Whether you are a parent who has been diagnosed with cancer, or you have to tell a child about another family member's diagnosis, it is challenging to find the right words to say. Help your child overcome his or her fears by explaining the situation in a calm and reassuring way.

Telling your child about cancer

If a family member is ill or stressed, children sense that something is wrong, even if they don't know what it is. Talking it over with them, in words they can understand, is always better than hiding it. If you keep things from them, children think the situation is worse than it actually is. Remember that children may overhear conversations between adults and worry more if they feel that important news is held from them. Talk with your children and listen to them to make sure they understand what is happening.

Tips for talking to your child

Tell them about the illness. Although cancer is complicated, there are appropriate ways of discussing it with children. "Mommy is very sick, so she has to go to the hospital to get well again," is usually enough for very young children; for older children, a more detailed explanation is better. The more they can understand, the less helpless and afraid they will feel.

Name the illness. Using the word "cancer" when talking is best to promote clarity and reduce confusion and misunderstandings.

Practice your explanation beforehand. Your child will appreciate you remaining as calm as possible when you talk about cancer, especially if you are the one who is ill. Try to practice the conversation with your spouse or a friend, so that you can focus on your child's fears and put aside your own for the time being.

Avoid blame. The younger children are, the more likely they are to feel responsible for a parent’s or sibling's illness. Reassure them by saying that nothing they or anyone else did caused the cancer.

Explain to them that cancer is not contagious. Most children first experience sickness when they get a cold and are used to hearing adults say they caught someone else's strep throat or flu. Explain to them that cancer is not contagious. Reassure them that they are safe.

Try to balance optimism with pessimism. Telling your child that someone will be fine will only make him or her more confused and upset if it is not true. Offer a realistic but hopeful assessment of the situation and focus on the efforts that are directed toward recovery. For example, telling your child that "daddy is working hard with his doctors to get better" accurately sums up the situation without false promises.

Keep in touch with your children. If you or another family member are in the hospital for any extended time, your children may think you don't want to be at home with them. Staying in touch will help reassure them that your illness has nothing to do with how much you love them. A daily phone call from the hospital, a note delivered by a relative who visited the patient, and other creative ways for staying in touch may reassure the child of the parent's love.

Take your children's feelings seriously. Children have many different reactions when they learn that a parent or sibling has cancer. These feelings can include anger, sadness, guilt, fear, confusion, and even frustration. All of these responses are normal. Let them know that it is okay for them to have lots of different feelings and that you have many of them, too.

Welcome questions warmly. Let your child know that all questions are welcomed, even if you cannot answer them right away. Be honest and don’t be afraid to say, "I don't know." You may tell your child, "I don't know the answer, but I will ask the doctor at our next visit and get back to you on that." For children, the amount of information you give them is usually less important than making them feel comfortable with what you say.

Help children understand treatment. Children often fear the unknown. Explain the treatment process in a way that is appropriate for their age. Don’t forget that children may confuse the side effects of treatment with symptoms or signs of the cancer itself. Chemotherapy may be interpreted as being bad because it makes a parent ill. Taking the time to separate the effects of treatment from the disease itself may also provide some comfort.

Prepare your children for the effects of treatment. Cancer and cancer treatment can often affect someone’s appearance. Physical changes such as hair or weight loss can sometimes frighten children, or make them think a person has changed or is different. Explain this change to them beforehand so they are prepared. For example, you might say, "When mommy was sick in the hospital, she lost weight, and her hair fell out. But don't worry, it will grow back. She is still the same mommy on the inside."

Let children help but don't burden them with responsibility. Let children know they can help their parent or family member feel better; it will make them feel less helpless if you let them run an errand, get a glass of water, or perform some other task that is appropriate for their age. However, be careful not to burden them with too much. The stress of having someone ill in the family can be severe. They will need lots of time to just play, relax, and be children. This need is especially true of adolescents, who are often struggling to maintain their own friendships and interests and may feel burdened if they are also asked to look after younger siblings.

Be prepared to discuss death. Although this is both difficult and sad, it is important to be prepared to discuss death with your children. You may want to consult a trained counselor or clergy first. One of the most important things to remember is to take your child's age into account when discussing death. Preschoolers, for instance, do not understand that death is final. In general, by the age of 10, children begin to understand that death is the end of life. Try to use very clear, specific terms. Avoid euphemisms such as, "sleeping forever" or "put to sleep," because children will think sleeping is like death, or be afraid that if they sleep, they might die. Remember, too, that it may take a long time for a child to fully understand, and to accept, any type of loss.

Counseling can help

To appropriately address children's unique needs and their developmental stage, many people with cancer consult with counseling professionals soon after they are diagnosed. Such counseling can help parents break the news, manage their children's reactions, and reassure their family that they are doing everything possible to get better, but will need their family's help and support. Some parents may also benefit from talking with a counselor who has training in child development. Ask your doctor or nurse to tell you about the resources available at your medical center.

When a sibling has cancer

Finding out that a family member has cancer can be especially traumatic for children if the illness is diagnosed in a sibling.

A child may feel guilty that the sibling is ill, or jealous that the ill child has become the center of attention. Healthy siblings may also experience feelings of inadequacy since they are unable to "fix" the cancer.

Spending time together and talking about the concerns may be helpful. Counselors trained in child development may also provide helpful tips to promote family understanding and age-appropriate advice.

More Information

How a Child Understands Cancer

Cancer and Siblings

Additional Resources

CancerCare for Kids