A difficult part of a cancer experience is trying to help your child understand what’s happening. Children of different ages understand cancer in their own way. They’ll have their own questions, reactions and ways of coping.
Talking to children about cancer is important because they can sense when things aren’t normal, when people close to them are sad or worried, or when there’s a change in routine. When children don’t have enough information, they may imagine things are worse than they really are. Children cope better with difficult situations when they know what’s happening.
Whether you’re going through cancer yourself or someone close to your child is, we’re here to support you with different ways to have honest and caring conversations.
How can I prepare to talk to my child about cancer?
You can prepare for this conversation in advance by thinking about what you want to say and writing it down. Simple, direct words are best. Stick to basic information such as the name of the cancer, the part of the body it affects, treatment and potential side effects.
You can ask for help. You can speak to the healthcare team, who might have some useful books, videos or websites to recommend, or they can refer you to someone who can help. You can also find support groups or other resources in your community. You can find people to talk to in our online support community, CancerConnection, or support services near you with our Community Services Locator. You might choose to refer to helpful cancer information on cancer.ca.
Choose a time when you’re calm and when you and your child can talk for as long as you need to. A quiet place can help you both feel comfortable showing your feelings. Keep in in mind that your child might not react how you think they will. Be patient and let them know they are allowed to feel however they feel.
How can I help toddlers or babies (3 years old and younger) cope?
Children under 3 years old live in the present, physical world. Because they’re sensitive to the world around them, they might sense that something is wrong. Some children might understand that someone is sick and isn’t themselves, but children this age are too young to understand cancer as a disease. They can pick up on changes to routines, as well as changes to the emotions and behaviours of the people close to them.
When talking about cancer to a child 3 years old or younger, do your best to answer any questions without going into too much detail. Your conversation might include, “The doctor told Daddy that he’s sick. That’s why he’s tired and needs to rest,” or “I need to go to the hospital to take medicine to help me get better.”
Your child might ask questions about why their loved one is away so often, about changes to their loved one’s appearance or the medicines they’re taking. This can be an opportunity to help them understand what’s going on while also understanding how it makes them feel.
Very young children need a sense of safety and security, so it’s important to maintain their schedules as much as you can. If possible, ask people in your support system to take your child to their regular activities and keep their schedules as normal as they can be. If your child is old enough, it can help to tell them in advance how things might change so they can prepare for any changes to their routines. If you are sick or cannot be with them as much as usual, let them know who will be taking care of them while you’re away.
Overall, it’s important to surround very young children with as much love and support as possible. Ask family, friends, daycare providers or other people in your support network for help during this time. Consistency and security are the best ways to help your baby or toddler cope with changes.
How do I talk to young children (4-6 years old)?
Children 4-6 years old may have heard the word ‘cancer’ before. Using real words when explaining the disease can help your child make sense of what’s happening. Young children can understand clear, straightforward facts but may get confused by too much information or details. Being direct and honest in your explanation also reduces the chance of them misunderstanding something and becoming confused.
Some ways to start a conversation with a 4 to 6 year old child could be, “Have you ever heard about cancer before? What do you think it is?” or “I have cancer. That means something is wrong in my body and it’s making me sick.”
It’s common for children in this age group to ask lots of questions to make sense of the world. When talking to them about cancer, it’s important to take time to listen to their questions and concerns. Find out what they understand about cancer and what is happening to the person they love. This can help you correct any misunderstandings and ease some of their anxiety.
Because their vocabulary isn’t fully developed yet, young children use emotion-based communication and will mostly show you how they feel through their attitudes and behaviours. Generally, this age group can understand that cancer can make someone very sick, but usually see it as a temporary situation. They have trouble understanding that cancer can be life-threatening.
When children learn that someone they love has cancer, they usually react more to how it affects them than to the disease itself. They might be angry or sad because they can’t be with their loved one as often as usual, or they might be upset about changes to their routines. Talking to them about their emotions teaches them to how recognize their needs and respect other people’s feelings.
To help your young child cope, reassure them that they will be cared for. Whenever possible, let them know if their schedules will change, who will be looking after them if you have to be away, and do your best to make them feel safe and secure.
How do I talk to preteens (7-12 years old)?
Preteens can understand some things about cancer, such as the different types and the body parts they can affect. For the most part, preteens understand cancer based on the symptoms they can see.
Some ways to start a conversation about cancer with a preteen could be, “What do you know about cancer? Do you know there are different types of cancer?” or “Although some people die from cancer, the type that Mom has can be treated. Her doctors believe that she should get better.”
At this stage, children 7 to 12 years old think of cancer as a puzzle to solve. They will most likely ask many questions to understand the whole process of the disease. They will try to find connections between the cancer and the symptoms they can see. Some questions they ask you might be difficult for you to answer – but not impossible. Be honest and direct to keep them informed. If you can’t answer a question right away, let them know that you’ll have an answer for them later.
The best way to help preteens cope is for them to know that they can come to you to talk and ask questions. Do your best to be an active listener and encourage them to develop an open dialogue with you. This can help them avoid withdrawing because they feel misunderstood or unheard. It’s also better for them to find out what’s going on from you rather than learning about it from somewhere else. Like younger children, they might also use their imagination to fill in the blanks and think that things are worse than they are.
Preteens can have a hard time expressing and dealing with everything they feel. They can express their anxiety and fear in different ways – they might have trouble concentrating, lose self-confidence, become dependent on you or withdraw from their loved ones. Try to create a large network of care around your child. Reach out to their teachers, friends’ parents and other community members, and let them know that your child might need extra support and attention.
How do I talk to teenagers (13 years and older)?
Teenagers know enough about the body to understand more detailed information about cancer, treatment and side effects. When you talk to a teenager about cancer, it’s important to accurately name and explain the disease.
Some ways to talk to a teenager about cancer might be, “I have been diagnosed with cancer, but it’s at an early stage. The doctor says that the treatments should help me get better,” or “To have the best chances of recovery, Dad needs to have chemotherapy and radiation therapy. When these treatments are finished, he’ll have more tests to see if they got rid of the cancer.”
Teenagers will have many questions and will likely do their own research to get answers. Make sure to check in about what they’ve learned because not all information online is accurate or applies to their loved one.
Teenagers are going through strong hormonal and emotional changes. Because of this, younger teens might act out because they find it difficult to express their thoughts and feelings. They might take their frustrations out on the people closest to them or even regress and act younger than they are. Older teens may become more independent and want to be treated like an adult. They might hide their emotions to protect you. They could also attempt to remove themselves emotionally from the situation or take part in risky behaviours as a way of acting out.
To help your teen cope, reassure them that you love them and are willing to talk about what’s on their mind. Let them know it’s normal to feel depressed, angry or anxious in this situation. Encourage them to be honest with you and express what they’re feeling. Watch for changes in their behaviour and reach out to the healthcare team or a mental health professional if you or your child need help coping. Be patient and see them for who they are rather than their behaviours, mistakes or mood swings. It’s also healthy for them to keep up with their lives, activities and support systems outside of home.
Encourage your teen to share their ideas, join discussions and help in decision-making where appropriate. Being included can help them cope with feelings of anxiety and helplessness. You will also make them feel recognized, trusted and reassured. You can also trust your teen to take on some responsibilities and help take care of the people they love. You could encourage them to help with making meals, doing laundry or cleaning.
However, it’s also important for your teen to understand that having responsibilities doesn’t mean being responsible. Be careful not to make them feel that their loved one’s well-being depends on what they do or don’t do. For example, their loved one’s recovery doesn’t depend on your child doing chores or helping with certain tasks.
How can I build trust?
When talking to your child about cancer, using active and receptive dialogue can help keep communication open and supportive. Active dialogue means trying to start a conversation with your child. This can mean saying something like, “Let’s talk about it.” This can help you learn about their feelings, including the ones they might not be able to name. Active dialogue can also help your child put confusing ideas into words and communicate their needs. Active dialogue is helpful when you first talk to your child about cancer. It’s also helpful as you give them updates throughout treatment.
Receptive dialogue means being open and giving your child a safe space to discover, explore and express their feelings. Tell them, “I’m listening. I hear you.” It’s important to let your child open up at their own pace. This will help them understand and manage all of their emotions, including the uncomfortable ones.
Not every conversation has to be about cancer. It’s important to let kids be kids. Allow them to express themselves in different ways. Encourage them to write stories, draw and explore other ways to express their feelings, ease tension, think about and share ideas they have trouble putting into words.
How do I talk about death with my child?
It’s not unusual for a child to ask if their loved one with cancer is going to die. You might consider the prognosis, if the person with cancer is likely to die in the future or if your child will understand what it means to die.
Talking about death with your child is not an easy conversation, but there are ways that you can prepare for it. You might want to prepare yourself by understanding your own feelings and thoughts about death, and think about the values and beliefs you want to share with your child. This can help your conversations be more open and natural.
The most important thing for this conversation is honesty. This helps build trust and safety in children. By talking to them about this topic openly, you’re helping them make sense of something frightening and hard to understand. Give them time to process information and ask more questions. You can use their questions as a way of understanding their concerns and how to help them cope with anxiety.
Being direct is also very helpful. Research shows that using words like ‘death,’ ‘dying’ and ‘dead’ give children a better understanding of what happens. Saying phrases like ‘passed away’ or ‘gone to sleep’ might confuse children and create even more fear.
What other changes might I need to prepare for?
Behavioural changes in children are common during difficult situations. There is no right or wrong way for a child to react when they find out someone they love has cancer. This might look like anger or aggressiveness, trouble concentrating in school, having trouble sleeping or withdrawing from close relationships. Those behaviours might come from a fear of being abandoned, of their loved one dying or anxiety about changing routines. Understanding what’s causing their behavioural changes can help you figure out how to help them cope. Getting a mental health professional involved can also be helpful.
A big change to prepare for are hospital visits. This can be scary for young children but talking to the healthcare team before bringing your child for a visit can be helpful. This will help you figure out when the person with cancer will have the most energy or if there are any medical procedures scheduled. You should also consider how your child’s visit will make the person with cancer feel.
Let your child know what to expect before the visit. Their loved one might look different or might not seem like themselves depending on the stage of cancer. If your child doesn’t want to go, do your best to respect their feelings but gently explain that their visit can help their loved one feel better. At the hospital, your child might feel better if they feel like they’re being helpful. You can have them bring a glass of water or ice chips, fluff pillows or arrange blankets, talk to their loved one or hold their hand. This can help your child feel closer to them.
We can help
If you need to have a difficult conversation with your child about cancer, you’re not alone.
The healthcare team can answer difficult questions and give you ideas on how you might talk with your child about cancer. They can also suggest or put you in touch with professionals in your area who can help, such as social workers, psychologists or therapists. Books are also a great resource to help your child understand their emotions and life changes. Talk to a patient educator at the cancer centre or speak to a librarian.
You can call our Cancer Information Helpline for any cancer-related questions or information about emotional support services. Our online cancer support community, CancerConnection, is a great place to talk to people who have been through similar situations. If you’re looking for support services in your area, our Community Services Locator can help you find what you’re looking for. To learn more about cancer information, visit cancer.ca.