Talking about your child’s cancer

Perhaps one of the hardest parts of caring for a child with cancer is knowing what to say and how much information to give them and other loved ones. Your first instinct is always to protect your child, but it's important to include your child and build trust. It's best to be honest with your child and use clear, age-appropriate information.

It’s best to call their illness ‘cancer’ 

This prevents confusion and distrust later on. Children who don't know that they're unwell due to cancer and aren't fully aware of their circumstances can often try to ‘fill in the blanks’. For example, they may think they're unwell because they did something wrong and they're being punished. 

Listening to your child is the best support you can provide

Hearing their feelings and worries means you can give them the support they need at that particular time, without overloading them with information.

Tips for talking to your child

• Find out what your child understands about cancer. And what they already know about their own illness. Let them express their emotions without interrupting. Your ability to listen and respond calmly will send out the message that even though their illness is difficult it is not too scary to talk about. The fear of the unknown can be more frightening than the truth.
• Talking openly and honestly is best. This encourages trust and security. Secrecy can lead to isolation, fear and anxiety for your child.
• Use clear and simple language.
• Don’t feel you have to know the answer to every question.
• Some children don't ask questions immediately, but this does not mean that they don't want to know what's happening. They may be afraid and uncertain of many things. Remember that children process news differently. Your child will come to you with questions when they are ready.
• Encourage your child to talk to you whenever they want. 
• Let your child know what will happen next. 
• Treat older children and teenagers separately to younger children in the family when talking to them about cancer. 
• Say to your child ‘I don’t know’ if you are unsure about anything. You don’t need to know everything, but you can let them know that you will find out together.
• Tell your child that they are loved and cared for.
• Don’t lie. 
• Don’t make promises that you may be unable to keep. 
• Don’t force your children to talk if they don’t want to, but keep the lines of communication open.

Common fears

Younger children may be frightened of being separated from their parents. It is important to reassure them that this will not happen. Older children may be more frightened of pain. It can help to reassure them that there will be plenty of medicine to ease their pain.  Doctors and nurses will be happy to explain this and can help you to ease your child’s fears.

Talking to teenagers

• Teenagers are at a stage of development where they are striving to be independent. Very often they are more aware of health problems than their parents realise. They may be experiencing feelings of confusion, fear of the unknown or fear of dying. 
• They can understand more than they can handle emotionally. 
• Explain to teenagers that talking about their feelings and worries is a helpful way of coping with stressful situations. They may not be used to expressing their feelings or may be afraid to ask questions in case it upsets you.
• By listening as much as you can and keeping a supportive and positive environment you can help them express their fears and worries. 
• Always give reassurance and encouragement to your teenager. 
• Include them in all discussions about their diagnosis and treatment planning. This includes the benefits, risks, and side-effects. Some teenagers find that knowing about their treatment helps them to get on top of things and have a sense of control.
• Your teenager is likely to be worried at times and it may not be easy for them to talk about their fears. 
• Teenagers can be at a stage in their lives when they are naturally trying to be more independent and do things for themselves. Arrange for visits with friends. Teenagers with cancer need and like to be with others their own age. 
• To help your teenager deal with fears and feelings, you may want to say “I love you” often. 
• Ask your teenager to try and share their feelings with family, friends, the cancer team and other staff. 

Talking to brothers and sisters

• Use clear and simple language. 
• Give an amount of information to suit the age of your child. Full details can be given for the older child. For younger children you could say ‘Your brother/sister has a lump in his head which the doctors need to take out.’ 
• Be truthful and remember it is acceptable to say ‘I don’t know’. Children respect honesty and will sense if you are lying or hiding something. 
• It can help to rehearse what you are going to say too. That way it might help you to foresee any questions your child might ask.
• When breaking the news, do not start the conversation by saying something like ‘You might be sad’ or ‘I have some bad news for you’ or ‘Please be brave and don’t cry now’. 
• Children have a remarkable ability to step outside any upset or grief. They can listen to your news and go out to play afterwards without a bother. Allow them time to understand and ask questions. 
• Expect and be prepared for a range of emotions that may follow, e.g. sadness, fear, anxiety and anger. 
• Be prepared for curiosity, especially in younger children with simple questions like ‘How big is it?’ or ‘What colour is it?’ 
• The details may need to be repeated at intervals over the course of your child’s hospitalisation. 
• Older children often hide their feelings and fears, as they will be very aware of your anxieties. Often they choose a close relative or friend to confide in instead because they may not wish to burden you with their concerns. 

Talking to other people

• It is normal to find it difficult to talk about it to others. But each family will have their own way of dealing with the situation. Most parents find that it is best to tell close relatives and friends the truth. Their support will be invaluable and it will be a relief to talk to them. They may not know what to say or be worried to bring up the subject. 
• If you are receiving a lot of phone calls it might be helpful to nominate one person to pass on the news to the rest of the family. Your medical social worker will also be happy to give you advice as will any member of the nursing or medical staff.
• With acquaintances or colleagues, a short simple explanation is all that is needed.