Advice on talking to children about cancer

Telling children and teenagers about your cancer can be daunting. But, as a parent, you know your child best. You’ll understand their reactions and know what support they need.

Being honest, specific and using simple language is usually a good approach. What they’ll need to know and how they will react will depend on their age. Drawings or books may help younger children understand, while you may need to encourage teenagers to ask questions.

Tell children the name of the cancer, where it is in your body and how it will be treated. Reassure them that nothing they did caused the cancer and there will always be someone there to look after them. Asking open questions can encourage children to express their feelings and guide the conversation.

Consider who else needs to know. It may be useful for teachers, other parents or nursery staff to be aware of the situation. With teenagers, it’s usually best to talk this through with them first. If you’re concerned about how your child is coping, ask your cancer doctor or nurse for advice about counselling or psychological services.

Telling your children that you have cancer

You’ll probably need time to cope with your own feelings before talking to your children. But 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.

Who should tell them

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 could 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. However, some parents do prefer to let their partner tell the children and not to be there themselves. You should do whatever feels right to you.

The right time and place

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, it’s best to tell them together if you can. This prevents them feeling like their siblings know more than them. If you’re telling them separately, do it 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.

How to tell them

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.

If you want to, you can practise what you’re going to say beforehand and anticipate some of the questions they may ask. But 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. It’s the beginning of an ongoing process of gradually giving 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 asking questions that encourage them to express what they’re thinking, rather than a one- or two-word reply.

Some examples of openers are:

  • ‘Tell me about ….’
  • ’How can we …?’
  • ’What do you feel about …?’

Be honest

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. But, depending on your situation, you can 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 possible to get you 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.

Teenagers may react differently from younger children or adults when they’re told a parent has cancer. They may ask for more information about the diagnosis and what it means for family life, and they may need more time to work through their feelings.

As with younger children, teenagers will benefit from being told the truth about the cancer and your treatment plan. It’s best to encourage them to ask any questions they have, and to answer these gently yet honestly. Remember that although teenagers value their independence, they’ll still look to you for reassurance and support.

Making a start

You’ll need to use words your children will understand. These will vary, depending on their ages Here are some tips to help you through the conversation:

  • Find out what they know and correct any misunderstandings.
  • Use simple, straightforward language and short sentences to explain what’s going on.
  • Keep information relevant to the current situation rather than things that will happen in the future.
  • Be as specific as you can – children worry more when things aren’t clear.
  • Ask them if there’s anything else they want to know.
  • Take it at the child’s pace and be prepared for them to react in their own way.
  • Repeat the information for younger children, especially those under seven, as they may not take it in or understand.
  • Children also need to understand how their lives and routines are likely to be affected.

Explaining cancer to 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:

  • 'I have a lump growing inside my body (explain which part) that shouldn’t be there. It’s called cancer and I’m going to have an operation to take it away. After that, the doctor will give me medicine so that the lump doesn’t come back.’
  • 'I have an illness called cancer. The doctor is giving me medicine to help me get better. The medicine might make me feel sick or tired some days, but other days I’ll feel fine.'
  • If your child asks you what cancer is – 'Our bodies are made up of lots of tiny things called cells. They all have a different job to make our bodies work and keep us healthy. Cancer is when some cells in the body stop working properly and stop the healthy cells doing their jobs. The cancer cells can grow into a lump.'

Teenagers in particular may look for information about cancer on the internet. You or your doctor could help them understand whether the information they find is accurate and relevant to your diagnosis.

We have a cancer information section specifically for teens and young adults.

Hope Support Services or Riprap might also be helpful. Riprap is a website for teenagers who have a parent with cancer. You can also search for other useful organisations that are here to help you.

Important points to get across

Children, particularly those under 10 years old, often worry about things like causing the cancer or catching it. All children need reassurance that:

  • nothing they did or thought caused the cancer
  • cancer isn’t like a cold and you can’t catch it – it’s okay to sit close, hug or kiss
  • there will always be someone to take care of them
  • they can always ask you questions and talk to you about how they feel
  • you’ll listen to their worries and try to help them cope.

Who else needs to know?

You’ll usually want to tell your close family and other adults who your children know and trust. Let them know what you’ve told your children – it’s important that your children get the same message from everyone. Let your children know who you’re going to tell and why.

It’s usually helpful to have a conversation with your children about who else needs to know, for example club leaders or their friends’ parents. 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.

Teenagers may be facing exams or coursework at school, college or university. If they’re finding it difficult to keep up with their studies, it may be a good idea to speak with one of their teachers to find out whether any support is available.

You should speak to the teenager before doing this, as school or college may be one of the few places where things still feel ‘normal’, and they may be hesitant about letting people know. Asking them will also reaffirm their trust that you’re telling them everything and including them.

It may be important to speak to their school or college about how they’re coping. Teachers or staff can offer support, and they may notice issues or behaviours that aren’t always apparent at home.

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.

Macmillan has a toolkit called Talking about cancer. It’s aimed at helping teachers discuss cancer openly and honestly with 9–16-year-olds. The pack contains everything teachers need to give young people the facts about cancer. It includes lesson plans and DVD clips.

Understanding and reactions at different ages

Children’s understanding and emotional reactions can depend on how old they are. They’re usually able to understand more about illness as they get older, but this depends on the child – some younger children may understand things more easily than older children.

Babies and toddlers

Babies and toddlers won’t understand what’s happening. They’ll be aware of changes to their routines, and especially changes to who’s looking after them.

Try to create an environment that’s as familiar and consistent as possible, especially for when you’re not there. If possible, choose someone to care for your child who knows them well and is able to look after babies/toddlers. Keep to familiar routines when you can.

Children aged 3-5

Young children don’t really understand illness, but they pick up on tensions, changes in adults’ emotions and physical changes. They react to changes in their routine and to being separated from you.

They may also believe that wishing or hoping can make things happen. They might feel guilty that they’ve done something to cause the cancer. Or if you’re in hospital, they might worry that they’ve made you go away. Older children in this group are beginning to understand what illness is, and they may worry they’ll get cancer too.

This age group can become clingy and scared of being separated from their parents. They may start to do things they’ve outgrown, like thumb-sucking, bed-wetting, talking like a baby or having tantrums. They may become quieter than usual or have bad dreams.

How to help:

  • Use a doll, teddy or simple drawing to explain where the cancer is and/or where you’ll have an operation.
  • Ask someone they know and trust to take care of them.
  • Keep to everyday routines when you can.
  • Let them know that the cancer isn’t their fault and they can’t catch it.
  • Set usual limits and boundaries, but don’t be surprised if they start doing things they’ve outgrown.

Children aged 6-12

At this age, children can understand fuller explanations about the cancer and its effects on the body.

They often have fears they may not mention to you. This includes worrying you’re going to die, that they’ve caused the cancer, or that they can catch it. They may try to be especially good, setting impossibly high standards for themselves. You may see changes in their behaviour, concentration, schoolwork or friendships.

How to help:

  • The suggestions for children aged 3–5 still apply to many children in this age group. You may find the following tips helpful too.
  • 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’s okay to enjoy themselves.
  • Give them little things to do to help out.


Teenagers usually understand what’s going on in terms of the cancer, but they can be reluctant to talk about it. They may find it hard to talk to you or show how they feel. It’s important to encourage them to ask any questions they have and make sure they feel involved.

Teenagers may be keen to help out. But they may have to do more at home when they want to be more independent and spend less time in the house. This can make them feel angry and guilty at the same time. Sometimes their behaviour may seem hurtful to themselves or others.

How to help:

  • Tell them about useful sources of information.
  • Ask them what they think and include them in the same way as you’d include an adult.
  • Help them see that talking about feelings is a positive and mature 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 out a bit more with things like cooking, tidying up or looking after younger siblings. But tell them that you’ll let them know when they’re doing enough.
  • Show them you appreciate their help.

Allowing teenagers to help out shows them that you need and trust them. Talk to them about it first and don’t allow them to take on too much responsibility.

When children need help

Children can have lots of different emotional reactions. They can show their feelings by being angry or by misbehaving. Your child may react to your illness with behaviour you wouldn’t normally accept. Some children may have problems with eating, sleeping or bed-wetting, or problems at school. They may seem sad and withdrawn, or have physical symptoms like going off their food, headaches or tummy aches.

These changes aren’t necessarily unusual but if they carry on or if there’s anything worrying you about your child, you can ask for help.

People who can offer you and your child support are:

  • your GP (family doctor)
  • teachers
  • the school nurse
  • social workers
  • psychological services at your hospital
  • local counselling services.

Your cancer doctor or nurse will give you advice about counselling or psychological services to help you support your child.

You may be able to access help from social workers. In England, Scotland and Wales, social workers are accessed through your local authority (council). In these countries you can search for contact details of your local council online. In Northern Ireland social services are accessed through Health and Social Care Trusts.

Teenage years are already a time of emotional ups and downs, but knowing that a family member has cancer can make things even harder.

Some teenagers may be less comfortable speaking about their emotions directly and prefer to express themselves through writing, art or music. Remember that if they aren’t telling you how they feel, it doesn’t necessarily mean they don’t have anyone to speak to. They may well have the support of their friends and/or other adults, such as an uncle, aunt, grandparent or other relative. It’s 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. They can also get online support.

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