frightening that reality.

All of the appropriate information about your diagnosis and treatment plan does not have to be shared at once, but it is important to keep them informed about your current medical status and share information throughout your experience as changes arise. These updates can help your child understand, process, and cope with the additional changes they are witnessing and/or enduring due to your diagnosis and treatment plan. Preparing your child for changes that are coming (such as a hospitalization, chemotherapy, radiation, frequent doctor appointments, surgery, hair loss, fatigue, weight gain/loss, mood changes) can help increase feelings of security during unpredictable times.

Anticipate Their Responses and Needs

You may have an influx of feelings and emotions during this conversation with your children. No parent wants to divulge that they have cancer to their children. Know that it is OK to express your emotions in front of your children. This can help your children know it’s OK to have many feelings when learning about a loved one’s cancer diagnosis and can open the door for you to model appropriate forms of coping. Children look to those around them to learn how to cope during serious situations such as this. Help them find appropriate ways to express their feelings, whether it be shock, sadness, confusion, worry, or even anger. It is also OK for them to say they do not want to talk about it in that moment if that is what they are feeling.

Let them know that their needs will be taken care of, and keep them informed about any changes that may occur with regard to their daily routine, environment, or caregivers. Strive to keep their routines as normal as possible for a sense of normalcy during uncertain times.

Reassure your children that they are not alone and that the feelings they are having are normal. Children and teens often believe they are the only ones experiencing their unique feelings and emotions during a stressful situation. It can be helpful to have a trusting adult (who is not a family member) available for your children to talk with, should they want extra support. Children want to protect their parents just as much as parents want to protect their children, so having an additional adult involved for support whom you and your children trust can be helpful.

Ultimately, each child will react differently when learning about your new cancer diagnosis. Allow them time to process this new diagnosis in their own way and continue to give them time to process each conversation that comes throughout your cancer experience.

Get more information on specific coping responses and ways to support.