Listen to the Cancer.Net Podcast: Preparing Your Child for Medical Procedures , adapted from this feature.
Doctors may need to perform a variety of medical tests and procedures to learn more about your child's cancer and provide the best treatment. Thinking about and having these procedures can be a major source of anxiety and stress for both children and parents. Fortunately, you can reduce much of the anxiety you and your child feel about procedures by carefully preparing.
Children's fears depend on their age and personality, and the procedure:
Infants and younger children: They are most afraid of being separated from their parents.
Older children: They are most afraid of pain.
Teenagers and young adults: They are afraid of pain but embarrassed to admit their fear. They may also be embarrassed about their bodies and worry about privacy during the procedure.
Procedures involving needles: Pain is usually the biggest fear.
Surgery: Children may be afraid of feeling pain during the surgery itself. They may not understand the "special sleep" associated with general anesthesia. They need to be reassured that you will be there after the surgery. Older children and teenagers may also worry about how their bodies will look after surgery.
It is important that you discuss and acknowledge your child's fears and feelings. Let your child know that his or her fears are normal and that other children feel the same way.
Although most children learn to cope well with procedures, not all children do. This is especially true if your child has a pre-existing fear, such as a fear of needles, or has had a bad experience with a procedure that did not go well. If your child is fearful of a certain procedure, he or she may benefit from working with a child life specialist, psychologist, or psychiatrist.
Why preparation helps
Some parents think they should not tell a child about an upcoming procedure, especially if they anticipate it may hurt. However, children need clear and honest information. If you tell your child that a procedure will not hurt, and then it does, the child may be surprised and confused. Your child may then expect all procedures to hurt and will not believe you if you say otherwise.
Many children can cope with pain, loud machines, or uncomfortable positions if they know when it will happen and how long it will last. Learning this information ahead of time, your child may be able to express what he or she needs to stay calm and bear the unpleasant experience. You may want to explain to your child that unpleasant things have to be done to help him or her get better. But remind your child that this procedure isn’t happening because he or she did anything wrong. A social worker, nurse, child life specialist, or another member of the health care team can help you find the right words to explain the medical procedures to your child.
It is natural for you to be upset if your child is in pain or scared. Learn about the procedure and prepare yourself emotionally. Knowing what to expect will help you stay calm and allow you to better comfort and support your child.
Find out the details of the procedure by asking:
Who will perform it?
How long should it last?
What kind of sedation or anesthesia will be provided?
Which parts of the procedure may be painful or frightening for your child?
What measures will be taken to control his or her discomfort?
How can you best prepare your child to be relaxed?
Will you be able to stay with your child?
Preparing your child
Children older than age 2 should be given as much information about the procedure as they ask for. But gear your discussions to your child's age and level of understanding.
Below are suggestions for making sure your child knows what to expect:
Be honest and open. But avoid graphic or overly frightening descriptions.
Prepare his or her senses. Address what the child will see, smell, hear, taste, or touch during the procedure.
Encourage questions. But look for signals that your child has received enough information, such as changing the subject or expressing a lack of interest in talking.
Ask about preadmission programs. These hospital-provided programs allow children and families to learn about the procedure and the equipment that will be used. You can also ask a nurse or social worker to explain the procedure to your child.
Seek out educational materials. Many hospitals provide story or coloring books, videos, or pamphlets designed for children.
“Play” a procedure with your child. Younger children may want to watch the procedure being done on a teddy bear or doll first. A child life specialist or social worker can help guide your child's play session. At home, you may want to rehearse this procedure with your child. For example, with radiation therapy or a magnetic resonance imaging (MRI) test, you can practice with your child by holding still for the length of time that the treatment or procedure will occur.
Keep your child’s bed a safe space. If your child is staying overnight in the hospital, speak to the nurse or child life specialist about using the treatment room bed instead of the child's hospital bed for any procedures.
Prepare for separation. Most children count on their parents for support during procedures and want a parent to stay with them. But this may not be possible in some situations. So ask the doctor who will be present so that you can ask them to comfort and support your child.
When to tell your child about an upcoming procedure depends on both the age and personality of your child. In general, preschool-aged children only need to be told a day or so in advance. School-aged children and teenagers may want to know earlier. But some children may worry for days if they are told about a procedure too far in advance. Meanwhile, some school-aged children and teenagers may find it helpful to keep appointments on a calendar. Experiment to find out what works best for your child.
You and your child may want to set up a special plan for procedure days. For instance, determine who will go to the hospital, what you will bring with you, and what special treat you will give your child after the procedure. Older children may want to write plans down. Having a plan helps children feel more in control of the situation. Be sure to discuss your plan with a member of your child's health care team to make sure it will not interfere with the procedure.
It is also important to make arrangements for your other children in advance of the procedure day. You should also inform them in an age-appropriate manner of what will be happening with their brother or sister. Try to keep their routine as regular as possible, and make sure that the siblings know how to contact you on that day.
During the procedure
Consider these tips for helping your child remain as calm as possible during procedures:
Comfort your child. Use soothing words and gentle touches, and offer to hold your child's hand.
Provide distraction. Try telling a story, singing, or reading a book. Older children may want to listen to music on headphones. Some hospitals have video players in treatment rooms. Sometimes children like to imagine pleasant scenes during a procedure, such as going shopping, playing at the beach, or scoring the winning goal.
Bring along a favorite object. This could include a teddy bear or blanket. Or you may want to give your child something of yours, such as a scarf or keys. Having a favorite object is especially helpful for procedures when your child must be alone in the room. Encourage your child to bring his or her own music or audio book to listen to during longer procedures.
Give your child an achievable goal. For example, you could ask him or her to hold still. Tell your child that is okay to cry, but that his or her job is to keep still during the procedure.
After the procedure
You may notice some behavioral changes in your child after the procedure. Some children may regress by acting younger than their age. Others may need to be near you more than usual and will not separate from you as easily as they have in the past. These are common reactions that usually disappear with time. Acknowledge your child's frustrations and behavior. But continue providing age-appropriate activities and remaining consistent with your family's regular routine and behavioral guidelines.
Preparing for your child’s medical procedure can help reduce stress and anxiety for both children and parents. You can support your child by tailoring the information about the procedure to your child’s age and level of understanding. Ask your health care team if you need more information about the procedure to best prepare for it.
For Children 
CureSearch: Anxiety Around Medical Procedures 
National Cancer Institute: Children with Cancer: A Guide for Parents 
Child Life Council: How a Child Life Specialist Can Help Your Child and Family