Talking about cancer

Why talk to kids about 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 information 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. 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.

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

When you can’t talk about cancer

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.

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 information 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.

Key points: Talking about cancer

• Start with questions to check what your children know about cancer and if they have any  misconceptions.
• Offer basic information and provide more details if they ask.
• Practise your response to potential questions before talking to kids.
• Give yourself time to answer a question; it’s fine to say, “That’s a great question, I need to think about how to answer that”.
• Explain that the cancer is not their fault and they can’t “catch it”.
• Assure them they will always be looked after, even if you can’t always do it yourself.
• Ask questions and listen to your children so you know how they really feel.
• Share your own feelings to show kids that it is okay to feel strong emotions about the situation.
• Continue daily routines as much as you can. Talk about your children’s own activities as well, and let them know that it’s still okay to have fun.

Below we explore how children of different ages may understand a cancer diagnosis.

Key points include:

• Children may react in different ways. They may feel angry, sad or guilty. Physical reactions can include bedwetting or a change in appetite or in sleeping patterns.
• Teenagers may find it hard to talk to you or show you how they feel.

Newborns, infants and toddlers 0-3 years

Preschoolers 3–5 years

Primary school children 5–12 years

Teenagers 12–18 years