How to tell your child that you have cancer

Cancer is a hard thing to keep secret. Even very young children can sense when something is not right. When children do not know the truth, they fear the worst. In the face of not knowing, your child may think up a story that could be far worse than what is really going on. For example, your child may blame herself that you are sick.

You also risk having your child learn from someone else that you have cancer. This may harm your child's sense of trust. And once you start cancer treatment, you may not be able to hide the side effects from your child.

Find a quiet time to talk with your child when there are no other distractions. If you have more than one child, you may want to tell each one separately. This will allow you to gauge each child's reaction, tailor the explanations to their age, and answer their questions in private. Your child may also be inhibited from asking questions that are important to them in the presence of a sibling.

When talking about your cancer, start with the facts. These include:

• The kind of cancer you have and its name.
• What part of your body has the cancer.
• How your cancer or treatment will affect your family and focus on how it will affect your kids. For example, tell them you may not be able to spend as much time with them as in the past.
• Whether a relative or other caregiver will be helping out.

When talking to your children about your treatment, it may help to explain:

• The types of treatment you may have, and that you may have surgery.
• About how long you will receive treatment (if known).
• That the treatment will help you get better, but may cause difficult side effects while you are having it.
• Be sure to prepare children ahead of time for any physical changes, such as hair loss, that you may experience. Explain that you may lose weight, lose your hair, or throw up a lot. Explain that these are side effects that will go away.

You can adjust the amount of detail you give based on your child's age. Children age 8 and younger may not understand complex words about your illness or treatment, so it is best to keep it simple. For example, you can tell them that you are sick and you need treatment to help you get better. Children ages 8 and older may understand a bit more. Encourage your child to ask questions and try to answer them as honestly as you can.

Keep in mind that your children may also hear about cancer from other sources, such as social media, websites, TV, movies, or other kids or adults. It is a good idea to ask what they have heard, so you can make sure they have the right information.

There are some common fears that many children have when they learn about cancer. Since your child may not tell you about these fears, it is a good idea to bring them up yourself.

• Your child is to blame. It is common for children, especially younger children, to think that something they did caused a parent's cancer. Let your child know that no one in your family did anything to cause the cancer.
• Cancer is contagious. Many children worry that cancer can spread like the flu, and other people in your family will catch it. Make sure to let your child know that you cannot "catch" cancer from someone else, and they will not get cancer by touching or kissing you.
• Everyone dies from cancer. You can explain that cancer is a serious illness, but modern treatments have helped millions of people survive cancer. 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. Just because Uncle Mike died of his cancer, it does not mean that you will too.

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

Here are some ways to help your children cope as you go through cancer treatment:

• Try to stay on a normal schedule. Schedules are comforting to kids. Try to keep the same mealtimes and bedtimes.
• Let them know you love and value them. This is especially important if your treatment is keeping you from spending as much time with them as you used to.
• Keep up their activities. It is important for your kids to continue with music lessons, sports, and other after-school activities during your illness. Ask friends or family members for help with rides.
• Encourage kids to spend time with friends and have fun. This is especially important for teens, who may feel guilty about having fun.
• Ask other adults to step in. Have your spouse, parents, or other family or friends spend extra time with your children when you cannot.

Many kids are able to cope with a parent's illness without any major problems. But some kids may need extra support. Let your child's health care provider know if your child has any of the following behaviors.

• Seems sad all the time
• Cannot be comforted
• Has a change in grades
• Is very angry or irritable
• Cries a lot
• Has trouble concentrating
• Has changes in appetite
• Has trouble sleeping
• Tries to hurt themselves
• Less interest in usual activities

These are signs that your child may need a little more help, such as talking with a counselor or other specialists.

American Cancer Society website. Explaining cancer to children of different ages. www.cancer.org/cancer/caregivers/helping-children-when-a-family-member-has-cancer/dealing-with-treatment/intro.html. Updated September 15, 2020. Accessed June 17, 2024.

American Cancer Society website. Telling a child someone they love has cancer. www.cancer.org/cancer/caregivers/helping-children-when-a-family-member-has-cancer/dealing-with-treatment/talking-to-kids.html. Updated September 15, 2022. Accessed May 15, 2024.

National Cancer Institute website. When your parent has cancer: a guide for teens. www.cancer.gov/publications/patient-education/When-Your-Parent-Has-Cancer.pdf. Updated February 2012. Accessed May 15, 2024.

Updated by: Paul Ballas, DO, Attending Psychiatrist, Friends Hospital, Philadelphia PA. 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.