How to talk to children about cancer

Our colleagues at Dana-Farber/Children’s Hospital Cancer Center (DF/CHCC) recently shared this very helpful blog post on how to talk to young children with cancer about their illness. After reading it I wanted to share with Thriving readers, as many of the suggestions apply to a number of pediatric illnesses. For more information on pediatric cancer and its treatment, please visit DF/CHCC’s blog, Insight.

Helping a loved one face cancer is never easy, but the challenge is especially daunting when the patient is your own child. The clinicians at DF/CHCC work with pediatric cancer patients and their families every day. Lisa Diller, MD, Anna Muriel, MD, and Jorge Fernandez, LCSW – offer these tips for talking with your children about their illness.           

1. Include them in the discussion. For many parents, the natural instinct is to not give their child information about their diagnosis to avoid scaring them. But children can view this protection as exclusion, a feeling that they are not important enough to include in the discussion. It’s also anxiety-provoking in that it creates uncertainties and fears that the situation may be worse than it really is.

2. Find a good time and place. Figure out the best time to talk to your child; maybe in bed, or in the car, or even while doing something fun or active. Whatever feels most comfortable to them. We have resources that can help in the discussion.

Lisa Diller, MD

3. Be age-appropriate. The youngest kids, for whom cancer has no real meaning, need to realize that they are ill and that they can trust the doctors to make them better. Elementary-age kids need to understand their own specific situation, and what needs to be done, rather than just a global picture of cancer. Teenagers need to feel they have a say in decision-making about their treatment, and need to have the opportunity to talk to medical caregivers alone.

4.  Dispel the myths. For many young children, their only experience with cancer might be grandparents or older people in the movies who died. For kids, cancer is generally not a fatal disease; the most common childhood leukemia has a 90 percent cure rate. It’s important they understand that they most likely will be cured.

5. Follow their lead. A child can feel overwhelmed by too much information, so go at a pace that makes them comfortable. Some kids are more focused on what’s going to happen to their family, and less on their own diagnosis. Listen and figure out what they want to talk about.

6. Use “real” words. No matter how young a child, words like “leukemia,” or “osteosarcoma” can be less confusing than “bump” and “boo-boo.” You want to be as honest as possible, so that when they overhear information – and invariably they will – it will be consistent with what you’ve told them.

7. Don’t avoid talking about fears. Parents do worry sometimes that their child is going to just give up and crumble. You don’t want children to feel left alone with their worries, so whatever the capacity is for conversation or communication, have it so that your child can talk about their fears.

Anna Muriel, MD

8. Provide a safe environment to answer – and ask — questions. Sometimes parents get worried that the kid is going to stump them. If you don’t know the answer, be ready with simple replies like, “That’s a really good question. Let’s make sure we ask the nurse or doctor the next time we go to the clinic.”

9. Include siblings. Even if the focus for now is on the child with cancer, you want your other kids to continue feeling important. Take time to spend just with them, doing something they enjoy. Include them in discussions about cancer, especially about things that will affect their everyday lives. And if they have questions about their sick sibling, answer them honestly.