Helping children understand cancer
Eight-year-old Megan imagined all sorts of horrible things about the place her mother was going for cancer treatments. It was scary enough when her mom first told her that she was sick and needed to go to the hospital to get better. But Megan did not understand why her mom often came home even more sick than when she left. Both of her parents seemed so sad and tired all the time, and she was too afraid to ask what was going on or whether her mom was going to ever get better again.
Nearly 3 million children in the United States live with a parent who is a cancer survivor or is currently undergoing treatment for cancer. According to a recent study published in the journal Cancer, an estimated 14% of cancer patients are parents to a minor child.1 Nearly one-third of these patients are caring for a child who is younger than 6 years. For many children, dealing with a parent's cancer evokes fear and anxiety that can have an adverse effect on their emotional development and personal relationships throughout their lives.
Parents often worry about how and when to tell their kids about their cancer. They want to know the best way to tell their children the news, how much information they should reveal or withhold, and how to help their children cope. Talking to children about cancer is never easy, but clear communication helps families affected by cancer better handle the changes that lie ahead.
The best time to talk to children is soon after the diagnosis. When children know they are being kept informed, the experience is less frightening and helps build trust. Even from an early age, children can sense when something is wrong. Hiding information may lead them to invent explanations that are more frightening than the reality. Or worse, they may blame themselves as the cause of the problem. While parents naturally want to shield their children from their cancer, withholding the truth can do more harm than good.
Taking into consideration a child's age and previous experience with serious illness, parents should be as honest, accurate, and specific as possible about their cancer. Using age-appropriate language (words that are common and familiar) will give children an easier understanding of what to expect. Simple and concrete terms, such as saying the word "cancer" or describing where the cancer is located on the body can help young children understand what is happening.
Younger children, especially, may need to be reassured that they did not do anything to cause the cancer. Giving them age-appropriate tasks such as bringing a glass of water or an extra blanket can help them feel that they are doing something meaningful for their parent's care. Provide older children with an opportunity to visit the treatment center. After Megan visited the cancer center where her mother received treatment and met with members of the health care team, she no longer felt afraid of her mother's treatments.
Parents may find it helpful to write down what they want to say beforehand and practice saying it aloud until they feel comfortable. Having a spouse or other support person in the room can also make the conversation easier.
Regardless of age, all children need comfort when coping with a parent's cancer diagnosis. The tone of the conversation is as important as what is said. A calm and reassuring voice helps children better cope. Let them know that they will always be cared for, even if a parent cannot provide care directly at the time. Children may experience a wide range of emotions such as fear, confusion, anger, or guilt. Ask them about their feelings, even those that are uncomfortable.
Encourage patients to build a support network beyond their immediate family that includes extended family members, close friends, or school teachers. You can also help patients by directing them to organizations such as CancerCare, which provides free counseling and support group services for parents and children by professional oncology social workers. The American Cancer Society (www.cancer.org) and the National Cancer Institute (www.cancer.gov) also provide excellent information for helping children affected by cancer. Kids Konnected (www.kidskonnected.org) offers free, face-to-face support groups for children affected by cancer in many locations across the United States. Another free program, Group Loop (www.grouploop.org), is an online support community specifically for teenagers who are affected by cancer.
A cancer diagnosis affects the entire family, and so the care of a patient should include support for all the members of a family, especially when young children are involved. The long-term ramifications of a parent's cancer diagnosis can be profound and are still being studied by researchers. By promoting open and honest communication, you can play a critical role in helping children and their parents cope with a cancer diagnosis. ONA
Helen Miller is CEO of CancerCare.
1. Weaver KE, Rowland JH, Alfano CM, McNeel TS. Parental cancer and the family: A population-based estimate of the number of US cancer survivors residing with their minor children. Cancer. 2010;116(18):4395-4401.