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Talking to Your Kids about Cancer

by Fred Wilkinson, LICSW

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Cancer. Can there be a more terrifying word to hear? Talking to children about a diagnosis and treatment can be a struggle for many adults, who are often still trying to find the right words for themselves. There are many factors to take into account when talking with children. Among these are the age of the child, the child’s developmental level, and the child’s prior experience with cancer.

Use the word “cancer.”
First and foremost, it is important to use the word “cancer” with the type of cancer your family is facing (leukemia, breast cancer, lymphoma, etc.). Kids, especially older ones, often hear more than adults realize. They eventually will hear the word from someone, whether it is a family member, friend, or medical professional. It can be scary to say, especially at the beginning, but being open and honest will help in the long run. Using the word “cancer” can assist in taking away some of the mystery and stigma that often follows a diagnosis. If you do not use both words, children may think, “My mom has leukemia and cancer too?”

Kids, especially older ones, often hear more than adults realize.

Author of Article photo

Fred Wilkinson

Use age appropriate language.
Use language that your child will understand. Younger kids may only need to know the basics. Too much information can be overwhelming. Children under five will often ask questions that come immediately to mind and then move on to another subject, start playing, or leave when they have enough information. Take your cues from their statements and behaviors. Example: “Your brother’s blood is sick, but he is going to get some medicine so we can try and make him better.”

As kids get older, they are better able to understand more of the complexities of the illness and treatment, though they sometimes have misconceptions. Kids between the ages of six and ten need to be reassured that nobody “caused” the cancer and that it is not contagious. Encourage them to talk about how they are doing.

Finally, be honest. Let children know what is going on. Prepare them for what to expect. This includes explaining where they may be staying (hospital, friend’s house, home) and how someone might look or be feeling. You can take pictures of the hospital room, machines, and hospital staff to show them before they come to the hospital. Example: “Mommy will be going to the doctor a lot to get medicine for her cancer. It will make all my hair fall out, but it won’t hurt.”

Listening is as important as talking.
Adults often get so caught up in how to tell a child what is happening that we forget to listen to what they say and pay attention to how they behave. Kids often act out or regress (act younger than their age) during family stress and change. Acting out can be due to fear, medications (if a child is the one with cancer), feeling out of control, or using it as a way of seeking information. Keep a familiar object with them, such as a blanket, stuffed animal, or picture. As kids get older, talk to them about how much they want to be involved in information gathering and decision making.

Cancer affects everyone in the family.
While only one person may be undergoing treatment, everyone is being affected by the diagnosis. Parents report feeling helpless and begin seeking information. Kids often feel left out, less important due to being sent to a friend’s or relative’s, or guilty for feeling jealous of all the attention someone else is getting. If the child is the one receiving cancer treatment, he or she may seek ways to control their situation like refusing to eat or take medications or becoming more attached to parents. Each person in the family will respond differently depending on his or her age, gender, or experience with cancer or loss. It is important to communicate as a family and get the support you need.

When someone in the family is undergoing treatment for cancer, parents often feel like they have to do everything “right.” The truth is, you are doing the very best that you can in a difficult situation, and it is important to trust your instincts. You are the expert on your kids. We know that kids are resilient and typically do better than anyone else does. If you have questions or concerns about how your child is doing, please talk with your social worker, child life specialist, doctor, or nurse practitioner.

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Fred Wilkinson is a pediatric oncology social worker at Children’s Hospital and Regional Medical Center in Seattle, WA. For questions or comments, he can be reached at (206) 987-3449.

This article was published in Coping® with Cancer magazine, May/June 2008.