TALKING ABOUT CANCER WITH CHILDREN

When somebody is diagnosed of cancer, one of the first questions that comes is “How will I tell this to my kids?”. I’m going to try to give some guides on talking about cancer with children. I can’t tell there is an easy way to talk to children about cancer, because there isn’t any, but some guidelines may be helpful. You can tell them in a quiet moment and place, ensuring nobody is doing anything else, like watching TV, eating or doing homework.

First of all, it is important to tell them. There will be changes: new routines, new schedules, frequent hospital dates, possible changes in mother/father’s appearance, etc. Even it is understandable the wish to hide this information to children, to spare them to suffer, they will find it out anyways. So, if we tell them that nothing happens, what we will do is to increase his/her anxiety, and the kid will be able to imagine, or even make up, his/her own answers.

Then, the information should be truthful, and explained in a way that he/she can understand it, according to age and comprehension level: using an easy and known vocabulary. It is important to specify in which body part is the tumor located. You can also use metaphors, or compare the situation with stories from cartoons or movies he/she may know. Another important thing is to be somebody of his/her confidence the one who talks him/her about the disease: a parent, a grandparent, etc. This is not a thing supposed to be done by the doctor. 

After telling the news to children, they will make questions, and some of them can be difficult to answer. These are some of this possible questions, and the answers we can give them:

• “Why did this happen to you?” There is no reason. Sometimes people becomes ill, but doctors are there to help me.
• "Could it happen to me?” Some kids have cancer, but most of the people suffering it are adults. And every time more affected people get recovered.
• “And what will happen to me now?” There will be some changes (with examples), but we will try, all together, to make things the better.
• “Are you going to die?” I don’t know. But every time there is more recovered people, because medicines are improving. Close to the physicians we will try to make whatever we can for this not to happen.
• “Are you going to lose your hair?” [grown children associate cancer with hair loss and other side effects of cancer treatment]. It’s possible, but it doesn’t happen to everyone. And if it happens, we will buy a cap or a scarf, and I will be using it until my hair grows again.
• “Are you afraid?” Yes, a bit. But with the doctor and with all of you, it will be easier for me get over this fear.

There are more things we can tell them:

• That it’s important that all the family contributes to make things work the better, and that maybe some habits (e.g. dinning out on Saturdays) won’t be possible as much often as they used to.
• That they can make as many questions as they want, and all them will be answered. Now and later on.
• That it’s normal to cry or get angry, and that there will always be somebody beside them, to help them not feeling lonely.
• That there is nobody to blame on for cancer (even it sounds bizarre, children may think that as they didn’t behave, their mother/father’s cancer is a sort of punishment). And that cancer can’t be transmitted to other people.

It is also important not to make the recovery conditional to their behavior: sometimes I hear people saying “If you don’t behave, your Mum won’t heal of cancer”. Leaving apart that this is a lie, making a kid responsible for the recovery is too much for him/her. The fact that a kid is expected to behave has nothing to do with the disease. Another thing is that the kid should change his/her behavior to show his/her opposition to the diagnosis. With patience and normal education rules, it all tends to normalize after some time.

I finally recommend to talk to his/her teacher in school, to explain what happened. The kid may be more sad and show a lower performance, so it’s important to be aware of him/her, and help him/her if it’s necessary.

In summary: To tell him/her the true situation, with an understandable language, and to show availability to answer his/her questions and to be beside him or her.

Click this link to the American Cancer Society webpage to find extended information on how you can talk to children about cancer.

Joan Salvador Vilallonga (Psyco-oncologist)

PSYCHOLOGY AND HEALTH PLACE