For parents of kids with cancer, one of the biggest challenges is telling and talking to their child about the diagnosis. These are important conversations to have, though. If they’re not told, younger children will make up their own explanations. They will often blame themselves for their condition. Older children, meanwhile, can understand what’s happening for them, so keeping information from them is difficult, if not impossible. In both cases, children who understand their condition and treatment are more cooperative with care and less stressed.
Exactly how to tell a child told about a cancer diagnosis should be left to the parents, who know their child the best. This can be a very difficult conversation, so parents can ask someone on the care team to help.
Before having this conversation, plan out what you’re going to say and how you’re going to say it. Think about the questions your child might ask and be ready with answers. Common questions children ask include:
- Why me?
- Will I get well?
- What will happen to me?
Talking on their level
When having these conversations, use age-appropriate language that is clear and direct. Explain meaning of words that the child might not understand, and don’t avoid the word cancer. Children will hear others use it. If you don’t, it might confuse them.
How exactly you talk to your child will depend on his or her age. Younger children have shorter attention spans, so be ready to have frequent, brief conversations about their diagnosis with them. Encourage them to ask questions as they think of them.
Other age-specific advice includes:
Up to age 2
Children at this age don’t understand cancer. They only understand what they can see and touch. Most of the time, they’re worried about what’s happening at that particular moment. They’re scared of being away from their parents in an unfamiliar place. Let them know that you’ll be with them the whole time and that they’re not going to be left alone at the hospital.
Because so much is out of their control and just not understood during treatment, young children can feel powerless during treatment. Give them a sense of control by letting them make small choices whenever possible (e.g. “Do you want to color or play a game?” or “Do you want milk or juice?”).
Older children in this group can understand simple things like visiting the doctor or getting a shot. For these children, be honest with about medical tests and treatments, using simple language that’s easy to grasp. Say it’s ok to cry or to be scared and that they can turn to you for comfort.
Ages 2 to 7
Younger children can understand some basic explanations about cancer. You can tell them that some bad cells in their body that are making them sick, and that treatment is supposed to help get rid of the bad cells and help them get better. Be honest about treatments, acknowledging that it may hurt, but that you’ll be there to help them. Don’t let them fill in the blanks about what is happening and why. At this age, children will make up their own explanations for their illness, and will often blame themselves.
Ages 7 to 12
During these years, children can understand more complicated explanation about their illness, including what may have caused it and how certain treatments work. They can also understand the value of treatment, though they’re still afraid of the pain and discomfort it might cause. Explain to them more directly what’s happening, using age-appropriate language.
At this age, children can pick up news about cancer from television or school. Ask them if they have any questions about their condition, or if they’ve heard anything they want to talk about.
Teenagers are able to understand complex explanations of their condition, and may have complex questions. They understand the connection between treatment and health and may want to have a say in treatment decisions.
They tend to think about their disease in terms of how it will impact their life, such as their friendships, activities, schooling, etc. They may also be concerned about side effects, like hair loss. Talk honestly with them about what they can expect.
MD Anderson has several programs designed to help young people during their cancer treatment. Visit Children’s Cancer Hospital’s Support Programs for more information.
Three years ago, at age 17, I was diagnosed with melanoma. As I learned, cancer is tough, especially for teens, who often think they are immune to it.
For teens, a cancer diagnosis isn’t expected at all. Most teens think that they aren’t susceptible to any type of cancer. As parents and adults, the best thing we can do is educate young people about the dangers of cancer, and how every little thing -- sunburns, not using sunscreen, not taking care of yourself -- can affect you, now or later.
When dealing with a teen who has cancer, here are a few things to keep in mind.
Teens are scared
First of all, even though they may not show it, they are scared.
Teens don’t spend their time researching cancer and other diseases, so fear of the unknown is great. A lot of times, teens will try to act like adults and be strong after finding out they have cancer, but the news can often be too much for the teen mind to comprehend.
Let teens come to you at their own pace
Teens also don’t really like asking for help. When I had cancer, I constantly had to ask for help -- help carrying my heavy bags, help cleaning my bandages and help driving to appointments. Teens want to do it all, so having to rely a lot on others during cancer treatment and surgeries is a definite lifestyle change.
It’s important to be supportive and available, but let the teen come to you at his or her own pace.
Respect communication wishes
Often, many teens will not want to talk about their cancer with people they know. Cancer can seem like a “weakness,” and teens want to feel invincible and youthful.
It took me three years before I felt completely comfortable sharing my story with anyone except those who are very close to me. As a parent or guardian, keep this in mind. Your teen may not want everyone in the world knowing that they have cancer, so be respectful of that. Cancer is a hard enough thing to deal with as a young person without the constant questions and comments that others will have.
Support makes a difference
Cancer is scary, especially for people who think they have many years to go before they have to think about it. Make sure you’re available for the teen in your life. She's not a teenager with cancer, she's just a teenager. Cancer doesn’t define anyone, and getting it at a young age should do nothing to deter a person’s feelings about herself or what she can accomplish.
As an adult, encourage the teens around you to go to their dermatologists regularly for skin checks. It might be hard to fit into a teen’s busy schedule, but it is absolutely worth it.