One of the first thoughts many patients have after learning they have cancer is, “How do I tell my children?”
At first, you may be inclined to avoid the question altogether. This is understandable; you need time to understand the reality of your diagnosis and process your thoughts. And sometimes, your instinct to protect your children from sadness and stress can override the desire to help them prepare for the realities of the situation.
But discussing your cancer with your family is an important conversation to initiate. And believe it or not, just talking about your cancer can reduce stress while providing your children with the necessary information to help them adjust in healthy, age-appropriate ways.
Why You Need to Talk About Your Diagnosis
Many patients believe it’s better not to discuss a cancer diagnosis with young children. They worry that the children’s lives will be so negatively impacted that it’s better to pretend that life is continuing as it always has.
However, try as you might to hide your diagnosis, children can pick up on the pulse and tone of daily life in your family - and that includes the stress or anxiety you may be feeling about having cancer.
For example, your child may notice that their grandmother is visiting more often than usual, they are spending more time in childcare, or you are too tired to play the way you used to. When young children detect nuances within the home but are not informed about why things have changed - no matter how subtle the changes may seem - they quickly come to their own conclusions (which may be worse than the reality).
So even though you try to minimize their exposure to difficult emotions, children generally know that something is wrong.
They Need to Hear It From You
Children are great listeners, and often they overhear friends or family members talking in hushed tones about a parent’s illness. Or sometimes, well-meaning family members may talk to your child about your diagnosis before you’ve had a chance to clarify the situation. Talking to your children can avoid the possibility that they will learn about your diagnosis and treatment from someone else, which could impact your relationship with your child, and may lead to loss of trust.
A conversation like this is never easy. However, when children are provided with age-appropriate information about the disease, an understanding of how your treatment will impact their lives, and the ability to ask questions, they gain awareness of the healthy ways that families come together to support one another during difficult times.
Adult children, too, need to be considered. They may want to be involved in helping to support you through your treatment. Your kids will want to care for you. They will want to express their worry, as well as their love and care. Not telling your children about your cancer prevents them from acting on their concern for you and your health.
When your friends and family understand your diagnosis, your treatment options, and what cancer will mean for you, they will be better prepared to comprehend what it will mean for them as well. By talking about your cancer, you may be able to avoid adverse emotional outcomes and gain the family support you need.
How to Start the Conversation
Deciding when to have this discussion with your children is almost as important as what you say. In general, you may want to avoid times when your child is tired, stressed or hungry, or when you may be interrupted. If your family includes children of various developmental stages, you may want to tell the older children first, then allow them to take part in the conversation you have with younger children.
As you prepare for your conversation, keep the age of your child(ren) in mind. Because children – even children in the same family – develop at their own pace, determine in advance how to approach this discussion. Very young children (ages 3 to 6 years old) may be satisfied with generalizations, but older children may want specifics and an outline for a plan.
Along with thinking about your child’s age and developmental stage, you’ll also want to consider your child’s temperament. While some children’s anxiety is eased by your state of calm, others may need additional information and/or frequent check-ins. Even siblings can respond differently to the same information.
Tailor your conversation to the needs of your child. Some children will be reassured by more physical contact with you; others may need to have activities to help them process the information. Let your children know that any feeling they experience is okay, and that they can come to you with any questions they may have.
In this way, you can provide a positive forum for your children to develop their own set of emotions around your diagnosis, while letting them know they are a part of a family that works together to manage difficult problems and situations.
If you can only focus on the basics, the following three points are most important for children to understand:
- First, let your children know that cancer is not their fault. It’s not anyone’s fault; it just happens. It’s common for young children (ages 4 to 12 years old) to engage in “magical thinking,” therefore believing that they somehow caused the cancer to happen. Reminding them that cancer is no one’s fault can help them come to understand this.
- Cancer is not contagious. It’s not like a virus, the flu or a cold.
- And finally, let your family know that it's safe to ask any questions about your diagnosis.
Explain what your diagnosis might mean in your family’s daily life. For example, while you may be actively involved in your child’s favorite activities, you might not be able to have the same level of involvement during treatment. Clarify that you always want to be with your child to support the activities they love, but that you will need to do so now in a different, quieter way. Perhaps rather than coaching your child's soccer team, you observe and take stats.
Explain to younger children that the cells in your body are doing things that may make you more tired than usual so you won’t be able to play outside right now. So instead of rough housing, maybe you can read a book or watch a favorite movie. Children will appreciate knowing how your cancer treatment will affect them. And you can reassure your children – and yourself – that your cancer diagnosis doesn’t mean sacrificing quality time together.
Finally, if you have adult children, allow them to be a part of your journey by helping you. For example, your adult children can provide transportation, grocery shopping, meals or quiet, supportive conversation.
Your cancer diagnosis might be a shock that feels uniquely yours alone, but it also affects your family and friends, and that includes your children. When you are aware of your cancer diagnosis but your children aren't, you might be leaving them in the dark about a life-altering event. The one factor to remember when talking to your family about your illness is to keep the lines of communication open.
One sure way to reduce the stress of your circumstances, your children’s fear of the unknown, and anxiety about your diagnosis is to provide an age-appropriate explanation for your cancer, and look for ways your children can actively support you. For more information about this topic, check with the American Cancer Society or the Cancer Support Community. Both of these organizations offer online publications on helping children when a parent has cancer.
In addition, your oncology social worker is a great resource for these and other difficult situations that arise when undergoing treatment for cancer.