For Parents: What Children Want to Know When a Parent Has Cancer

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What, how, and when you tell your children about your cancer will depend on their ages and maturity, as well as your preferences and style. Certain facts about your illness will be important to share with all your children, regardless of their ages.

Use your judgment as to how and when you bring up these points. You might find it easier to take on one or two items at a time, and come back to the discussion later. Try to remember that you don't have to discuss everything at once, and that you will likely return to these conversations from time to time. As usual, try to follow your children's lead in this and other discussions. They'll usually let you know when they've had enough or need further detail.

Cancer isn't contagious, and your children can't catch it from you.

Most children, especially younger ones, worry about this, and may even avoid being near you. After all, many of the sicknesses they know about, such as colds and chicken pox, can be passed from one person to another. But cancer cannot. This is one thing you can tell your family for certain.

However, your children may have heard that certain cancers have a tendency to "run in the family." If they ask about this, or if you have questions or concerns of your own, discuss them with your treatment team. Your doctors and other health care professionals are in the best position to talk to you about the risk that your children will develop cancer in the future, and to help you figure out how to respond to this type of question.

You didn't get cancer because of something bad you did.

You might begin by asking your children how they think cancer gets started. Children often believe that people get sick as a punishment. Or your children may worry that the stress of being a parent caused you to develop cancer. You can reassure them that there is no evidence that stress or bad behavior causes cancer.

Explain that cancer can happen to anyone, whether they have been good or bad, relaxed or stressed out. The disease happens because something goes wrong in the body, not because the person misbehaved or said something hurtful. While certain activities, such as smoking or spending lots of time in the sun, can increase the risk of getting cancer over a long period of time, this is very different from being punished for yelling or acting badly.

Cancer can't be caused by your child's behavior.

While children under eight years old are more likely to believe that they could have caused your illness, children of all ages may occasionally worry that they did something to bring on your cancer.

Even if they never mention this, consider reassuring them that they had nothing to do with the cancer. You might say, for example, "This is not your fault. Cancer is a complicated disease, and it usually happens because of things that we cannot control." Add that your children can't cause cancer in other people by having angry thoughts or feelings toward them

Cancer does not have to be kept a secret: There are many times when it is okay to talk about cancer with others.

Some children are not sure what they should and shouldn't say about your cancer outside the home. Decide if you are comfortable having your children share this news with teachers, friends, coaches, neighbors, or other extended family members. Also, think about how much information you would like your children to share. Let them know they have your permission to talk to others if they choose. If they indicate that they would like to, help them identify people they might want to talk to, and what they might want to say.

You might also tell your children that you find it easier to deal with your cancer when you can share your worries with others.

If you have confided in friends or relatives, let your children know whom you have talked to, and what you have said. This may help your children realize that they don't have to face this or any other difficulty alone, and may make it easier for them to bring up the cancer with others outside the family. Your children also will be better prepared if someone mentions something to them about your health.

Many people live long lives with cancer.

We know a lot more about cancer and its treatment today than ever before. We also have much better ways to tell when someone has cancer, and start their treatment when the disease is just beginning. And scientists are coming up with new treatments all the time. As a result, more than eight million Americans are now living with a cancer diagnosis, often for many years.

Lots of children have parents who are living with cancer, or who have had cancer. Many people who have been diagnosed look and act just like everyone else, so your children may not even know that their friends have gone through this, too.

Be aware that some children will press you to admit that people do die of cancer, and will tell you about their worries that you might, too.

If your child responds in this way, assure him or her that you are not dying now, and that you hope to live a very long time. It is helpful to let them know that you will give them updates on how you are doing, and that you want them to ask questions and share their worries.

Of course, not all cancers are the same, and you should use your knowledge of your specific situation to respond honestly to your children's concerns.

Sometimes you may feel tired, ill, or sad, and you may not have your usual patience or energy.

It's completely normal and understandable if you're occasionally irritable or impatient with your family. However, your shifting feelings may confuse your children, who may worry that they have done something to cause your bad mood. If you find yourself becoming more easily annoyed, reassure family members that they have done nothing wrong, but that you are not feeling well or are stressed. Ask for their understanding, and tell them that you hope you will feel better soon.

Your children can be important sources of support to you.

Most people appreciate the chance to help out in times of trouble. Your children are no exception. They may feel powerless and frustrated that they cannot take away your cancer.

Offer them the opportunity to help by doing housework or fetching your medicine. Older children may be able to run errands for you or baby-sit younger siblings. Your children also can provide moral support by keeping you company, giving you hugs, and offering words of encouragement. Sometimes even the routine, everyday things that you usually do together are comforting (folding laundry, brushing the dog, watching a favorite TV program).

Be aware, however, that children will not always want or be able to be helpful and may sometimes even resent having to help.

Try to accept this common reaction, and let them know that you understand that the cancer is an extra burden for them, too.

A cancer diagnosis and its treatment may change the day-to-day lives of your children.

Many children will react to your illness based on how it affects their daily lives. While this may seem self-centered, it is entirely normal. From your children's point of view, you are there to take care of them and manage their lives. Cancer treatment disrupts this process and changes the family's routines, schedules and activities.

As a rule, children and adults usually don't like change. But cancer brings change in many forms. Your home may be filled with extra people helping out. You may not be as emotionally available to your children. You may not be able to give them a bath, drive them to soccer games, or help them with their homework.

Anticipate what changes you and your partner will have to make, and then consider sharing them with your children.

When possible, describe what will happen instead, and when you might be able to return to your usual routines. ("For the next four weeks, Jason's dad will drive you to and from your games. If everything goes well, then I may be able to take over again.") When children know what to expect, they often feel less resentful and worried.

Your children may be upset on occasion.

When given support and information, most children adapt well to a parent's having cancer. However, like you, they may at times feel sad, worried, or even mad about what is happening. So when your 4-year-old cuts the telephone cord because you are talking to your doctor instead of to her, or refuses to go to bed because she doesn't want to leave you, remind yourself that she cares about you and may be worried about your health. She also may be upset or mad because her regular routine is disrupted, or because she has less of your attention than normal.

Try to understand why your children may be upset or behaving badly, and let them know that you realize this is a challenging time for them, too. Find some time to provide extra comfort when you can.

At the same time, it is helpful to try to separate out what may be their emotional ups and downs related to your cancer and what is the disruption in their usual routines and rhythms of daily life.

Children find comfort in established routines and limits, so maintaining regular household rules and responsibilities can be helpful. It provides valuable structure to them when they see that as parents you are still in charge and will continue to manage the family needs.

For instance, when your son refuses to take out the garbage, think about what else has been going on lately. Did you mention to your son that you have not been feeling well lately? Did he have a fight with his best friend, or get cut from the varsity team?

If you ask your son what's wrong and he responds, stop whatever else you are doing and pay attention. Let him determine the pace and direction of the conversation. Your discussion puts you in a better position to decide what to do about the garbage. Maybe you will insist that your son complete his chores. Or this may be a time when you say instead, "Sometimes we all need a break. Forget about the garbage for now. It will still be there tomorrow and you can take care of it then."

But what if your son denies that anything is wrong, and refuses to talk with you? Use your best judgment and instincts to decide what to do. If your son consistently avoids chores and responsibilities, you might choose to discuss this with him directly. If this is your son's first offense, you might choose to let it go, perhaps with a comment such as, "Sometimes I don't feel like doing the things I need to do either. Don't worry about it this time."

Your children benefit from continuing regular daily activities and friendships.

Your children may worry about leaving the house to go to school or participate in sports or social activities. They may feel they should stay home to take care of you. Try to find ways to let them know that they are not responsible for you; that it is important that they continue to maintain their normal routines, and that you have lots of other people to lend a hand. You might also thank them for the many ways they already help out.

Remind your older children that they have their own lives and priorities. Reassure them that you don't want them to give up friends and activities they enjoy because you are ill. You might even explain that when your daughters and sons focus on their schoolwork, their activities, and their friends, they are giving you the best possible support: the reassurance that they are living their lives as normally and as happily as possible.