Talking with Children and Grandchildren About Cancer

Parents or grandparents diagnosed with cancer often worry about what to tell children, how to tell them, and when. Some even wonder if they should tell them at all.

No matter what their age, it's important to talk with children about what's going on because:

• They might sense that something is wrong and wonder if it is their "fault."
• Their imaginations may create something worse than what is actually happening.
• They may hear it from someone outside the family and feel disappointed that you withheld this important information from them.
• Knowing what is happening will prepare them to support you during treatment and to understand that things are not quite "normal" for a while.

First, take time to plan ahead and think through what you want to say. Consult with your spouse or the children's other significant caregivers. It may help to talk with a social worker or another member of your health care team. Part of your planning might be to decide who will be present with you and the children when you tell them.

Choose a time when you and the children are rested and not rushing off to activities. You'll want to have open-ended time to support and reassure them as well as respond to any questions they may have.

What you say and how you say it depends upon the child's age and maturity level. Explain that you have a disease called cancer and where it is in your body. Let them know that it's not contagious and that nothing they did or can do has anything to do with you getting cancer. You may also want to talk to older children about how the family's routine might change. Emphasize your love for them and reassure them that they will be taken care of.

Keep the discussion simple at first and let their questions and responses guide you. Picture books, stuffed animals, or dolls may be helpful in talking with young children. Those conversations are likely to be brief. Older children and teenagers will want more information and may have emotional reactions to what they're hearing.

Many children may not say much or seem to react very strongly during this initial talk, which is not uncommon. They may open up more later. It is best not to push them to respond or to expect any particular response from them. However, do watch for any disturbances in their behavior and consider telling their teachers and other trusted adults in their lives so they may also be alert to the child's concerns.

Talk with children or grandchildren again in later days and weeks as they ask more questions or as you have more information to share. Include them in activities when appropriate and make special efforts to have fun together.

Many hospitals sponsor support groups for children who have a loved one with cancer. Those groups can help them talk about their feelings and concerns with trained counselors and meet other children who are coping with similar family situations.

How To Tell Your Children: Information Resources

Here is a list of books and websites that may be of assistance to you.

Books

Carney KL: What is cancer anyway?: Explaining cancer to children of all ages, Dragonfly Publishing Co., 1999.

Harpham WS: When a parent has cancer: a guide to caring for your children. HarperCollins, 2004.

Harpham WS: Becky and the worry cup: a children's book about a parent's cancer, Perennial, 1997.

McCue K, Bonn R: How to help children through a parent's serious illness, St. Martin's Griffin, 1996.

Cohen, CK, Heiney JT: My daddy's cancer: an interactive book for children. Promise Publishing Co., 1999.

Kohlenberg S, Crow L: Sammy's mommy has cancer, Magination Press, 1993.

Websites

KidsKonnected. Questions Commonly Asked by Children Who Have a Parent with Cancer.   http://www.kidskonnected.org/html/body_faq.htm

Dana-Farber Cancer Institute. Family Connections: A Resource for Parents with Cancer and Their Families.  http://www.dfci.harvard.edu/pat/support/familyconnections/

Y-Me National Breast Cancer Organization. How to Talk to Your Children. http://www.y-me.org/coping/relationships/how_to_talk_to_children.php

Cancerbackup. Talking to Children about Cancer. 2005.   http://www.cancerbackup.org.uk/Resourcessupport/Relationshipscommunication/Talkingto children

University of Iowa Hospitals & Clinics. Talking with Your Child About Your Cancer. 2003.  http://www.uihealthcare.com/topics/medicaldepartments/cancercenter/ talkingwithchildren/index.html

American Cancer Society. Talking with Children About Cancer. 2001.   http://www.cancer.org/docroot/ESN/content/ESN_2_1x_Talking_with_Children_About _Cancer.asp?sitearea=ESN

Cancercare. Helping Children Understand Cancer: How to talk to Your Children about Your Cancer Diagnosis. http://www.cancercare.org/pdf/fact_sheets/fs_children_en.pdf

KIDSCOPE. Designed to help families coping with a caretaker’s cancer. Video: My Mom Has Breast Cancer. http://www.kidscope.org