Many parents tell us that when they are diagnosed with cancer, they're most
concerned about how the disease and its treatment will affect their
families. Often their top priority is to limit both the short- and
long-term effects of their illness on their children.
When you first get your diagnosis, you may worry about how to let your
children know that you have cancer. While you have taught your kids
about many other important things, talking to them about your illness
probably takes you off guard.
It's common for parents to feel a little lost about whether, how, and when to
share this information with their children. We'd like to share what
other families found helpful as they faced the challenges of a cancer
diagnosis, and to describe what health care professionals think are the
most important aspects of these early conversations.
Remember: There are no absolute right or wrongs. Like most of parenting, the
actual words you use are not as important as letting your children know
that you are there for them, and that they can bring their questions and
fears to you. You may even find that as you talk about your illness,
you and your children develop a closer connection that strengthens your
discussions about other issues.
Each family finds its own unique way to adjust. You will find yours.
Families communicate in many different ways. Some parents know
immediately that they will tell their kids about their diagnosis at
the earliest opportunity. Others know they will eventually discuss
the diagnosis with their children, but may delay until they have
more information about the cancer and its treatment, or until the
children are a bit older. Still others worry that they are
burdening their kids by including them in
Prepare yourself by thinking about what you hope to convey to
your children through your words and actions. It's perfectly
understandable if you find this difficult. Talking to your children
about your cancer may be one of the hardest things you've ever had
to do. However, when parents give their children a chance to share their worries, they often
feel a sense of relief and are able to move forward as a family in
dealing with their situation.
You may want to share your ideas and feelings about telling your
children ahead of time with your partner, someone from your health
care team or faith community, a friend, therapist, or social
worker. You may find it helpful to write down your most
important points so you're able to to pay attention to your kids and
Talk as naturally as possible, and invite your children to ask questions early on. You
could encourage them to tell you what they already know, what they
would like to know, and how they think your illness will affect
them and the family. Remind them that it's okay to ask you
questions, and that you'll do your best to answer. As a result, you
show them it is possible to talk together about hard
Anticipate how you might respond to your children as you talk
together. It's okay to be emotional; this is tough stuff. You may
find that when you do include them in your situation, your kids
feel closer to you and have a better understanding of their own
thoughts and feelings.
When that happens, it may be better to either delay telling your
kids until you feel somewhat stronger or to ask for help. You may
need a chance to talk further about your own concerns first as a
way to feel more ready to share with them. You can ask your
partner to help out, or invite someone else to join you for this
discussion. You might even consider asking this second person to lead the conversation.
This doesn't mean you have to be unemotional when you talk with
your children about your illness. It's fine to let them see that
you have feelings, or even to cry together. The key is for you to
stay focused on their concerns and questions as you talk.
Consider also the possibility that your kids can tolerate, and maybe
even benefit from knowing that you, too, are
willing to share your emotions. For example, you might say, "This is all new
to me, too, and I feel worried and sad right now. But we will get
through this together, and I will feel better sometime soon."
When you include your kids in
your family's experience of your illness rather than "protect" them
from feeling upset or sad, you give them permission to have and
share their own responses. You can let them know that their
feelings may change over time, just as yours will.
Do you and your partner both want to be there? If that's not
practical, can you communicate your partner's support and point
of view? Is there another adult you
want to include? Who would you like to begin and lead the
discussion? Is it appropriate to talk to your children when they
are all together or individually (knowing
that depending on ages, siblings often share with each other)?
Ideally, plan your conversation so that you can spend as much
time as needed to answer your kids' questions and to comfort them if they are upset. Try not to begin
this important discussion when you are tired, pressed for time, or
feeling especially ill or discouraged.
Likewise, start this
conversation when your children are well rested and free of other
commitments. But don't be surprised or upset if many of these
conversations are quite short. If your children show signs that
they have had enough, bring your conversation to a close and return
to it later.
To a large extent, what you say and how you say it will depend
on your kids' ages and capabilities. If your family
includes children of different ages, you may decide to talk to them
individually or in pairs rather than as a group. In this way, you
can tailor what you say to their ability to understand it.
Children this young do not need a lot of details. They are very
concrete and will tend to focus on the cancer symptoms or side
effects that they can see, such as hair loss, rather than on what
is happening invisibly inside your body. Use a doll, stuffed
animal, or picture to show your children where the cancer is
located in your body. Make it clear that cancer is not contagious,
and that your kids cannot "catch" it from you.
Ask your children if they have questions about what will happen now that you have cancer. Answer only what they ask. Use
simple, direct words. Attention spans at this age are short, so
keep conversations brief, and be prepared to come back to the
discussion at another time.
You may end up using a variety of approaches with children in
this group. With younger kids, you may need to keep the discussion
brief, and use a stuffed animal, a doll, or a picture to help your
children understand, just as you would with preschoolers. Be
prepared for your children to go off and play as though
they are unaffected by your news: kids of this age may react later,
or may show their response through behavior (being angry
or quieter than usual) rather than words.
Older elementary school children may be familiar with the basics
of the human body, so use their knowledge as a starting point for
your conversation. For instance, if your children have already
studied cells, you might explain that cancer cells do not behave
the same way as normal cells. Provide more details, such as the
name of the cancer and the basics of your treatment plan.
Emphasize that cancer is not contagious and they did not
do anything to cause your cancer. Kids of all ages,
including teens, can worry about this, so offer lots of
Teenage children have heard a lot more about
disease and cancer than their younger siblings. As a result, they
may be quite worried, but afraid to upset you, or themselves, by
asking questions. Take your cue from
them whenever possible, and share as much information as they seem
to want and are ready to handle. And while they may appear in
control as you talk together, be prepared for some emotional
response, either as your discussion continues, or at some later
time. Your teen's reactions may, in turn, trigger your own
feelings, which may be tough on both of you. But try not to back
away: in the long run, everyone will benefit if you can develop
enough trust to share painful thoughts and feelings without
worrying about being judged or questioned.
In this way, you, not your neighbors or your children's
friends, determine what your kids will know about your illness. You
will also prevent their finding out by overhearing a
conversation or being consoled by a concerned adult who doesn't realize you haven't mentioned your diagnosis.
Let your children know if you have confided in others and what
you have told them. By sharing this with your children, you help
them realize that they don't have to face your illness alone, and
may encourage them to talk about their concerns with trusted
friends and relatives.
See What children want to know for more suggestions.
Most parents dread this question, often because they are afraid
of how they and their kids will react to the discussion. In
addition, parents frequently don't know what to say. Consider
saying something like, "People do sometimes die from cancer, but
lots of people don't. I am not dying. I am going to take strong
medicine and/or have surgery to get rid of my cancer. I will be
checked often by the doctors."
Also, whenever possible, share positive information. Depending
on your circumstances, you might say, "There are lots of new
treatments for cancer," "The doctors have given me some very strong
medicine that they think will help get rid of the cancer, and they
think that I have a very good chance of recovering," "I am doing
everything I can to make sure I get better," or "They caught my
cancer early, before it had a chance to do much damage."
Ask your children what they have heard about cancer or
if they know someone whose family member has had cancer. Children
can assume that cancer is all the same illness. You can share that
there are many types of cancer and treatment, and how someone is
affected can be different for each person, even when patients have
the same type of cancer.
See Questions parents often ask for more suggestions
on how to answer "Are you going to die?" Also remember that you will
have the chance to revisit this conversation many times, and that
you will be able to repeat complicated information and correct your
children's misunderstandings. You don't have to cover
everything in one discussion.
Over time, your children will hear you and absorb the important
information, but they may not be able to do this right away. Many
children initially express their reactions through their behavior
rather than through words, so you may learn more about what they
are thinking and how they are feeling by observing changes in their
play, mood, or friendships. For instance, your daughter who says
little during your initial conversation may have trouble sleeping
over the next several nights, or you son may walk away wondering
who is going to drive him to Little League now that you're
Be patient, try to accept your kids' reactions, and don't worry
unless these reactions persist over time.
"Stress warning signs in children" offers more information on
figuring out when your child may be really struggling with the news
of your diagnosis, and if he or she may need some additional
There is no "perfect" way to have this conversation. You may
burst into tears before saying a word, or snap at your partner for
telling your kids to "behave," or cringe when your son makes light
of the whole conversation. Forgive quickly. This is a tough time
Your children may not have much to say during your first
conversation with them. Try to encourage them to ask you questions
or tell you their worries, but don't worry if you and your partner
do most of the talking. You and your sons and daughters may
frequently revisit how and why people get cancer, what side effects
mean (and don't mean), and how your illness will affect your and
their lives. The important thing is that by including your kids in
these discussions, you let them know you are open to hearing their
questions and answering them honestly.
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