Talking With Your Child About Cancer

  • Tips for Handling a Difficult Conversation

    Telling your child that someone they know or love has cancer may be one the hardest thing you’ll ever do as a parent. And out of love, your first instinct may be to protect your child by keeping the diagnosis to yourself.

    But cancer is a hard secret to keep. Kids often overhear adult conversations, and even very young children can sense when something is wrong. “And without an explanation, what they imagine might be more upsetting than the truth,” said Paula Finestone, PhD, a clinical psychologist at Fox Chase Cancer Center.

    That’s why it's generally best to talk to your child about the diagnosis as early as you can. But how can you share the news in a way that helps your child feel safe and secure? Finestone offered the following advice.

    It helps to prepare. Thinking about what you’re going to say—and even practicing—can both help you feel more confident about talking to your child, as well as allow you to do a better job of communicating. It may also help to get feedback about your approach with a trusted love one.

    Set the tone. Do your best to be calm, truthful, and reassuring. “If you shed a few tears, that’s OK—this can be a tough time,” Finestone said. “You can reassure your child with a comment like this: ‘I feel sad that Grandma is sick. But having you in our lives helps both of us tremendously.’”

    You might start with a question. For example, you might ask your child something along these lines: “Maybe you’ve noticed that your teacher has been gone a lot lately. Do you know why?” This lets you know what your child might already suspect—and you can continue the conversation from there, Finestone said.

    Cover the basics. Every child should know these four things:

    • The name of the cancer, such as breast cancer or lymphoma
    • Where the cancer is located in the person’s body
    • How it will be treated
    • How the child’s life will be affected

    Tailor your explanations. Younger children need simpler, less-detailed explanations than older ones. "It's also important to tell younger kids that cancer isn’t contagious and that they didn’t do anything to cause the person to get cancer,” Finestone said.

    Don’t overwhelm your child with too much information. Answer all of their questions honestly, but if you go into a lengthy explanation, your child might get confused or tune out. “Even cancer doctors give out information in small doses so that their patients have time—maybe days and sometimes weeks—to process information,” Finestone said.

    Answer this question: “Is Uncle John going to die?” It’s a topic many parents dread, understandably. But you need to address it even if the question isn't asked.

    Finestone suggested that you say something like this: “Cancer is serious, and some people do die. But many people don’t, and your Uncle John has a group of very good doctors. He is doing everything they told him to do to get better.” Be honest, realistic and hopeful. Whenever possible, share positive information.

    Remember, there’s no right or wrong way for your child to respond. “Some children might pepper you with questions,” Finestone said. “Others might quietly process the information on their own.” Siblings may each react differently to a cancer diagnosis.

    While feeling sad and stressed is normal, a child who cannot be comforted or acts very differently than usual may need extra help. Talk to your child’s doctor or a school counselor if your child is struggling to cope with the diagnosis.

    Keep talking. “Look at this as only the beginning of an ongoing conversation you have with your child about the person’s health,” Finestone said. Keep sharing information and encourage your child to come to you with any concerns.

    And be aware of this: Every talk can strengthen your relationship with your child. “These talks let your child know that you’re there for them and that the two of you can talk about any topic, even difficult ones,” Finestone emphasized.

    Fox Chase offers a variety of support services to help patients and families cope with cancer. You can read about those services at .