Talking to children about cancer

If your loved one has been diagnosed with cancer and has children or grandchildren, one of your (and their) first thoughts might have been for the children. What will you tell them? How will it affect their lives?

You’re not alone – each year, about 30,000 people are diagnosed with cancer, and about one-quarter of these, or 7,500 people, have a child under 18. On top of this is the large number of grandparents who play an active role in their grandchildren’s lives and are diagnosed with cancer each year.

This page is for people who are caring for a parent or grandparent with cancer, and who want to help the person with cancer talk to their children about it. It is also for parents who have one child with cancer and need to talk to the other children in the family. It is intended to offer some advice on when and how to talk to the children about the cancer and some common issues that are faced.

Why children need to know

Some parents avoid talking about their cancer because they want to protect their children. However, there is strong evidence that children who are told about their parent’s cancer have lower levels of anxiety than children who are kept in the dark.

Moreover, if children find out difficult news from someone else, it can give them the wrong idea and they can feel deeply hurt that they have been excluded.

There is also evidence that with good support, children can cope with hearing the news of a cancer diagnosis of a parent or grandparent. This is particularly true where kids are given an opportunity to talk about their feelings and ask questions.

From toddlers to teenagers

What you will say and how you will support children will of course depend on their age. For newborns, infants and toddlers, the key issue is maintaining continuity of care to meet their physical and emotional needs while your loved one is receiving treatment.

Pre-school children may worry that they have caused the cancer by being naughty, or that they can catch it. They might worry about what will happen to them if their parent dies.

Primary school children may have simple cause-and-effect logic – so they might think that cancer is contagious, that all people with cancer die, or that smoking causes all cancer. This age group can feel guilty about things they have done or said to the parent and might try to be "very good" to avoid troubling their parent.

Teenagers can feel an overwhelming sense of responsibility, just at a time when they are looking for more independence. This conflict can make them feel frustrated and guilty. Friends and social outings are extremely important for teenagers and they can feel angry about having to take on more family responsibilities and feeling like they are "missing out".

Ways to help your kids cope

Open the door

For many people, cancer is a long and uncertain journey, and you and your loved one will be constantly learning new things. This means that telling children about cancer is not a one-off event – it is a case of opening the door to talk about cancer and leaving that door open throughout the cancer experience.

Don’t expect to be perfect

Talking to kids about cancer can be confronting and upsetting. Don’t panic if the first conversation doesn’t turn out exactly as you planned.

Let your kids ask questions

Try not to overload kids with too much information at once. Sometimes it can be easier to give them small amounts of information, and then see if they have any questions. Answer they questions as accurately as possible, considering their age and experience of cancer in the family. It helps to show you appreciate their questions by saying something like "You have such great questions."

You don’t have to immediately answer questions if you don’t know the answer. You might want to say "That’s a really good question and I want to talk to dad/mum/the doctor. I’ll let you know what they say."

Often children’s questions have a hidden meaning, so try to tease that out with responses like "That’s interesting. What got you thinking about that?"

Take every opportunity to communicate

Most parents know the times and situations when their kids are more likely to open up. For one child, it may be bath or bedtime, for another it might be the walk or drive to school. Ron, whose wife had cancer, found that the best time to talk to his daughter Kelly about the cancer was when they played basketball in the backyard. Between shots, Ron would occasionally ask how she was feeling.

Be honest and maintain trust

You can’t protect your children by avoiding the truth. Once you’ve established good communication about cancer, keep it going by being as open as you can, even if the news isn’t good.

Ask them what they know

Encourage your children to tell you what other people have told them about cancer. This gives you the chance to clear up any misunderstandings and if they hear anything that upsets them, they know they don’t have to worry alone.

Set them straight

Children often worry that they caused a parent’s cancer. Make it clear that nothing they have done caused the cancer and nothing they do can affect the course of the cancer.

Show your love and emotion

As always, it’s important to show your children that you love them, with lots of hugs and spending special time together. Assure them that they will be looked after through your loved one’s treatment. Don’t be afraid to show your emotions in front of your children – this shows them that it’s OK for everyone to talk about their feelings.

Preserve family time and change their routine as little as possible

If you can, during treatment try to set aside time for the whole family as well as each of your kids. Tell your kids it’s OK to go about their life as usual – to see friends, play sport, do after-school activities and have fun. Welcome their efforts to help out at home but don’t take it for granted.

If people come to your house to help, it’s important to make sure they don’t take over or help too much. Sometimes it can be useful to let helpers know that a particular day or afternoon is family or quiet time.

Be prepared to listen

When you’re talking about the cancer and treatment, remember to stop and listen to your children. Sometimes parents are so intent on talking about the medical information, they don’t hear how their kids really feel.

Other information

The Cancer Council NSW has produced a publication, "When a parent has cancer: how to talk to your kids", which is available here. This publication contains a list of books for young children, older children and parents, as well as organisations that can offer support.

The National Breast Cancer Centre has developed a website called My Parents Cancer (www.myparentscancer.com.au) for 13-19 year olds whose mother has breast cancer.

Canteen is an organisation that is mainly for young people with cancer, but also runs groups for siblings or children who have a parent with cancer (contact 1800 639 614).

You can also contact the Cancer Council Helpline on 13 11 20 for free and confidential telephone support with trained staff. You may also be interested in joining a telephone support group for parents, where you can practise what you would say to your kids and hear from others what has worked and what hasn’t gone so well.