Talking to children and teenagers

It may be difficult starting to talk to children about cancer. But if you do not talk to them, they may:

• feel frightened because they do not know what is happening
• get the wrong idea about what is happening
• feel alone and worried with no one to talk to
• think they are not important enough to be included
• worry that they have done or thought something that has made someone unwell.

Children often find out about what is going on, even when you have not told them. For example, they may hear something from friends whose families know yours. They may wonder if they can trust you to tell them about important things.

Children also learn things from TV, the internet and conversations they hear. But this information is not always accurate. If you do not speak to them about what is really happening, they may continue to believe this information.

If you are the parent, you are the expert when it comes to your child. You know the best way of talking to them, how they might react and what support they will need. If you are not the parent or guardian, you should talk first to the person who is.

Try to find a time when you are feeling calm. The first conversation is just a starting point. You can then slowly give your children small, relevant pieces of information and reassurance.

If you can, let your child’s reactions and questions direct the conversation. Listen and keep it as open as you can. Try to ask questions that will encourage them to say what they are thinking, rather than giving a ‘yes or no’ reply.

It is best to be honest with children. If they think you are hiding something, they may think they are not being told the truth. Try to not make things sound less serious than they are.

Depending on the situation, you may be able to tell them that cancer is serious, but many people get better. You might be able to tell them that doctors are doing everything possible to help.

You may not be able to answer all their questions. Tell them you will try to find the answers and will tell them when you know.

Teenagers may react differently from younger children when they are told someone has cancer. They may ask for more information about the diagnosis and what it means for family life. They may need time to work through their feelings.

As with younger children, it is best to tell teenagers the truth about the cancer and your treatment plan. Encourage them to ask any questions they have, and answer these gently but honestly. Remember teenagers value their independence, but they will still look to you for reassurance and support.

Children who have learning disabilities, learning differences or who are neurodivergent can find talking about change hard. But in most situations, they will cope better if they are involved and prepared. Some children may think or learn in a different way to others. Try to use communication styles that the child is comfortable with.

• Plan what you want the child to know, and how much information you need to share.
• Pick a quiet space to talk.
• Talk slowly and clearly.
• Give a small piece of information and then stop.
• Give the child time to process each bit of information before talking again.
• If you need to repeat the information, use the same words. You might have to explain more than once, especially if you are having a long course of treatment.

If the child finds diagrams helpful, our easy read booklets may help with your conversations. They have simple diagrams about cancer, cancer treatment and life with cancer.

You could try using calendars that show your hospital appointments or visits, and your child’s activities. It will help your child see how your treatment will fit in with their life. Try to keep their routine the same if possible. Keep things they are used to around them and explain what is happening every day.

It may also help to prepare them for possible physical changes. They may cope better if they have time to prepare. Reassure your child that they are coping well with the change.

It might be useful to talk to any teachers or support workers who are involved in your child’s care.

You may find our podcast, Talking to children about cancer, helpful. The National Autistic Society also has more information on helping children prepare for change.

How children understand about cancer and how they react will depend on how old they are. You may have to repeat the things you tell them. Younger children may not understand what is happening, but they will notice changes to their routine.

Teenagers or young people usually understand, but they may find it hard to talk about what is happening. They may ask for more information and what it means for family life. They may also need more time to work through their feelings.

Babies and toddlers will not understand what is happening. They will be aware of changes to their routine, or to who is looking after them.

How to help

Try to keep their routines as normal as possible, such as bedtimes, meals and nursery. If possible, someone who knows the child well should care for them.

Young children do not really understand illness. But they often notice physical changes, or changes in adults’ emotions. They react to changes in their routine and to being separated from the people who usually care for them.

Young children may feel guilty that they have done something to cause the cancer. Or, if you are in hospital, they might worry that they have made you go away.

Some children in this age group may understand what illness is. They may worry that they will get cancer too.

They can become clingy and scared of being separated from the people who care for them. They may become quieter than usual or have bad dreams. They may start to do things they have outgrown, such as:

• sucking their thumb
• wetting the bed
• talking like a baby
• having tantrums.

How to help

• Ask someone they know and trust to take care of them.
• Keep to everyday routines when you can.
• Stick to their usual boundaries. Do not be surprised if they start doing things they have outgrown.
• Let them know that the cancer is not their fault, and they cannot get cancer from you.
• Use a doll, soft toy or simple drawing to explain where the cancer is or where an operation may be.
• Try to prepare them for any physical changes.

At these ages, children can understand more about cancer and its effects on the body. They often have fears they may not talk about. This includes worrying that the person with cancer is going to die, that they have caused the cancer, or that they can catch it.

They may try to be especially good and set high standards for themselves. You may see changes in their behaviour, concentration, schoolwork or friendships.

How to help

You may find the following tips helpful:

• Use books to explain the cancer and its treatment.
• Reassure them that many people with cancer get better.
• Make sure they keep up with school, other activities and friendships.
• Let them know it is okay to enjoy themselves.
• Give them little things to do to help out.
• Let their school know, so they can also offer support.

Teenagers usually understand what it means to have cancer, but they may not want to talk about it. They may find it hard to talk to you or show how they feel. It is important to encourage them to ask any questions they have and make sure they feel involved.

Some teenagers may be keen to help out. But they may have to take on more responsibilities at home at a time when they want to be more independent.

This can make them feel angry and guilty. Sometimes their behaviour may seem hurtful to themselves or others.

How to help

• Ask them what they think and talk to them like an adult.
• Help them see that talking is a good way of coping. Encourage them to talk to someone close, such as their friends, a relative or a family friend.
• Make sure they keep up with friendships, activities and normal life as much as possible.
• Give them time and space to themselves when they want it.
• Keep to usual rules and limits – these can be even more important now than before.
• Explain that they might need to help a bit more with things like cooking, tidying up or looking after younger children. Letting them help shows that you need and trust them. But reassure them you do not expect them to do everything, and that people will care for them too.
• Show them you appreciate their help.
• Tell them about information that may help, such as Riprap and Hope Support Services.

Being a teenager can be an emotional time. But this can be even harder if a family member or friend has cancer.

Some teenagers may not be comfortable talking about their emotions. They may prefer to express themselves through writing, art or music. Remember that if they are not talking to you about how they feel, they may be talking to someone else. They may have support from their friends, or another adult such as an uncle, aunt or grandparent. It is important to make sure they have someone to speak to outside of the family.

Teenagers may feel more comfortable joining a support group than speaking to a counsellor.