Cancer; Pediatrics

How to talk with your kids about a cancer diagnosis in the family

Cancer; Pediatrics

Young boy talking with his mother outside in a park setting.
Talk with your children about a cancer diagnosis in the family as soon as you can. Waiting opens the door for kids to be confused or misinformed by other sources.

Before Catherine, Princess of Wales, announced her cancer diagnosis to the world, she and Prince William faced a situation no parent wants to be in: Telling their children that their parent has cancer.

The conversation can be especially scary for parents facing lengthy treatment or a late-stage diagnosis. But the truth is children are very observant, and they likely already know something is wrong. Young kids will certainly notice changes in your demeanor or to the family’s routine, even if they don’t speak up about it.

Kids are resilient, but in the absence of information they tend to fill in gaps with imagined worries: Did I cause the cancer? Is it contagious? Is Dad going to die?

When we talk with patients in our Psycho Oncology Clinic at UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center, we encourage them not to hide their diagnosis or delay disclosing it to their children. Word travels quickly in families, communities, and on social media – you’ll want to control the message from the start. Hearing the news directly from you will reinforce your bond and feelings of trust with your children.

We’ve outlined a few strategies to help you initiate straightforward, age-appropriate discussions with your children about a cancer diagnosis in your family.

Preschool-aged kids: Clear, concise, and repeated

Preschoolers are very concrete thinkers. They relate sickness to their own experiences, so they might expect it go away after a day or two of rest. However, they are old enough to understand that when their caregivers are sick, their routines will change: someone else might handle drop-offs and pick-ups at school or practice, Mom might need an afternoon nap or Grandpa might not be available as much during treatment.

Tips to connect about cancer:

  • Be clear and use simple terms: Instead of “gastrointestinal cancer,” say that you have an illness in your stomach called cancer.
  • Set expectations: Tell them about schedule changes or new routines as soon as possible. Many young kids struggle with change, and being clear will make new steps in the day easier for everyone.
  • Don’t expect them to remember: Preschoolers live in the moment, and they don’t always recognize that what you told them yesterday also pertains to today. Prepare to repeat yourself and understand that they aren’t ignoring or “forgetting” on purpose.

At this age, children likely understand the concept of death and dying but may not realize it is permanent. It’s not uncommon for a very young child to ask, “When will I see them again?” even if they are told someone has died. If you or another caregiver has a terminal diagnosis, chances are that the family may need to have that conversation with the child several times to help them understand.

Related reading: Death of 'Black Panther' star sheds light on young adults' colon cancer risks

Elementary school and pre-teens: Control the message

The level of information you provide to elementary school children and pre-teens should be based on their personality. If they’re a worrier, just give them the information they ask for. If they’re inquisitive, give more in-depth information with your explanation.

For all children, start with the basics – ask whether they know what cancer is and give them time to answer. This is an opportunity to clear up misinformation. Your child should know that you will be the source for accurate information and that they can always come to you for answers.

Tips to connect about cancer:

  • Control the message: As word spreads about your diagnosis, well-intentioned peers and adults may approach your child with condolences or advice. Let the child know they will always get the truth from you first.
  • Use real words: Say terms like “tumor” and “chemotherapy” if the apply to your treatment. Children may not ask for specifics, but if they do, it’s OK to share details such as what type of cancer you have.
Teenage girl in bed reading her phone.
Giving teens the facts about a cancer diagnosis in the family leaves less room for them to fill in the gaps with misinformation on the internet and social media.

Remember – even at a young age, children can be very savvy internet researchers and are excellent at eavesdropping on adult conversations.

  • Show and share emotions: As you discuss your illness, give your child space to react.Don’t hide your tears or frustration – seeing your emotions and demonstrating how to deal with them in a healthy way is a good way to validate your child’s feelings and to model this skill. As you go through treatment, pull together other “adult helpers” to keep an eye on your child. Friends, family members, parents of your child’s friends, school counselors, and teachers may see emotions or behaviors or get questions that your child doesn’t express at home. Prepare these helpers for the big feelings or changes that may bubble up throughout your treatment and ask for help when you need it.

Teens and young adults: Prepare and observe

In the age of the internet and social media, it’s reasonable to expect teenagers and young adults to source their own information on pretty much everything, including cancer. Teens have been known to doomscroll on Google, TikTok, or YouTube to find answers to their questions, even after having an in-depth conversation with you.

Tips to connect about cancer:

  • Prepare answers to tough questions: Whether it’s about your specific type of cancer or questions about your prognosis, teens are known for asking blunt, emotional questions. Give honest, clear answers and stick to them – they need to see you as the source of consistent truth.
  • Talk about possible changes to responsibility: If you have an older teen, there may be an increased level of responsibility placed on them during this time. If your child is at college or lives away from home, you may need more help from them if they are an older sibling or they may want to come home. However, this will be a personal decision based on your child’s personality, your finances, and the family dynamic.
  • Be observant of changes: Changes to your teen’s habits, such as dramatic changes to their daily behaviors, academic performance, or peer group, can be indicators that they are struggling.

If your child has anxiety or depression, don’t withhold information. Let their mental health provider know your family is going through a tough time. Again – much like with younger children, giving them the facts leaves less room for them to fill in the gaps with misinformation.

Related reading: Learn more about additional support services at UTSW’s Simmons Cancer Center

While your family conversations are not under a spotlight like those of the Princess of Wales, it doesn’t make the idea of discussing cancer with your kids any easier. Explain to your kids that you have many “helpers” involved in your care - from doctors, nurses, support services, loved ones, and friends. This burden is not yours or theirs alone.

By talking openly with kids on their level, you can validate their feelings and give them the truth as your family system faces cancer together.

To learn more about our psycho-oncology support services, please visit our website or talk with your oncologist about requesting a referral. Call 214-645-4673 .