When a parent is diagnosed with cancer: Talking with younger children

by Janice Pazar, PhD

A diagnosis of cancer interrupts the carefully planned daily and weekly schedules of school, work, and family life. Often when a parent is diagnosed with cancer, deciding what, when, and how to share this news with children is a primary concern. Each family develops its own values, beliefs, and styles of parenting. Same aged children vary in temperament and maturity.  Even as the parent is learning about his or her disease and plans for treatment, the parent, now a patient, scrambles to find ways to maintain the routines and needs of family life. In the midst of this steep learning curve about a cancer diagnosis and treatment, a parent worries about the impact of his or her illness on the children.

Some parents decide to not talk to the children at all, deciding to keep the illness a secret, perhaps hoping to protect the children from any disturbance or distress. Other parents opt to talk openly and share every detail, perhaps hoping to maintain strong family bonds through complete honesty. For most families, a middle course, providing selected information geared to the child's level of development and ability to understand, is more satisfactory than establishing either a pattern of keeping secrets or sharing very detailed information that may confuse or unnecessarily frighten a young child. As a parent and mental health professional, I believe our role as parent includes modeling a style of coping and resilience in response to challenging times. Our aim is not to be perfect.  We are continually challenged to respond to novel life events, both wonderful and dreadful.

Although we wish to protect our children from distressing events, honesty is essential for trust. Even the youngest children will sense when something is wrong. Children have vivid imaginations and given no information, their minds may create a very distorted sense of a problem. In general, clear, simple explanations are best.  Listen carefully to their questions. Be sure the child understands that nothing your child did or said caused your cancer and that no one can "catch" cancer from you. Tell the child that your illness requires strong medicine and that you are doing everything you can to get well. When we decide to adapt to a cancer diagnosis with openness to asking questions, with a determination to review priorities, identify resources, make informed decisions, and accept help graciously, to some degree we model effective coping.

Let your child know that feeling mad, sad, or scared is ok and that you (and other trusted adults) will be sure he or she is taken care of and able to go to school, daycare, sports, and other activities with as few interruptions as possible. Let the child know a few ways he or she can be helpful to the family during this time. Be sure to tell them that you love them and that their questions and concerns are important to you. Inform a child's teacher of the changes occurring at home and maintain open communication with child-care providers. Your pediatrician, school counselors, and cancer care team are available to discuss strategies for sharing information with your children and family members throughout your course of treatment.

The following information may be helpful as you decide what, when, and how to discuss your illness with your loved ones. Please explore these online resources and feel free to bring other favorites to our attention. 

www.dfci.harvard.edu/  Dana Farber Cancer Institute at Harvard University has a Family Connections website. (Click on Family Connections, then Information for Parents.) Extensive information on many issues related to talking with children about cancer.

www.uihealthcare.com/topics/medicaldepartments/cancercenter/talkingwithchildren/  Provides clear recommendations regarding if to tell, when, who, and what to tell children with specific age ranges.

http://www.clevelandclinic.org/ In the Health Information section: Talking with your Child about Cancer discusses the why, when, who, what, and how of telling your child about your cancer.

www.cancer.gov/cancertopics/takingtime/  The National Cancer Institute provides extensive online support for people with cancer. Family Matters covers many topics of interest for talking about your cancer with people who care about you.

http://www.cancer.org/   American Cancer Society: Talking with Children about Cancer

www.cancerbacup.org.uk/Resourcessupport/Relationshipscommunication Suggestions for talking to children of different ages and stages.

www.cancer.med.umich.edu/learn/pwtalking.htm  An excellent list of articles and children's books grouped by age level to help adults talk with children about a loved one's cancer.