Helping your child understand a cancer diagnosis

It can be tempting not to tell children about cancer. Of course you want to protect your child from fear. But all children with cancer need to know that they have cancer. Most children will sense something is wrong and may make up their own stories about what it is. Children have a tendency to blame themselves for bad things happening. Being honest tends to lessen a child's stress, guilt, and confusion.

Also medical terms like "cancer" will be used by health care providers and others. Children need to understand why they are visiting with doctors and having tests and medicines. It also may help children explain their symptoms and discuss feelings. It will help build trust in your family.

It is up to you when to tell your child about the cancer. Although it is tempting to put it off, you may find it is easiest to tell your child right away. It may become harder as time goes on. And it is best for your child to know and have time to ask questions before starting treatment.

If you are not sure when or how to bring it up, talk with your child's provider, such as a child life specialist. The health care team can help you give your child the news about a cancer diagnosis and what needs to be done about it.

Here are some things to keep in mind when talking about your child's cancer:

• Keep your child's age in mind. How much you share with your child depends on your child's age. For example, very young children may only need to know very basic information, while a teenager may want to know more details about treatments and side effects.
• Encourage your child to ask questions. Try to answer them as honestly and openly as you can. If you do not know the answer, it is OK to say so.
• Know your child may be afraid to ask some questions. Try to notice if your child has something on his mind but might be afraid to ask. For example, if your child seems upset after seeing other people who have lost their hair, talk about what symptoms he may have from treatment.
• Keep in mind that your child may have heard things about cancer from other sources, such as TV, the movies, or other kids. It is a good idea to ask what they have heard, so you can make sure they have the right information.
• Ask for help. Talking about cancer is not easy for anyone. If you need help with certain topics, ask your child's provider or cancer care team.

There are some common fears that many children have when they learn about cancer. Your child may be too scared to tell you about these fears, so it is a good idea to bring them up yourself.

• Your child caused the cancer. It is common for younger children to think that they caused the cancer by doing something bad. It is important to let your child know that nothing they did caused the cancer.
• Cancer is contagious. Many children think that cancer can spread from person to person. Make sure to let your child know that you cannot "catch" cancer from someone else.
• Everyone dies from cancer. You can explain that cancer is a serious illness, but millions of people survive cancer with modern treatments. If your child knows someone who has died of cancer, let them know that there are many kinds of cancer and everyone's cancer is different.

You may need to repeat these points many times during your child's treatment.

Here are some ways to help your child cope during cancer treatment:

• Try to stay on a normal schedule. Schedules are comforting to kids. Try to keep as normal a schedule as you can.
• Help your child stay in touch with classmates and friends. Some ways to do this include email, cards, texting, video games, and phone calls.
• Keep up with any missed class work. This can help keep your child connected to the school and lessen any anxiety about falling behind. It also lets kids know that they should be preparing for the future because they have a future.
• Find ways to add humor to your child's day. Watch a funny TV show or movie together, or buy your child some comic books.
• Visit with other children who have had cancer. Ask your provider to put you in touch with other families who have successfully coped with cancer.
• Let your child know it is OK to feel angry or sad. Help your child talk about these feelings with you or someone else.
• Make sure your child has some fun every day. For younger kids, this could mean coloring, watching a favorite TV show, or building with blocks. Older kids may prefer to talk to friends on the phone or play video games.

American Cancer Society website. Finding help and support when your child has cancer. www.cancer.org/content/cancer/en/treatment/children-and-cancer/when-your-child-has-cancer/during-treatment/help-and-support.html. Updated September 21, 2017. Accessed November 4, 2022.

American Cancer Society website. Helping your child adjust to a cancer diagnosis. www.cancer.org/cancer/survivorship/children-with-cancer/after-diagnosis/helping-your-child.html. Accessed June 14, 2024.

National Cancer Institute website. Children with cancer: A guide for parents. www.cancer.gov/publications/patient-education/children-with-cancer.pdf. Updated September 2015. Accessed November 4, 2022.

Updated by: Stergios Zacharoulis, MD, Associate Professor of Pediatric Oncology at Columbia University Irving Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.