Some Tips on How to Tell

Set aside a quiet time that won't be disturbed by others. Parents may want to talk to each child individually, tailoring the conversation to their age and level of understanding. Choose a private, personal, space-like home that provides comfort and security. Avoid doing it in public areas, as where distractions and the lack of privacy may inhibit the free expression of emotions and tender conversation.

During the conversation, use simple language and avoid jargon or complex medical terms to prevent confusion. Parents can plan ahead for what to say and anticipate possible questions. Writing down what to say and practicing the conversation can be helpful.

If they are unsure about the treatment outcomes, parents can be honest with their children, for example, by saying, "We are not sure how well this treatment will work, but we will keep you updated throughout." For the younger children, telling them that there are also plans for their care in the midst of uncertainty and chaos can also be reassuring. Parents can also encourage the child to write down what they want to know from the doctor at the next visit.  Alternatively, parents can note their queries and let them know they will seek answers on their behalf.  Not everything needs to be shared at once; take time to pace the conversation with themselves and the children.

What Should the Children Know?

Explaining cancer to children can be challenging. Here are some tips on how to communicate with children about cancer with clarity and sensitivity:

• Explain About Cancer

When there is a lot to tell, break the news or information into smaller pieces. Discuss concretely what cancer is, where it is located in the body, how it affects the body, the treatment plan, and potential side effects. Many children are often curious about what cancer is and they do not have the projected emotional baggage or fear that many adults have about cancer.

• Address Misunderstandings and Misconceptions

Find out what children already know and what they want to know. Create a safe space for them to share what they've learned or observed, whether from direct or indirect sources. Allow them to ask freely. All kinds of questions should be permitted; there are no “bad” questions.  Allowing their concerns and fears to surface and addressing them may be more important than trying to give them the right facts.

Children’s interpretations will vary based on their developmental stage, as will the misunderstandings they have. For instance, a younger child might fill in the gaps with imagination and self-centered thoughts, such as: “Grandma died in the hospital. Dad is in the hospital now, so he will die too,” or “Mom is sick because I made her upset by not clearing my toys.” Therefore, it's crucial to ensure that they have accurate and age-appropriate information to avoid any distorted understanding or distressing assumptions.

• Inform About Changes in Routine

Keep the conversation focused on the present without prophesying the future. Explain how cancer might affect their daily life and routine now, such as who will take them to school or be there when they come home.

• Let Children Know They’re Loved

Ensure children know they are still loved and cared for despite the cancer diagnosis and changes in family life. Acknowledge that frequent appointments and treatments will affect family time, but reassure them of our continued love and care. This helps increase their sense of security and reduce feelings of anxiety and abandonment.

Additionally, it is important to reassure children that it's perfectly alright for them to enjoy themselves despite a parent's cancer diagnosis. Emphasize that their happiness is important. They can still have fun and be happy with their friends or at school during these difficult times.

• Listen and Support

Allow children to express their feelings after discussing cancer. Younger children, in particular, might struggle to articulate their emotions. Let them know it’s normal to feel sad, angry, or scared. Encourage them to share their feelings and reassure them that it’s okay to talk to you or another trusted adult. Seek support from professionals such as social workers, counselors, or psychologists if you need help supporting children in coping with the illness.

In summary, talking to children about cancer is challenging, but it's important not to leave them in the dark. This 2-part article guides approaching these discussions, highlighting the significance of involving trusted adults for support and initiating the conversation promptly after diagnosis. It also emphasizes the importance of keeping children updated about any developments, the value of timing, and selecting an appropriate setting. Moreover, it emphasizes the need for using straightforward language and clarifying any misconceptions. Lastly, it is important to address children’s emotions, providing reassurance, and reaffirming the unwavering love parents have for their children, regardless of the cancer condition.

“Expert knowledge means better care for cancer”

Written by:

Ms Jaclyn Lee
Supportive and Palliative Care Clinician
OncoCare Cancer Centre