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Talking to children about cancer can be very difficult, but it's important to try to help them to understand. Talking to them will help them to talk openly about their feelings.
Thinking about telling children that a parent or family member has cancer can be overwhelming. Parents sometimes feel that by not telling their children they’re protecting them. It’s natural to want to protect your children from difficult news, worry and distress. But not telling them may make children more vulnerable, as it doesn’t give them the chance to talk openly about their fears and worries.
Children know when something serious is affecting the family. They’ll notice unusual comings and goings, phone calls and hushed conversations. They’ll pick up on different atmospheres and how you and other adults around them are feeling.
Parents understandably have different concerns that delay them or stop them from telling their children. You may feel that it will bring home the reality of the situation when you’re still struggling to come to terms with it yourself. The thought of coping with the children’s distress may feel like too much to cope with on top of everything else. Or you may worry that the news will disrupt family life and that cancer will become the focus instead of things like school and exams.
Talking to children about cancer is a hard thing to do. There are many benefits to being open and involving your children:
Remember that children often cope with difficult news better than we think they will.
It’s natural to want to protect children from difficult news. But if you don’t talk to them, they may:
Children often find out about what’s going on even when they haven’t been told. Finding out like this can have a negative effect on a child’s relationship with their parent. They may wonder if they can trust you or other adults to tell them about important things. Children also pick up things from the television, internet and overheard conversations, but this information can sometimes be misguided and inaccurate.
You’ll probably need time to take things in and cope with your own feelings| before you talk to your children. Try to talk to them before they pick up on things and start to worry. Be as prepared as you can and make sure you have all the information you need first and that you understand it.
If you’re a two-parent family it’s usually best to tell them along with the other parent, but this can depend on how you usually talk as a family. If you’re a single parent you may feel able to, and want to, do it on your own. Or you can do it along with someone close who your child knows and trusts.
Even if you’re not doing the telling, it’s still a good idea to be there so you know what’s been said.
Choose a time and a place when your children are most likely to listen and feel at ease, and where you won’t be interrupted. There may be places where you and your children feel more able to talk. Make sure it’s somewhere they’ll feel able to express their feelings.
If you have more than one child, you can tell your children together or separately, depending on their ages and personalities. If you’re telling them separately, do this as close together as possible. Some children may wonder why they were told last. Try to avoid only telling the older children, as this can place a burden on them.
Avoid telling them before bed time as they may not be able to sleep. If it’s unavoidable, make them feel supported and answer any questions they have before they go to sleep.
As a parent you’re the expert when it comes to your child. You know how best to communicate with them, how they might react and what support they’ll need. You can practise what you’re going to say beforehand and anticipate some of the questions they may ask.
Don’t try too hard to have the perfect conversation. If you plan too much, a question from your child may throw you. Children can ask questions you weren’t prepared for, and these may come hours or days later.
Choose a time when you’re feeling fairly calm. See the first conversation as a starting point - this is the start of an ongoing process where you’ll gradually give your children small, relevant chunks of information and reassurance. Allow the conversation to be directed by your children’s reactions and the questions they ask. Listen and keep it as open as you can. Try to ask questions that encourage them to express whatever they’re thinking rather than ones that give a one or two word reply.
Some examples of openers are:
It’s best to be honest with children. If they think you’re being vague or hiding something, they’ll find it hard to believe they’re being told the truth. Don’t make things sound less serious than they are. Be hopeful with them and let them know that although cancer is serious, many people get better. Tell them that you and your doctors are doing everything you can to get well again.
It’s fine to say you don’t know if you don’t have all the answers to their questions. Tell them you’ll try to find out and will tell them when you know.
You’ll need to use words your children will understand and this will vary depending on their ages|. Here are some tips to help you through the conversation:
Children also need to understand how their lives and routines are likely to be affected.
There are some helpful books| that help explain cancer to children. You may be able to use our other information booklets about cancer types| and treatments| to help explain cancer to older children.
Children need some information about the name of the cancer, where it is in the body and how it’ll be treated. Here are some examples of how you can explain cancer to young children:
Children, particularly those under 10 years old, often worry about things like causing the cancer or catching it. All children need reassurance that:
Knowing about your treatment and its side effects will help your children prepare for what to expect and will make them feel less anxious. What they’ll need to know will depend on their age|. It can vary from simple information for young children to the same information you need for teenagers.
If you’re struggling to take it all in yourself, it may help to talk to our cancer support specialists| first. They can send you booklets about your type of cancer| or treatment|, which may help you explain treatments to children.
Explain that this is an operation| and the doctor/surgeon will:
Before they visit you in hospital prepare them for how you’ll be after the operation. For example, if you’ll have drips or tubes, tell them what they’re for and explain that you’ll only have them for a short time to help you get better.
If children want to look at a scar it’s usually fine to let them see it, but it may be best to wait until the swelling and redness settles down. If they’re not interested or seem reluctant to look, don’t push them.
Explain to them that chemotherapy| is:
It’s also helpful to tell children how the chemotherapy may change your routine and how it may make you feel. Let them know that:
Explain to them that radiotherapy| is:
Depending on where you’re having the radiotherapy, you can explain that:
Children need to know that side effects will usually go away when your treatment is finished, but that this is often gradual. They should also know that side effects don’t mean you’re getting sicker and that not everyone gets the same side effects. Some children may worry that the cancer is getting worse if they see you unwell, or they may think that the treatment isn’t working if you don’t get side effects.
Tell your children that treatment can be hard and it’s normal for you to feel down or frustrated at times, but it’s not because of anything they’ve done. Help them feel involved by asking them to get you a drink or to do little things to help around the house, like tidying their toys away.
Children usually cope and adjust well if they’re told about any changes in your appearance in advance. Younger children, particularly those under 10 years old, struggle most with this. Letting them know in a matter-of-fact way is often the easiest way to explain things. Older children may feel embarrassed and want to avoid talking about it. If you’re struggling to cope with it yourself, you may prefer someone else to explain it to them or to get further help|.
You’ll usually want to tell your close family and other adults your children know and trust. Tell them what you’ve told your children - it’s important they get the same message from everyone. Let your children know who you’re going to tell and why.
It’s usually helpful to talk to your children about who else needs to know, for example friends’ parents or club leaders. Older children may have strong feelings about who should and shouldn’t know, so it’s good to talk this over with them. Some teenagers don’t want to be seen as different from their friends - but it’s important that certain people know and can be there to support them if they need it.
It’s a good idea to let nursery/school teachers and the school nurse know. They can be sensitive to your child’s needs, and it will help them understand any unusual or difficult behaviour. Ask them to let you know if your child shows any signs of worrying behaviour. You can ask them to support your child by giving them more one-to-one time, or you can involve the school nurse or counsellor.
Content last reviewed: 1 June 2011
Next planned review: 2013
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
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© Macmillan Cancer Support 2013
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