A guide to help children understand cancer

Each child is different. Some children understand more than others. Your day-to-day approach will depend on your child's age and maturity. Here is a general guide.

CHILDREN AGES 0 to 2 YEARS

Children this age:

• Only understand things that they can sense by touch and sight
• Do not understand cancer
• Focus on what is happening in the moment
• Are afraid of medical tests and pain
• Are afraid of being away from their parents

How to talk to children ages 0 to 2 years:

• Talk to your child about what is happening in the moment or that day.
• Explain procedures and tests before you arrive. For example, let your child know that the needle will hurt for a bit, and it is OK to cry.
• Give your child choices, such as fun ways to take medicine, new books or videos during treatments, or mixing medicines with different juices.
• Let your child know you will always be by their side at the hospital.
• Explain how long they will be in the hospital and when they will be going home.

CHILDREN AGES 2 to 7 YEARS

Children this age:

• May understand cancer when you explain using simple words.
• Look for cause and effect. They may blame the illness on a specific event, such as not finishing dinner.
• Are afraid of being away from their parents.
• May be afraid that that they will have to live in the hospital.
• Are afraid of medical tests and pain.

How to talk to children ages 2 to 7 years:

• Use simple terms like "good cells" and "bad cells" to explain the cancer. You can say it is a contest between the two types of cells.
• Tell your child that they need treatment so that the hurting will go away and the good cells can get stronger.
• Make sure your child knows that nothing they did caused the cancer.
• Explain procedures and tests before you arrive. Let your child know what will happen, and it is OK to be scared or cry. Assure your child that health care providers have ways to make tests less painful.
• Make sure you or your child's health care team offers choices and rewards.
• Let your child know you will be by their side at the hospital and when they go home.

CHILDREN AGES 7 to 12 YEARS

Children this age:

• Understand cancer in a basic sense
• Think of their illness as symptoms and what they are not able to do compared to other kids
• Understand that getting better comes from taking medicines and doing what providers say
• Are not likely to blame their illness on something they did
• Are afraid of pain and being hurt
• Will hear information about cancer from outside sources like school, TV, and the Internet

How to talk to children ages 7 to 12 years:

• Explain cancer cells as "troublemaker" cells.
• Tell your child that the body has different types of cells that need to do different jobs in the body. The cancer cells get in the way of the good cells and treatments help to get rid of the cancer cells.
• Explain procedures and tests before you arrive and that it is OK to be nervous or sick of it.
• Ask your child to let you know about things they have heard about cancer from other sources or any worries they have. Make sure the information they have is accurate.

CHILDREN AGES 12 YEARS AND OLDER

Children this age:

• Can understand complex concepts
• Can imagine things that have not happened to them
• May have many questions about their illness
• Think of their illness as symptoms and what they miss or are not able to do compared to other kids
• Understand that getting better comes from taking medicines and doing what providers say
• May want to help make decisions
• May be more concerned about physical side effects such as hair loss or weight gain
• Will hear information about cancer from outside sources like school, TV, and the Internet

How to talk to children ages 12 years and older:

• Explain cancer as a disease when some cells go wild and grow too quickly.
• The cancer cells get in the way of how the body needs to work.
• Treatments will kill the cancer cells so the body can work well and symptoms will go away.
• Be honest about procedures, tests, and side effects.
• Talk openly with your teen about treatment options, concerns, and fears.
• For older children, there may be online programs that can help them learn about their cancer and ways to cope.

Other ways to talk to your child about cancer:

• Practice what you will say before you bring up new topics with your child.
• Ask your child's provider for advice on how to explain things.
• Have another family member or a provider with you when talking about cancer and the treatments.
• Check in with your child often about how your child is coping.
• Be honest.
• Share your feelings and ask your child to share their feelings.
• Explain medical terms in ways your child can understand.

While the road ahead may not be easy, remind your child that most children with cancer are cured.

American Society of Clinical Oncology (ASCO) website. How a child understands cancer. www.cancer.net/coping-with-cancer/talking-with-family-and-friends/how-child-understands-cancer. Updated September 2019. Accessed February 28, 2024.

National Cancer Institute website. Adolescents and young adults with cancer. www.cancer.gov/types/aya. Updated February 15, 2024. Accessed February 28, 2024. 

Updated by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.